scholarly journals Approach to the Assessment and Management of Pediatric Patients With Atopic Dermatitis: A Consensus Document. Section I: Overview of Pediatric Atopic Dermatitis

2019 ◽  
Vol 23 (5_suppl) ◽  
pp. 3S-11S ◽  
Author(s):  
Irene Lara-Corrales ◽  
James N. Bergman ◽  
Ian Landells ◽  
Michele L. Ramien ◽  
Perla Lansang
Keyword(s):  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Patient Reported Outcomes ◽  
Assessment Tools ◽  
Care Providers ◽  
Patient Counseling ◽  
Consensus Document ◽  
Subjective Assessments ◽  
Patient Reported

Pediatric atopic dermatitis (AD) is one of the most common dermatoses encountered by health-care providers treating children. Diagnosis of AD is clinical, with no universally accepted biomarkers or assessment tools. Patient-reported outcomes and subjective assessments of quality of life in both the patient and family are important considerations when treating pediatric AD. Here, we provide an overview of pediatric AD epidemiology, its clinical presentation, burden, diagnosis, and assessment, with a focus on implications for patient counseling in order to optimize care.

scholarly journals Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 3S-5S ◽  
Author(s):  
Melinda J. Gooderham ◽  
Chih-ho Hong ◽  
Lorne Albrecht ◽  
Robert Bissonnette ◽  
Gurbir Dhadwal ◽  
...  
Keyword(s):  
Health Care ◽  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Expert Panel ◽  
Adult Patients ◽  
Clinical Expertise ◽  
Care Providers ◽  
Consensus Document ◽  
Practical Management ◽  
Consensus Statements

Background: Atopic dermatitis (AD) is a chronic, relapsing, and remitting inflammatory skin disease with complex pathophysiology, primarily driven by type 2 inflammation. Existing guidelines often do not reflect all current therapeutic options and guidance on the practical management of patients with AD is lacking. Objectives: To develop practical, up-to-date guidance on the assessment and management of adult patients with AD. Methods: An expert panel of 17 Canadian experts, including 16 dermatologists and 1 allergist, with extensive clinical experience managing moderate-to-severe AD reviewed the available literature from the past 5 years using a defined list of key search terms. This literature, along with clinical expertise and opinion, was used to draft concise, clinically relevant reviews of the current literature. Based on these reviews, experts developed and voted on recommendations and statements to reflect the practical management of adult patients with AD as a guide for health care providers in Canada and across the globe, using a prespecified agreement cutoff of 75%. Results: Eleven consensus statements were approved by the expert panel and reflected 4 key domains: pathophysiology, assessment, comorbidities, and treatment. Conclusions: These statements aim to provide a framework for the assessment and management of adult patients with AD and to guide health care providers in practically relevant aspects of patient management.

scholarly journals Approach to the Assessment and Management of Pediatric Patients with Atopic Dermatitis: A Consensus Document. Section II: Comorbid Disease in Pediatric Atopic Dermatitis

2019 ◽  
Vol 23 (5_suppl) ◽  
pp. 12S-18S ◽  
Author(s):  
Chih-ho Hong ◽  
Marissa Joseph ◽  
Vy HD Kim ◽  
Perla Lansang ◽  
Irene Lara-Corrales
Keyword(s):  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Pediatric Patients ◽  
Allergic Diseases ◽  
Care Providers ◽  
Barrier Dysfunction ◽  
Consensus Document ◽  
Common Skin ◽  
Genetic And Environmental Factors ◽  
Skin Conditions

Pediatric atopic dermatitis (AD) is one of the most common skin conditions encountered by health-care providers caring for infants, children, and adolescents. Pediatric patients with AD may present with other allergic and nonallergic comorbidities that require appropriate treatment and referral. They may also experience a trajectory of allergic diseases known as the atopic march, which depends on a complex interaction between genetic and environmental factors and likely involves early epidermal barrier dysfunction. Here we provide a review and clinical recommendations on the assessment and referral of comorbidities in pediatric AD.

scholarly journals “I Like the Idea of It…But Probably Wouldn’t Use It” - Health Care Provider Perspectives on Heart Failure mHealth: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Jennifer Dickman Portz ◽  
Kelsey Lynett Ford ◽  
Kira Elsbernd ◽  
Christopher E Knoepke ◽  
Kelsey Flint ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Qualitative Study ◽  
Real Time ◽  
Health Care Providers ◽  
Patient Reported Outcomes ◽  
Care Providers ◽  
Time Data ◽  
Patient Reported ◽  
Real Time Data

BACKGROUND Many mobile health (mHealth) technologies exist for patients with heart failure (HF). However, HF mhealth lacks evidence of efficacy, caregiver involvement, and clinically useful real-time data. OBJECTIVE We aim to capture health care providers’ perceived value of HF mHealth, particularly for pairing patient–caregiver-generated data with clinical intervention to inform the design of future HF mHealth. METHODS This study is a subanalysis of a larger qualitative study based on interviewing patients with HF, their caregivers, and health care providers. This analysis included interviews with health care providers (N=20), focusing on their perceived usefulness of HF mHealth tools and interventions. RESULTS A total of 5 themes emerged: (1) bio-psychosocial-spiritual monitoring, (2) use of sensors, (3) interoperability, (4) data sharing, and (5) usefulness of patient-reported outcomes in practice. Providers remain interested in mHealth technologies for HF patients and their caregivers. However, providers report being unconvinced of the clinical usefulness of robust real-time patient-reported outcomes. CONCLUSIONS The use of assessments, sensors, and real-time data collection could provide value in patient care. Future research must continually explore how to maximize the utility of mHealth for HF patients, their caregivers, and health care providers.

Article Commentary: Explaining the Shift to Value-Based Reimbursement in the Setting of Dermatology and Psoriasis

2016 ◽  
Vol 2 (1) ◽  
pp. 5-8
Author(s):  
Benjamin Farahnik ◽  
Mio Nakamura ◽  
Tina Bhutani ◽  
John Koo
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Skin Diseases ◽  
Fee For Service ◽  
Care Providers ◽  
Quality Reporting ◽  
Physician Participation ◽  
Patient Reported ◽  
Physician Quality Reporting System

The Department of Health and Human Services has announced a campaign for transitioning Medicare reimbursement from volume to value. A budget-neutral Value-Based Payment Modifier has been implemented that provides for differential payment to physicians based upon the quality of care delivered. The value modifier will be based partially on physician participation in the Physician Quality Reporting System (PQRS), which allows for reporting of information on quality of care to Medicare. The information reported includes both medical data and patient-reported experiences with health care providers. Starting in 2017, the value modifier payment adjustment will apply to all physicians who make Medicare part B fee-for-service charge claims. Physicians who do not participate in the PQRS and satisfy reporting requirements may be assessed negative adjustments to their payments. Dermatologists in particular will be impacted by these changes, as skin diseases, especially psoriasis, account for a significant economic burden in the U.S.

scholarly journals Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial

2021 ◽  
pp. 1564-1571
Author(s):  
Lieselot Cool ◽  
Jana Missiaen ◽  
Philip Debruyne ◽  
Hans Pottel ◽  
Veerle Foulon ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Service Use ◽  
Safety Data ◽  
Care Providers ◽  
Patient Centered ◽  
Potential Cost ◽  
High Quality ◽  
Randomized Controlled ◽  
Patient Reported

PURPOSE Given the increasing burden of cancer on patients, health care providers, and payers, the shift of certain outpatient procedures to the patients' homes (further indicated as oncologic home-hospitalization [OHH]) might be a high-quality, patient-centered, and cost-effective alternative to standard ambulatory cancer care (SOC). METHODS A randomized-controlled trial was conducted to evaluate the quality of a locally implemented model for OHH (n = 74) compared with SOC (n = 74). The model for OHH consisted of home administration of certain subcutaneous cancer drugs (full OHH) and home nursing assessments before ambulatory systemic cancer therapy (partial OHH). Quality was evaluated based on patient-reported quality of life (QoL) and related end points; service use and cost data; safety data; patient-reported satisfaction and preferences; and model efficiency. An equivalence design was used for primary end point analysis. Participants were followed during 12 weeks of systemic cancer treatment. RESULTS This trial demonstrated equivalence of both models (OHH v SOC) in terms of patient-reported QoL (95% CI not exceeding the equivalence margin of 10%). Full OHH resulted in significantly less hospital visits (mean of 5.6 ± 3.0 v 13.2 ± 4.6; P = .011). Partial OHH reduced waiting times for therapy administration at the day care unit with 45% per visit (2 hours 36 minutes ± 1 hour 4 minutes v 4 hours ± 1 hour 4 minutes; P < .001). No safety issues were detected. Of the intervention group, 88% reported to be highly satisfied with the OHH model, and 77% reported a positive impact on their QoL. At study end, 60% of both study arms preferred OHH above SOC. CONCLUSION The shift of particular procedures from the outpatient clinic to the patients' homes offers a high-quality and patient-centered alternative for a large proportion of patients with cancer. Further research is needed to evaluate potential cost-efficiency.

scholarly journals Leveraging Patient-Reported Outcomes Using Data Visualization

2018 ◽  
Vol 09 (03) ◽  
pp. 565-575 ◽  
Author(s):  
Lisa Grossman ◽  
Steven Feiner ◽  
Elliot Mitchell ◽  
Ruth Masterson Creber
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Reported Outcomes ◽  
Qualitative Interviews ◽  
Hospital Setting ◽  
Usability Testing ◽  
User Centered Design ◽  
Care Providers ◽  
Patient Reported ◽  
Design Requirements

Background Health care organizations increasingly use patient-reported outcomes (PROs) to capture patients' health status. Although federal policy mandates PRO collection, the challenge remains to better engage patients in PRO surveys, and ensure patients comprehend the surveys and their results. Objective This article identifies the design requirements for an interface that assists patients with PRO survey completion and interpretation, and then builds and evaluates the interface. Methods We employed a user-centered design process that consisted of three stages. First, we conducted qualitative interviews and surveys with 13 patients and 11 health care providers to understand their perceptions of the value and challenges associated with the use of PRO measures. Second, we used the results to identify design requirements for an interface that collects PROs, and designed the interface. Third, we conducted usability testing with 12 additional patients in a hospital setting. Results In interviews, patients and providers reported that PRO surveys help patients to reflect on their symptoms, potentially identifying new opportunities for improved care. However, 6 out of 13 patients reported significant difficultly in understanding PRO survey questions, answer choices and results. Therefore, we identified aiding comprehension as a key design requirement, and incorporated visualizations into our interface design to aid comprehension. In usability testing, patients found the interface highly usable. Conclusion Future interfaces designed to collect PROs may benefit from employing strategies such as visualization to aid comprehension and engage patients with surveys.

Quality of life in palliative care: principles and practice

2015 ◽  
Author(s):  
Stein Kaasa ◽  
Jon Håvard Loge
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Research Question ◽  
Patient Reported Outcome ◽  
Care Providers ◽  
Sequential Approach ◽  
Patient Reported

To improve or sustain patients’ health-related quality of life (HRQOL) is the main goal of palliative care. In health care, HRQOL encompasses a range of components that are measurable and related to health, disease, illness, and medical interventions. Another term, patient-reported outcome (PRO), is used and understood as any measure that collects responses directly from the patients and measures any aspect of patients’ health status that is reported by the patients without any interpretation by health-care providers or family members. The selection of PRO-instruments (questionnaires) is recommended to follow a sequential approach. Define overall aim(s), define the research question(s), agree upon the key outcome(s), and select the appropriate set of questions/questionnaires guided by the primary and secondary outcomes. In general, it is recommended to use a HRQOL measure of generic or disease-specific character and supplement it with domain-specific measure(s) (such as measurement of fatigue, pain, anxiety, depression, etc.) reflecting the purpose(s) of the data collection.

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