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Total 148 results found since Jan 2013.

Introduction to basal insulin therapy: clinical management of diabetes.
Abstract Diabetes is a series of metabolic conditions associated with many serious comorbidities, such as heart disease and stroke, peripheral arterial disease and lower-extremity amputations, retinopathy, nephropathy, and peripheral neuropathy. The American Diabetes Association, the American Association of Clinical Endocrinologists, and the International Diabetes Federation recommend that individuals with diabetes be as near to normoglycemic as possible. There are many glycemic management barriers among patients, such as cost, patient perceptions, and clinical inertia. Advancements in the treatment of diabetes wi...
Source: The American Journal of Managed Care - March 1, 2018 Category: Health Management Authors: Gonzalvo JD Tags: Am J Manag Care Source Type: research

Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.
Abstract Pseudobulbar affect (PBA), despite its prevalence and distinctive symptoms, is widely underrecognized and undertreated. It is characterized by uncontrollable laughing or crying that can occur in an exaggerated manner or inappropriately to a given situation or stimuli. PBA is thought to center around preexisting neurological conditions, which include Parkinson disease, multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer disease, traumatic brain injury, and stroke. The PBA Registry Series trial was created to measure the prevalence of PBA among patients with these underlying neurological conditions...
Source: The American Journal of Managed Care - December 1, 2017 Category: Health Management Authors: Demler TL Tags: Am J Manag Care Source Type: research

Under Affordable Care Act, Americans have had more preventive care for heart health, UCLA study finds
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health,a UCLA study found. Comparing figures from 2006 through 2013, researchers found that more people were screened for diabetes, high cholesterol, cigarette use and high blood pressure — all risk factors for heart disease — after the ACA was implemented than before.But the research, published in the peer-reviewed American Journal of Managed Care, also revealed a disparity between men and women in one key area. Although more men who are at r...
Source: UCLA Newsroom: Health Sciences - November 23, 2017 Category: Universities & Medical Training Source Type: news

Is higher patient satisfaction associated with better stroke outcomes?
CONCLUSIONS: Global patient satisfaction was positively associated with the quality of stroke care; however, improvements in patient satisfaction were linked to higher stroke care costs. In addition, patient satisfaction with discharge information was linked to worse outcomes. As a result, patient satisfaction should be used with caution as a quality indicator for stroke care. PMID: 29087636 [PubMed - in process]
Source: The American Journal of Managed Care - October 1, 2017 Category: Health Management Authors: Xiang X, Xu WY, Foraker RE Tags: Am J Manag Care Source Type: research

An integrated epidemiological and neural net model of the warfarin effect in managed care patients.
CONCLUSION: Enrichment methodology improves the statistical discrimination of meaningful endpoints when used in a health records-based analysis. PMID: 28572740 [PubMed - in process]
Source: Clinical Pharmacology: Advances and Applications - June 4, 2017 Category: Allergy & Immunology Tags: Clin Pharmacol Source Type: research

Exploring indications for the Use of direct oral anticoagulants and the associated risks of major bleeding.
Abstract Thrombosis is a leading cause of morbidity and mortality in the United States. Arterial and venous thromboses are implicated in the pathogenesis of major disorders, including myocardial infarction, ischemic stroke, and venous thromboembolism. Over the past decade, direct oral anticoagulants (DOACs) (eg, direct thrombin inhibitor and factor Xa [FXa] inhibitors) have been adopted as alternatives to warfarin due to their clinical advantages and efficacy for the treatment of thrombosis. As with all anticoagulants, treatment with DOACs is associated with a risk of major bleeding, including life-threatening gas...
Source: The American Journal of Managed Care - April 1, 2017 Category: Health Management Authors: Milling TJ, Frontera J Tags: Am J Manag Care Source Type: research

Less Intense Postacute Care, Better Outcomes For Enrollees In Medicare Advantage Than Those In Fee-For-Service Postacute Care
Traditional fee-for-service (FFS) Medicare’s prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure. After accounting for differences in patient char...
Source: Health Affairs - January 8, 2017 Category: Global & Universal Authors: Huckfeldt, P. J., Escarce, J. J., Rabideau, B., Karaca-Mandic, P., Sood, N. Tags: Managed Care - Medicare, Medicare, Quality Of Care Postacute Care Source Type: research

Red Blood Cell Distribution Width Is an Independent Predictor of Outcome in Patients Undergoing Thrombolysis for Ischemic Stroke
Semin Thromb Hemost DOI: 10.1055/s-0036-1592165An appropriate and timely management, including early diagnosis and accurate prognostication, is the mainstay for managed care of patients with acute ischemic stroke. Since red blood cell distribution width (RDW) was found to be an independent predictor of clinical outcomes in patients with thrombotic disorders, we designed a retrospective observational study to investigate whether the RDW value may also retain predictive significance in stoke patients undergoing thrombolytic therapy. This retrospective study was based on all patients admitted to the Emergency Department (ED) ...
Source: Seminars in Thrombosis and Hemostasis - November 2, 2016 Category: Hematology Authors: Turcato, Gianni Cappellari, Manuel Follador, Luca Dilda, Alice Bonora, Antonio Zannoni, Massimo Bovo, Chiara Ricci, Giorgio Bovi, Paolo Lippi, Giuseppe Tags: Review Article Source Type: research

A cost-effectiveness analysis of over-the-counter statins.
CONCLUSIONS: With proper labeling and consumer education, it is highly likely that OTC statins would be cost-effective, as they significantly improve population health without large increases in healthcare costs. PMID: 27266585 [PubMed - in process]
Source: The American Journal of Managed Care - June 10, 2016 Category: Health Management Authors: Stomberg C, Albaugh M, Shiffman S, Sood N Tags: Am J Manag Care Source Type: research

Potential of risk-based population guidelines to reduce cardiovascular risk in a large integrated health system.
CONCLUSIONS: The risk calculator provided risk estimates in most patients and demonstrated fairly good discrimination and predictiveness. The risk-based decision tool identified high-risk patients for treatment not identified by traditional guidelines, as well as low-risk patients for whom treatment may be unnecessary. PMID: 27266582 [PubMed - in process]
Source: The American Journal of Managed Care - June 10, 2016 Category: Health Management Authors: Inzhakova G, Zhou H, Morris M, Early MI, Xiang AH, Jacobsen SJ, Derose SF Tags: Am J Manag Care Source Type: research

Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study Epidemiology
Conclusion The magnitude of subsequent CVD risk varies according to cancer subtype and by the presence of CVRFs. Overall survival in survivors who develop CVD is poor, emphasizing the need for targeted prevention strategies for individuals at highest risk of developing CVD.
Source: Journal of Clinical Oncology - March 22, 2016 Category: Cancer & Oncology Authors: Armenian, Xu, Ky, Sun, Farol, Pal, Douglas, Bhatia, Chao Tags: Population and observational studies (SEER, WHI observational, etc.) Epidemiology Source Type: research

Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study.
CONCLUSION: The magnitude of subsequent CVD risk varies according to cancer subtype and by the presence of CVRFs. Overall survival in survivors who develop CVD is poor, emphasizing the need for targeted prevention strategies for individuals at highest risk of developing CVD. PMID: 26834065 [PubMed - as supplied by publisher]
Source: Clinical Prostate Cancer - February 1, 2016 Category: Cancer & Oncology Authors: Armenian SH, Xu L, Ky B, Sun C, Farol LT, Pal SK, Douglas PS, Bhatia S, Chao C Tags: J Clin Oncol Source Type: research

Oral anticoagulant discontinuation in patients with nonvalvular atrial fibrillation.
CONCLUSIONS: The risk of independent discontinuation of OAC treatment among NVAF patients was high. Patients on DOACs compared with warfarin and those with several comorbid conditions had significantly lower risk of discontinuation, while those with prior bleeding were more likely to discontinue. PMID: 26799200 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - January 23, 2016 Category: Health Management Authors: Kachroo S, Hamilton M, Liu X, Pan X, Brixner D, Marrouche N, Biskupiak J Tags: Am J Manag Care Source Type: research

Does distance modify the effect of self-testing in oral anticoagulation?
CONCLUSIONS: The benefits of PST were not enhanced among patients living farther from care. Restricting PST to patients living more than a certain distance from the ACC is not likely to improve its cost-effectiveness. PMID: 26799126 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - January 1, 2016 Category: Health Management Authors: Rose AJ, Phibbs CS, Uyeda L, Su P, Edson R, Shih MC, Jacobson A, Matchar DB Tags: Am J Manag Care Source Type: research

Do statins interfere with the flu vaccine?
Statins are powerful, unusual, and, like El Niño and Tom Cruise, not well understood. Statins have a huge upside. They improve survival after heart attacks and lower the risk of recurrent strokes. They are also the only cholesterol-lowering medications that have been clearly shown to reduce heart attacks and deaths in high-risk patients without heart disease. In addition to reducing cholesterol, statins also lower levels of inflammation in the body. Reducing inflammation probably helps statins to prevent heart attack and stroke. However, evidence is emerging that these statin effects may also have a downside, hindering th...
Source: New Harvard Health Information - November 30, 2015 Category: Consumer Health News Authors: John Ross, MD, FIDSA Tags: Cold and Flu Drugs and Supplements Health Heart Health Vaccines flu vaccine statins Source Type: news