Improving drug adherence will take more than money and technology
I recently asked, “Who’s to blame?” for patients not taking their medications and cited a couple of papers describing the poor state of medication adherence. I concluded nonadherence was a huge problem, and doctors failing to educate their patients was not a major cause.
To support my contention that physicians are not the reason why patients do not take their medications as ordered I submit the following new information.
A randomized clinical trial published online in JAMA Internal Medicine looked at patients who had been discharged after myocardial infarction and prescribed drugs known to decrease the incidenc...
Source: Kevin, M.D. - Medical Weblog - September 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/skeptical-scalpel" rel="tag" > Skeptical Scalpel, MD < /a > Tags: Meds Cardiology Medications Primary Care Source Type: blogs
Co-production of care: A different kind of health care than we ’re used to
More than anything, Willie needed a place to pee.
Elaine needed help walking.
Willie is homeless; Elaine is affluent. They both needed someone to listen to them and help them find solutions to their most pressing everyday challenges. That’s called “co-production of care.”
When Willie found out he had congestive heart failure, his doctor put him on beta blockers with diuretics.
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 7, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/sylvester-jones-and-laura-c-leviton" rel="tag" > Sylvester Jones and Laura C. Leviton, PhD < /a > Tags: Policy Cardiology Primary Care Public Health & Source Type: blogs
7 ways to combat compassion fatigue
This is the patient’s eight admission over the course of two weeks. The patient is a heroin abuser and has bacteremia and endocarditis. Their heart valve is failing and they are in and out of congestive heart failure. Every day, dozens of medical professionals converge on the patient to give treatment and advice. And every day after hearing that advice, the patient leaves the hospital against medical advice and goes to use IV drugs. They wind up back in the hospital out of fear or panic, or they are brought back in after overdosing by the police. The cycle continues.
In this common daily scenario, it is very easy as ...
Source: Kevin, M.D. - Medical Weblog - August 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jenny-hartsock" rel="tag" > Jenny Hartsock, MD < /a > Tags: Physician Cardiology Hospital-Based Medicine Infectious Disease Primary Care Source Type: blogs
Incentive-Based Systems to Improve Patient Compliance: Interview with Matt Loper, CEO of Wellth
Wellth, a digital health company based in New York, has developed a system that provides patients with daily financial incentives to improve their compliance with drug regimens. Low patient compliance results in significant issues in terms of patient health and increased financial costs. The company is particularly interested in targeting type 2 diabetes, congestive heart failure, post heart attack recovery, COPD, and asthma.
The Wellth system is geared towards high-risk, high-cost patients, and works by providing patients with daily incentives and reminders to take their medication. The patient sends a photo of their medi...
Source: Medgadget - August 14, 2017 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Geriatrics Medicine Public Health Source Type: blogs
5 ways to make dealing with death easier
My husband, the anesthesiologist, came home one evening, he was solemn, affected, not himself. His patient died in the recovery room. It was sudden and unexpected for my husband. Despite the team’s swift efforts and perfectly executed code, the patient died anyway. It’s relevant to note that his patient was an almost 90-year-old man with significant congestive heart failure, probably chronic kidney disease, and complete occlusion of one of his carotids who sustained hip fracture and thus required the surgery to pin his hip for both healing and comfort. This is the ultimate catch-22 in medicine (or at least in geriatric...
Source: Kevin, M.D. - Medical Weblog - July 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/shannon-tapia" rel="tag" > Shannon Tapia, MD < /a > Tags: Physician Geriatrics Palliative care Source Type: blogs
Finding Common Ground On Medicaid Reform For Dual Eligibles
Editor’s Note: This is the final post in a five-part Health Affairs Blog series, produced in conjunction with the Bipartisan Policy Center, examining current issues and care models in the delivery system reform effort. Each post is jointly authored by Democratic and Republican leaders in health policy. Read all of the posts here.
Medicaid is the primary source of health insurance for families and children that meet the income and program eligibility requirements. It is also the largest single source of financing for long-term services and supports (LTSS), which help individuals who need it engage in the activities of dai...
Source: Health Affairs Blog - June 15, 2017 Category: Health Management Authors: Cindy Mann and Avik Roy Tags: Featured Medicaid and CHIP Medicare Payment Policy Quality bipartisan delivery system reform dual eligibles Source Type: blogs
Parable Technology for Wound Care: Interview with Nathan Ie, Founder of Parable Health
Parable is a software platform that allows doctors and home health workers to collaboratively monitor wound healing and to flag any issues. The technology has been designed by Parable Health and allows doctors to assess wound parameters and healing progress from “smart” photos taken using a phone’s camera. The doctor can schedule virtual check-ins with the patient. The idea is that this will reduce transportation costs in bringing patients to and from health care facilities for regular checkups, streamline data collection, and allow for collaborative care between various healthcare professionals. The tech...
Source: Medgadget - May 30, 2017 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Medicine Plastic Surgery Vascular Surgery Source Type: blogs
MD vs. DNP: Why 20,000 Hours of Training and Experience Matters
By NIRAN AL-AGBA, MD
As southern states entertain legislation granting nurse practitioners independent practice rights, there are some finer details which deserve careful deliberation. While nurse practitioners are intelligent, capable, and contribute much to our healthcare system, they are not physicians and lack the same training and knowledge base. They should not identify themselves as “doctors” despite having a Doctor of Nursing Practice (DNP) degree. It is misleading to patients, as most do not realize the difference in education necessary for an MD or DO compared to a DNP. Furthermore, until they are required to...
Source: The Health Care Blog - May 29, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Cedars-Sinai Partners with Noteworth to Integrate Patient-Generated Data into the EHR
There was a time when input for the paper medical chart was restricted to healthcare professionals such as physicians and nurses. The contemporary EHR is now in the process of being"opened up" in the sense that patients have access to it for review through patient portals (see:What is a patient portal?) and patient-generated data is being integrated into it (see:Cedars-Sinai Partners With Noteworth to Integrate Patient-Generated Data With Epic EMR). Below is an excerpt from this latter article:Cedars-Sinai has signed a three-year deal withNoteworth, a healthcare data software as a service (SaaS)...
Source: Lab Soft News - May 24, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Food and Drug Administration Healthcare Delivery Medical Consumerism Medical Education Pharmaceutical Industry Quality of Care Source Type: blogs
A Consumer-Centered Framework For Quality: How Do We Get There From Here?
When buying a car, consumers are able to readily review some critical pieces of information, such as the price of the car; the mileage per gallon; what other owners thought of that model’s reliability; and how the car handles on various road tests.
When it comes to health care, however, consumers aren’t able to easily obtain the few, key summative, consumer-facing measures that could help them understand the quality of their care.
This isn’t because we don’t have quality measures in health care. To the contrary — there are in fact hundreds of measures. But these measures tend to be narrow in their scope (for ...
Source: Health Affairs Blog - May 18, 2017 Category: Health Management Authors: Ann Hwang Tags: Costs and Spending Quality quality measurements Source Type: blogs
Fight Aging! Newsletter, May 8th 2017
This report captures the state of the research community in a nutshell: progress in the sense that ever more scientists are willing to make the treatment of aging the explicit goal of their research, but, unfortunately, there is still a long way to go in improving the nature of that research. It is still near entirely made up of projects that cannot possibly produce a robust and large impact on human life span. The only course of action likely to extend life by decades in the near future is implementation of the SENS vision for rejuvenation therapies - to repair the molecular damage that causes aging. Everything else on th...
Source: Fight Aging! - May 7, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Heart Disease Risk Factors in Middle Age Predict Remaining Life Expectancy
Researchers have processed data from a long-running study to show that the presence or absence of heart disease risk factors in middle age predicts remaining life expectancy. Those with no risk factors live a somewhat longer, on average. It is interesting to note that only a small portion of the population are free from all risk factors at this stage in life, and that is largely the result of poor lifestyle choices leading to excess fat tissue and vascular decline. In an age of rapid progress in biotechnology, with effective treatments for the causes of aging on the horizon, it makes sense to avoid sabotaging your own heal...
Source: Fight Aging! - May 3, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Altered Lipid Metabolism Improves Healing and Reduces Inflammation
Researchers here demonstrate that tinkering with the normal operation of lipid metabolism in mice can improve healing and reduce inflammation following a heart attack, suggesting that the approach may have broader applications in cardiovascular disease.
Two immune responses are important for recovery after a heart attack - an acute inflammatory response that attracts leukocyte immune cells to remove dead tissue, followed by a resolving response that allows healing. Failure of the resolving response can allow a persistent, low-grade nonresolving inflammation, which can lead to progressive acute or chronic heart fai...
Source: Fight Aging! - May 2, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Beta-blockers, Statins, AF, and the Nocebo Effect
Our brains can easily fool us.
No experienced doctor would deny the power of the placebo effect.
Today I want to discuss the nocebo effect, which occurs when negative expectations of something causes it to have a more negative effect than it otherwise would.
Drugs can exert a strong nocebo effect. If your brain thinks you will have a side effect, you may actually get that effect.
Nocebo brain trickery is relevant to statins. That’s why I used this wording in my last post: (Note the italics)
The actual frequency of muscle symptoms is hotly debated. Randomized controlled trials (in which patients don’t know whether t...
Source: Dr John M - May 2, 2017 Category: Cardiology Authors: Dr John Source Type: blogs
Telemedicine Used in New Healthcare Settings Like Coaching
I continue to believe that telemedicine will be one of the key elements enabling hospitals to provide services to more consumers at a lower cost. Telemedicine was initially limited to simple, easily diagnosed conditions but is now expanding into areas like chronic care (see: Treatment of Patients with Chronic Diseases: Important for the Future of Telemedicine. Early adopters of telemedicine such as Kaiser Health (see:Kaiser CEO: Telehealth Outpaced In-Person Visits Last Year) and theCleveland Clinic are now testing new types of care delivery...
Source: Lab Soft News - April 21, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Delivery Healthcare Information Technology Medical Consumerism Preventive Medicine Quality of Care Telemedicine Source Type: blogs
