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Total 148 results found since Jan 2013.

Abstract PD4-2: Cardiovascular toxicity following aromatase inhibitor use in 13,273 survivors cared for in a HMO
Discussion These results indicate that variation exists in the type of CVD events that occur in breast cancer patients receiving AIs in comparison to tamoxifen users. For example, the risk of ischemic disease or stroke was not elevated in those who used AIs only versus TAM users. However, overall CVD events were greater in women who used AIs only (or sequentially after TAM), especially if they received left-sided breast irradiation. While these observational study results require cautious interpretation, they provide a basis for comparing the benefits and risks of endocrine treatments. Citation Format: Reina Haque, Joanne ...
Source: Cancer Research - April 30, 2015 Category: Cancer & Oncology Authors: Haque, R., Schottinger, J. E., Shi, J., Chung, J., Avila, C., Amundsen, B., Chlebowski, R. T. Tags: Poster Discussion Abstracts Source Type: research

Standards of care issues with anticoagulation in real-world populations.
Authors: Abstract Current guidelines recommend anticoagulants for reducing the risk of stroke in appropriate patients with nonvalvular atrial fibrillation (NVAF) and for the acute treatment of venous thromboembolism (VTE) and the prevention of recurrent VTE. Warfarin is the standard of care for both NVAF and VTE, yet International Normalized Ratio (INR) control remains suboptimal, even in the clinical trial setting. Maintaining INR within the recommended therapeutic range is associated with better outcomes in these distinct populations. In VTE, high rates of recurrence have been reported during the first few week...
Source: The American Journal of Managed Care - January 1, 2015 Category: Health Management Tags: Am J Manag Care Source Type: research

Direct mail does not improve screening in sickle cell disease
Because children with sickle cell disease have an increased risk for stroke, annual transcranial Doppler (TCD) screening is recommended for children diagnosed with sickle cell disease from ages 2 to 16 years, yet implementation has been limited. Can letters mailed directly to parents and primary providers improve compliance? To investigate this, Bundy et al mailed reminders to families and primary doctors of eligible children in one Medicaid managed care organization, and compared results with 6 other Medicaid managed care organizations serving as controls.
Source: The Journal of Pediatrics - December 18, 2014 Category: Pediatrics Authors: Paul G. Fisher Tags: The Editors' Perspective Source Type: research

Research to real-world application: experts weigh in on the underuse of anticoagulants.
Abstract Although numerous studies have shown that anticoagulants can reduce the risk of stroke and thromboembolic events in patients with nonvalvular atrial fibrillation, they are underprescribed in the clinical setting. While standardized risk scoring assessments are recommended in treatment guidelines to determine when anticoagulant use may be appropriate, they are not widely used in the real-world clinical setting. Many factors contribute to anticoagulant underuse, including patient characteristics and comorbidities. Reluctance to prescribe an anticoagulant may also stem from concerns about bleeding or other p...
Source: The American Journal of Managed Care - December 1, 2014 Category: Health Management Authors: Berger J, Balfour Iii DC, Biskupiak JE, Dunn J, Liotta DB, Merli GJ, Pezalla EJ, Shaya FT, Villanueva T Tags: Am J Manag Care Source Type: research

Health care burden of dyspepsia among nonvalvular atrial fibrillation patients.
CONCLUSIONS: NVAF patients with dyspepsia experienced more all-cause hospitalizations and required more outpatient medical services, all associated with greater expenditures than NVAF patients without dyspepsia. Additionally, dyspepsia may be a barrier to warfarin use among NVAF patients. PMID: 24684644 [PubMed - in process]
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research

The underuse of carotid interventions in veterans with symptomatic carotid stenosis.
Conclusions Few patients with symptomatic carotid stenosis who were admitted with stroke to the VA received carotid intervention. Future research should be directed at improving access to this procedure among eligible patients in the VA. PMID: 25295544 [PubMed - in process]
Source: The American Journal of Managed Care - October 12, 2014 Category: Health Management Authors: Keyhani S, Cheng E, Ofner S, Williams L, Bravata D Tags: Am J Manag Care Source Type: research

Primary care diabetes bundle management: 3-year outcomes for microvascular and macrovascular events.
Conclusions A system of care with an all-or-none bundled measure used in primary care for patients with diabetes may reduce the risk of MI, stroke, and retinopathy over a 3-year period. PMID: 25180500 [PubMed - in process]
Source: The American Journal of Managed Care - September 6, 2014 Category: Health Management Authors: Bloom FJ, Yan X, Stewart WF, Graf TR, Anderer T, Davis DE, Pierdon SB, Pitcavage J, Steele GD Tags: Am J Manag Care Source Type: research

Positive predictive values of ICD-9 codes to identify patients with stroke or TIA.
Conclusions: Administrative ICD-9 codes 434.XX, 433.X1, and V12.54 had consistently high PPVs in identifying patients with a confirmed cerebral event. These codes could be used as part of a probabilistic approach to focus care activities on patients with the highest likelihood of a cerebral event. PMID: 24738552 [PubMed - in process]
Source: The American Journal of Managed Care - April 19, 2014 Category: Health Management Authors: Olson KL, Wood MD, Delate T, Lash LJ, Rasmussen J, Denham AM, Merenich JA Tags: Am J Manag Care Source Type: research

Mayo Clinic Researchers Show Telestroke is Cost-Saving
PHOENIX — Jan. 16, 2014 — Researchers have found that using telemedicine to deliver stroke care, also known as telestroke, appears to be cost-effective for society. The research was recently published in the American Journal of Managed Care. In telestroke care, the use of a telestroke robot allows a patient with stroke to be examined in real [...]
Source: Mayo Clinic Research News - January 16, 2014 Category: Research Source Type: news

Process of care compliance is associated with fewer diabetes complications.
Conclusions: Employees with diabetes who received all 3 quality measures experienced fewer complications, risk-adjusting for other factors. These results provide support for the importance of care quality. PMID: 24512164 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - January 1, 2014 Category: Health Management Authors: Bayer FJ, Galusha D, Slade M, Chu IM, Taiwo O, Cullen MR Tags: Am J Manag Care Source Type: research

Bleeding as an Outcome Among Patients With Nonvalvular Atrial Fibrillation in a Large Managed Care Population.
CONCLUSIONS: Bleeding incidence among patients with NVAF in a real-world setting was high and increased with greater stroke and bleeding risk scores. Health care costs for patients with major bleeding events were elevated. All rights reserved. PMID: 24075151 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - September 25, 2013 Category: Drugs & Pharmacology Authors: Deitelzweig SB, Pinsky B, Buysman E, Lacey M, Makenbaeva D, Wiederkehr D, Graham J Tags: Clin Ther Source Type: research

Care of the TIA patient
I read with interest Al-Khaled et al. study on the prognostic impact of the stroke unit (SU) concept in patients presenting after a transient ischemic attack (TIA). They found no significant impact of SU care as compared to conventional care (CU) in TIA patients. Their study raises some interesting observations. The conventional teaching is that patients with TIA warrant emergent evaluation to identify and modify their stroke risk factors. This involves timely evaluation of the patients by a neurologist with expertise in stroke neurology followed by necessary neuroimaging, vascular, hematological and coagulation studies. T...
Source: Clinical Neurology and Neurosurgery - August 29, 2013 Category: Neurosurgery Authors: Nitin K. Sethi Tags: Letters to editor Source Type: research

Warfarin Use and Stroke Risk Among Patients With Nonvalvular Atrial Fibrillation in a Large Managed Care Population.
CONCLUSIONS: More than half of patients on warfarin had treatment gaps or discontinued therapy. Therapy gaps were associated with increased stroke risk. PMID: 23867114 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - July 15, 2013 Category: Drugs & Pharmacology Authors: Deitelzweig SB, Buysman E, Pinsky B, Lacey M, Jing Y, Wiederkehr D, Graham J Tags: Clin Ther Source Type: research