226 results match your criteria physicians intensify

Intensified and Standardized Digital Communication with Cystectomy Patients as a Potentially Simple and Effective Modality for Early Detection of Postoperative Complications: Results from a Pilot Study.

Eur Urol Open Sci 2020 Dec 24;22:3-8. Epub 2020 Oct 24.

Urologie St. Anna, Luzern, Switzerland.

Background: Postoperative readmission rates following radical cystectomy remain significant. Early identification of emerging complications could potentially allow for immediate institution of therapy.

Objective: To intensify postoperative patient-physician communication via a cellphone-based health care application (CHA) and to evaluate its potential for early detection of complications. Read More

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December 2020

Incentives for physician teams: Effectiveness of performance feedback and payment distribution methods.

Health Policy 2021 Jul 24. Epub 2021 Jul 24.

National Health Insurance Administration, Ministry of Health and Welfare, No.140, Sec.3, Hsinyi Rd., Taipei 106, Taiwan.

Best practices in team-based incentive design remain underexplored. This study examines under group-based pay-for-performance, how managers incentivize physicians for teamwork through internal feedback and payment distribution methods. In collaboration with Taiwan Association of Family Medicine, authors conducted a national survey of physician groups, with a response rate of 48. Read More

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Psychosocial factors associated with conflicts among health professionals in the operating room in a Greek sample.

J Nurs Manag 2021 Jul 26. Epub 2021 Jul 26.

University General Hospital of Ioannina, Ioannina, Greece.

Aim: The purpose of this study is to investigate conflicts and identify the factors that cause the creation of conflicts in the operating room as well as coping strategies for conflict resolution.

Background: The operating room is a special and changeable working environment, which is constantly evolving, and requires interdisciplinary team collaboration. Therefore, it is an environment that may cause conflict among employees. Read More

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Prediction of blood lactate values in critically ill patients: a retrospective multi-center cohort study.

J Clin Monit Comput 2021 Jul 5. Epub 2021 Jul 5.

Laboratory for Computational Physiology, Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.

Elevations in initially obtained serum lactate levels are strong predictors of mortality in critically ill patients. Identifying patients whose serum lactate levels are more likely to increase can alert physicians to intensify care and guide them in the frequency of tending the blood test. We investigate whether machine learning models can predict subsequent serum lactate changes. Read More

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Cost-Effectiveness of Hypertension Treatment by Pharmacists in Black Barbershops.

Circulation 2021 Jun 15;143(24):2384-2394. Epub 2021 Apr 15.

Columbia University, Vagelos College of Physicians and Surgeons, New York, NY (K.B.B., A.E.M., Y.Z., L.P.C., B.K.B.).

Background: In LABBPS (Los Angeles Barbershop Blood Pressure Study), pharmacist-led hypertension care in Los Angeles County Black-owned barbershops significantly improved blood pressure control in non-Hispanic Black men with uncontrolled hypertension at baseline. In this analysis, 10-year health outcomes and health care costs of 1 year of the LABBPS intervention versus control are projected.

Methods: A discrete event simulation of hypertension care processes projected blood pressure, medication-related adverse events, fatal and nonfatal cardiovascular disease events, and noncardiovascular disease death in LABBPS participants. Read More

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Current perceptions and practices in lipid management: results of a European Society of Cardiology/European Atherosclerosis Society Survey.

Eur J Prev Cardiol 2021 Jan 18. Epub 2021 Jan 18.

Department of Cardiology, Geneva University Hospital, Geneva, Switzerland.

Aims: We sought to evaluate physicians' opinions and practices in lipid management.

Methods And Results: A web-based survey by the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) was distributed to 70 696 individuals at two time points, before and after publication of the 2019 ESC/EAS dyslipidaemia guidelines. Respondents (1271 in the first and 1056 in the second part) were most commonly cardiologists in Europe. Read More

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January 2021

Cost-Effectiveness of the New 2018 American College of Physicians Glycemic Control Guidance Statements Among US Adults With Type 2 Diabetes.

Value Health 2021 02 6;24(2):227-235. Epub 2020 Nov 6.

Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Objectives: This study aims to estimate the national impact and cost-effectiveness of the 2018 American College of Physicians (ACP) guidance statements compared to the status quo.

Methods: Survey data from the 2011-2016 National Health and Nutrition Examination were used to generate a national representative sample of individuals with diagnosed type 2 diabetes in the United States. Individuals with A1c <6. Read More

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February 2021

Accuracy of Psychiatrists' Assessment of Medication Adherence in an Outpatient Setting.

Cureus 2020 Dec 2;12(12):e11847. Epub 2020 Dec 2.

Psychiatry, Lehigh Valley Health Network, Allentown, USA.

Background:  Many patients have uncontrolled psychiatric symptoms because they are not taking their medication as prescribed. Psychiatrists may have difficulty accurately assessing medication adherence, which is important because it helps guide them in how they prescribe. If nonadherence is the cause of uncontrolled symptoms, then strategies to improve adherence are advised. Read More

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December 2020

Outcomes and prognosis of diabetic foot ulcers treated by an interdisciplinary team in Canada.

Int Wound J 2021 Apr 25;18(2):134-146. Epub 2020 Nov 25.

Centre de recherche du CISSS de Chaudière-Appalaches, Lévis, Québec, Canada.

The aim of this study was to determine the wound healing outcomes of patients with a plantar diabetic foot ulcer (DFU) treated with an interdisciplinary team approach, and to identify associated variables. A retrospective observational cohort study of 140 adult patients, with a plantar DFU, treated between 2012 and 2018 at a wound care clinic of a University affiliated hospital was conducted. Predictive and explicative analyses were conducted with logistic multivariate methods and with a Receiver Operating Characteristics curve. Read More

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Association Between Pain, Blood Pressure, and Medication Intensification in Primary Care: an Observational Study.

J Gen Intern Med 2020 12 21;35(12):3549-3555. Epub 2020 Sep 21.

Center for Value-Based Care Research, Cleveland Clinic Community Care, Cleveland Clinic, 9500 Euclid Avenue, G10, Cleveland, OH, 44195, USA.

Background: Treating hypertension is important but physicians often do not intensify blood pressure (BP) treatment in the setting of pain.

Objective: To identify whether reporting pain is associated with (1) elevated BP at the same visit, (2) medication intensification, and (3) elevated BP at the subsequent visit.

Design: Retrospective cohort SETTING: Integrated health system PARTICIPANTS: Adults seen in primary care EXPOSURE: Pain status based on numerical scale: mild (1-3), moderate (4-6), or severe (≥ 7). Read More

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December 2020

Climate Change and the Practice of Medicine: Essentials for Resident Education.

Acad Med 2021 03;96(3):355-367

A. Bernstein is assistant professor of pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts; ORCID: http://orcid.org/0000-0003-1703-1041.

Despite calls for including content on climate change and its effect on health in curricula across the spectrum of medical education, no widely used resource exists to guide residency training programs in this effort. This lack of resources poses challenges for training program leaders seeking to incorporate evidence-based climate and health content into their curricula. Climate change increases risks of heat-related illness, infections, asthma, mental health disorders, poor perinatal outcomes, adverse experiences from trauma and displacement, and other harms. Read More

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An Electronically delivered, Patient-activation tool for Intensification of medications for Chronic Heart Failure with reduced ejection fraction: Rationale and design of the EPIC-HF trial.

Am Heart J 2020 11 28;229:144-155. Epub 2020 Aug 28.

University of Colorado School of Medicine, Aurora, CO. Electronic address:

Background: Heart failure with reduced ejection fraction (HFrEF) benefits from initiation and intensification of multiple pharmacotherapies. Unfortunately, there are major gaps in the routine use of these drugs. Without novel approaches to improve prescribing, the cumulative benefits of HFrEF treatment will be largely unrealized. Read More

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November 2020

Knowledge, Attitudes and Expectations of Physicians with Respect to Palliative Care in Ecuador: A Qualitative Study.

Int J Environ Res Public Health 2020 05 31;17(11). Epub 2020 May 31.

Pharmacology and Physical Medicine Department. University of La Laguna, 38200 San Cristóbal de La Laguna, Spain.

The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Read More

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Sexually transmitted infection and HIV/AIDS counseling practice in primary health care in the city of Montes Claros, Minas Gerais, Brazil, 2015-2016.

Epidemiol Serv Saude 2020 17;29(1):e2018478. Epub 2020 Apr 17.

Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil.

Objective: to investigate self-reported counseling practice of primary health care (PHC) professionals on sexually transmitted infections (STI) and HIV/AIDS in Montes Claros, MG, Brazil, 2015-2016.

Methods: this was a cross-sectional study using a questionnaire answered by PHC physicians and nurses; their practice was classified as being adequate/inadequate based on the recommendations of Ministry of Health manuals; four thematic areas were investigated - counseling provision; prevention measures; risk behavior and vulnerability assessment; serological testing.

Results: 146 professionals participated (41. Read More

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When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak.

Psychiatry Res 2020 06 13;288:112972. Epub 2020 Apr 13.

School of Medicine of Juazeiro do Norte (FMJ/Estácio) - Juazeiro do Norte, Ceará, Brazil; School of Medicine, Federal University of Cariri (UFCA) - Barbalha, Ceará, Brazil.

Background: The fact that COVID-19 is transmissible from human to human and associated with high morbidity and potentially fatality can intensify the perception of personal danger. In addition, the foreseeable shortage of supplies and an increasing flow of suspected and real cases of COVID-19 contribute to the pressures and concerns of health professionals.

Method: The studies were identified in well-known international journals found in two electronic databases: Scopus and Embase. Read More

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A Cross-Sectional Study of Overtreatment and Deintensification of Antidiabetic and Antihypertensive Medications in Diabetes Mellitus: The TEMD Overtreatment Study.

Diabetes Ther 2020 05 22;11(5):1045-1059. Epub 2020 Feb 22.

Department of Endocrinology and Metabolism, School of Medicine, Erciyes University, Kayseri, Turkey.

Introduction: Targeting better glycated hemoglobin (HbA1c) and blood pressure (BP) goals may endanger older adults with type 2 diabetes mellitus (T2DM). Overtreatment of T2DM and hypertension is a trending issue, although undertreatment is still common. We investigated the rates and predictors of overtreatment and undertreatment of glycemia and BP in older adults with T2DM and physicians' attitudes to deintensify or intensify treatment. Read More

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Effect of Elevated Calcium Score on Normal Myocardial Perfusion Study on Clinician Management of Coronary Artery Disease Risk Factors.

Crit Pathw Cardiol 2020 06;19(2):58-61

From the Malcom Randall VAMC, Gainesville, FL.

Elevated coronary artery calcification (CAC) scores are associated with higher cardiovascular (CV) risk even with normal stress myocardial perfusion imaging (MPI). Whether referring providers appropriately manage subclinical CV disease is unclear. We hypothesized that ordering clinicians would intensify medical therapy for CV disease in response to normal MPI and CAC ≥ 300. Read More

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Home Blood Pressure Monitoring in Cases of Clinical Uncertainty to Differentiate Appropriate Inaction From Therapeutic Inertia.

Ann Fam Med 2020 01;18(1):50-58

Department of Family and Community Medicine, University of Missouri, Columbia, Missouri.

Purpose: Conventional clinic blood pressure (BP) measurements are routinely used for hypertension management and physician performance measures. We aimed to check home BP measurements after elevated conventional clinic BP measurements for which physicians did not intensify treatment, to differentiate therapeutic inertia from appropriate inaction.

Methods: We conducted a pre and post study of home BP monitoring for patients with uncontrolled hypertension as determined by conventional clinic BP measurements for which physicians did not intensify hypertension management. Read More

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January 2020

Increased detection of enterovirus A71 infections, Germany, 2019.

Euro Surveill 2019 Sep;24(39)

The members of the network are listed at the end of the article.

We report on the increased circulation of enterovirus A71 in Germany in 2019. Strains were mainly identified in hospitalised patients with suspected aseptic meningitis/encephalitis. Molecular analysis showed co-circulation of EV-A71 sub-genogroups C1 and C4, a signal for physicians and public health authorities to include/intensify EV diagnostic in patients showing signs of aseptic meningitis, encephalitis or acute flaccid paralysis/myelitis. Read More

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September 2019

A Scoping Review of Physicians' Clinical Reasoning in Emergency Departments.

Ann Emerg Med 2020 02 29;75(2):206-217. Epub 2019 Aug 29.

Centre for Medical Education, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Institut de Recherche Santé et Société, Université catholique de Louvain, Brussels, Belgium.

Study Objective: Clinical reasoning is considered a core competency of physicians. Yet there is a paucity of research on clinical reasoning specifically in emergency medicine, as highlighted in the literature.

Methods: We conducted a scoping review to examine the state of research on clinical reasoning in this specialty. Read More

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February 2020

Impact of a system-wide quality improvement initiative on blood pressure control: a cohort analysis.

BMJ Qual Saf 2020 03 31;29(3):225-231. Epub 2019 Aug 31.

Center for Value-Based Care Research, Cleveland Clinic Community Care, Cleveland Clinic, Cleveland, Ohio, USA.

Objective: To assess the impact of a quality improvement programme on blood pressure (BP) control and determine whether medication intensification or repeated measurement improved control.

Design: Retrospective cohort comparing visits in 2015 to visits in 2016 (when the programme started).

Subjects: Adults with ≥1 primary care visit between January and June in 2015 and 2016 and a diagnosis of hypertension in a large integrated health system. Read More

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Post-Basal Insulin Intensification and Healthcare Resource Use in Type 2 Diabetes: A Web-Based Physician Survey in the United States and United Kingdom.

Diabetes Ther 2019 Aug 24;10(4):1323-1336. Epub 2019 May 24.

The Brod Group, 219 Julia Avenue, Mill Valley, CA, 94941, USA.

Introduction: Currently, there is limited knowledge of the healthcare resources and time needed to intensify patients with type 2 diabetes (T2D) treated with basal insulin to more complex treatment regimens. The purpose of the study was to investigate physicians' perspectives on the time and healthcare resources required for post-basal insulin intensification to basal-bolus and to basal in combination with a glucagon-like peptide-1 receptor agonist (GLP-1) regimens. The study also examined referrals to specialists for intensification and patient challenges with intensification. Read More

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Kratom policy: The challenge of balancing therapeutic potential with public safety.

Int J Drug Policy 2019 08 16;70:70-77. Epub 2019 May 16.

Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia. Electronic address:

Kratom (Mitragyna speciosa) is a tree-like plant indigenous to Southeast Asia. Its leaves, and the teas brewed from them have long been used by people in that region to stave off fatigue and to manage pain and opioid withdrawal. Evidence suggests kratom is being increasingly used by people in the United States and Europe for the self-management of opioid withdrawal and treatment of pain. Read More

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PatientConcept App: Key Characteristics, Implementation, and its Potential Benefit.

Neurol Ther 2019 Jun 26;8(1):147-154. Epub 2019 Mar 26.

Nervenfachärztliche Gemeinschaftspraxis Ulm, and NeuroPoint GmbH, Ulm, Germany.

Introduction: In addition to a wide range of disease-related burdens, patients with multiple sclerosis (MS) are challenged by long-term medication and complex disease management plans, often leading to decreased adherence. Earlier studies have indicated that patient support through intensified communication can positively impact adherence. During recent years, the use of mobile health applications has gained importance in patient communication and disease management. Read More

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[TeleDermatology : The teledermatological solution mSkin® for daily practice].

Hautarzt 2019 May;70(5):335-342

Infokom GmbH, Johannesstr. 8a, 17034, Neubrandenburg, Deutschland.

Background: Health care for the increasing number of patients with chronic illnesses has become a major challenge to the politics of public health, especially in rural areas. Follow-up care for those patients requires a great amount of resources. Apart from managing appointments, patients often have to accept long journeys and waiting times. Read More

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How are HCV-infected patients being identified in Brazil: a multicenter study.

Braz J Infect Dis 2019 Jan - Feb;23(1):34-39. Epub 2019 Mar 6.

Universidade Federal de São Paulo, São Paulo, SP, Brazil. Electronic address:

Background: Hepatitis C is an important health problem. In Brazil, 1-2 million people are infected. Despite this expressive number, and the availability of very successful treatment, many patients remained undiagnosed mainly because of the asymptomatic nature of the infection. Read More

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Factors associated with intensification of antihypertensive drug therapy in patients with poorly controlled hypertension.

J Geriatr Cardiol 2019 Jan;16(1):19-26

Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.

Objective: To assess antihypertensive management of older patients with poor blood pressure (BP) control.

Methods: Physicians, voluntary participating in the study, included six consecutive hypertensive patients during routine visits. Hypertension had to have been previously recognized and averaged office BP was ≥ 140 and/or ≥ 90 mmHg in spite of ≥ 6 weeks of antihypertensive therapy. Read More

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January 2019

[Promotion and support of successful training as a urologist by the Deutsche Gesellschaft für Urologie].

Urologe A 2019 Feb;58(2):139-142

Deutsche Gesellschaft für Urologie, Düsseldorf und Berlin, Deutschland.

The Deutsche Gesellschaft für Urologie (DGU) has set itself the task of supporting medical assistants on their way to becoming specialists in urology. At the same time, urological junior researchers have been given the opportunity to become part of the urological community at an early stage through the so-called junior membership of the DGU. The working group "Young Urologists" of the DGU addresses in particular topics such as the development of concepts for the promotion of young talent, improvement of further education, models for better compatibility of leisure/family and work as well as the compatibility of clinical and scientific work. Read More

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February 2019

Cardiovascular Disease and Mortality in Adults Aged ≥60 Years According to Recommendations by the American College of Cardiology/American Heart Association and American College of Physicians/American Academy of Family Physicians.

Hypertension 2019 02;73(2):327-334

Department of Epidemiology (J.N.B., P.M.), University of Alabama at Birmingham.

In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) and the American College of Physicians/American Academy of Family Physicians (ACP/AAFP) published blood pressure guidelines. Adults recommended antihypertensive medication initiation or intensification by the ACP/AAFP guideline receive the same recommendation from the ACC/AHA guideline. However, many adults ≥60 years old are recommended to initiate or intensify antihypertensive medication by the ACC/AHA but not the ACP/AAFP guideline. Read More

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February 2019

Easier and Faster Is Not Always Better: Grounded Theory of the Impact of Large-Scale System Transformation on the Clinical Work of Emergency Medicine Nurses and Physicians.

JMIR Hum Factors 2018 Dec 13;5(4):e11013. Epub 2018 Dec 13.

Pathology & Laboratory Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.

Background: The effectiveness of Lean Thinking as a quality improvement method for health care has been contested due, in part, to our limited contextual understanding of how it affects the working conditions and clinical workflow of nurses and physicians. Although there are some initial indications, arising from prevalence surveys and interviews, that Lean may intensify work performed within medical environments, the evidence base still requires detailed descriptions of the changes that were actually introduced to individuals' clinical workflow and how these changes impacted health care professionals.

Objective: The aim of this study was to explore ways in which a Lean intervention may impact the clinical work of emergency medicine nurses and physicians. Read More

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December 2018