The American journal of managed care
-
Parkinson disease, the second-most-common neurodegenerative disorder, affects approximately 1 million individuals in the United States, and this number is projected to increase to 1.2 million by 2030. Characterized pathologically by degeneration of dopaminergic neurons, with widespread pathology in nondopaminergic systems, Parkinson disease leads to an array of motor and nonmotor symptoms that can significantly impact an affected individual's quality of life. ⋯ OFF periods can occur for many individuals with Parkinson disease, especially as the disease progresses, and can pose a substantial burden to those with the disease and their caregivers. Available treatments for OFF periods may help alleviate this burden.
-
The relatively few examples of commercially funded condition-specific bundled payments provide insights into how to spread this alternative payment model further in the private insurance market.
-
Hepatocellular carcinoma (HCC) is the fastest rising cause of cancer-related deaths in the United States, increasing by 2% to 3% annually, with a dismal 5-year survival rate of 18%. The Barcelona Clinic Liver Cancer criteria used to guide treatment considers performance status and assessment of liver function by Child-Pugh score in addition to tumor size and location. Curative therapies for HCC include surgical resection, liver transplantation, and tumor ablation. ⋯ Patients with advanced HCC are at a high risk of adverse effects because of baseline hepatic dysfunction, comorbidities associated with chronic liver disease, and potential drug-drug interactions. Improved tolerance of therapies for advanced HCC may lead to reduction in treatment discontinuation and contribute to better patient outcomes. Managed care pharmacists should understand the recent efficacy and safety data, guideline recommendations, and treatment algorithms for management of HCC.
-
Surgical patients often leave the hospital with many questions and concerns after their surgery and will contact their providers to get answers. The growth of patient-provider communication (PPC) technologies allows for many new opportunities to study postoperative patient-initiated communication. We aimed to characterize a growing body of literature on postoperative patient-initiated communication. ⋯ As health systems adopt new technologies for PPC, understanding how and why patients initiate contact with providers postoperatively can inform efforts to strengthen PPC broadly. Moreover, research on sociodemographic variation in communication patterns after surgery can help address communication gaps that patient groups may experience. Future research can build upon this work to improve patient outcomes and increase clinic efficiency.
-
To measure the impact of patient-centered communication on mortality and hospitalization among patients with heart failure (HF). ⋯ Among community patients living with HF, excellent and good patient-centered communication is associated with a reduced risk of death. Patient-centered communication can be easily assessed, and consideration should be given toward implementation in clinical practice.