The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines

2020 ◽  
Vol 172 (5) ◽  
pp. 325-336 ◽  
Author(s):  
Vincent Mysliwiec ◽  
Jennifer L. Martin ◽  
Christi S. Ulmer ◽  
Susmita Chowdhuri ◽  
Matthew S. Brock ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Clinical Practice ◽  
Sleep Apnea ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Department Of Defense ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Insomnia Disorder ◽  
Obstructive Sleep

scholarly journals Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020

2022 ◽  
Author(s):  
Tsuneto Akashiba ◽  
Yuichi Inoue ◽  
Naohisa Uchimura ◽  
Motoharu Ohi ◽  
Takatoshi Kasai ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Sleep Apnea ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Medical Information ◽  
Sleep Apnea Syndrome ◽  
Adult Males ◽  
Obstructive Sleep ◽  
Number Of Patients ◽  
Apnea Syndrome

AbstractThe prevalence of sleep-disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern countries, including Japan. Since 1998, when health insurance coverage became available, the number of patients using continuous positive airway pressure (CPAP) therapy for sleep apnea has increased sharply, with the number of patients about to exceed 500,000 in Japan. Although the “Guidelines for Diagnosis and Treatment of Sleep Apnea Syndrome (SAS) in Adults” was published in 2005, a new guideline was prepared to indicate the standard medical care based on the latest trends, as supervised by and in cooperation with the Japanese Respiratory Society and the “Survey and Research on Refractory Respiratory Diseases and Pulmonary Hypertension” Group, of Ministry of Health, Labor and Welfare and other related academic societies, including the Japanese Society of Sleep Research, in addition to referring to the previous guidelines. Since sleep apnea is an interdisciplinary field covering many areas, this guideline was prepared including 36 clinical questions (CQs). In the English version, therapies and managements for SAS, which were written from CQ16 to 36, were shown. The Japanese version was published in July 2020 and permitted as well as published as one of the Medical Information Network Distribution Service (Minds) clinical practice guidelines in Japan in July 2021.

Clinical Practice Guidelines for Bipolar Disorder From the Department of Veterans Affairs

1999 ◽  
Vol 60 (1) ◽  
pp. 9-21 ◽  
Author(s):  
Mark S. Bauer ◽  
Ann M. Callahan ◽  
Chowdary Jampala ◽  
Frederick Petty ◽  
Martha Sajatovic ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs

BRCA testing within the Department of Veterans Affairs: concordance with clinical practice guidelines

2016 ◽  
Vol 16 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Danielle S. Chun ◽  
Brygida Berse ◽  
Vickie L. Venne ◽  
Scott L. DuVall ◽  
Kelly K. Filipski ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Brca Testing

Antimicrobial Use Control Measures to Prevent and Control Antimicrobial Resistance in US Hospitals

2006 ◽  
Vol 27 (10) ◽  
pp. 1088-1095 ◽  
Author(s):  
Alan J. Zillich ◽  
Jason M. Sutherland ◽  
Stephen J. Wilson ◽  
Daniel J. Diekema ◽  
Erika J. Ernst ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Antimicrobial Resistance ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Veterans Affairs ◽  
Control Measures ◽  
Antimicrobial Use ◽  
Cross Sectional ◽  
Term Care ◽  
Recommended Practices

Objective.Clinical practice guidelines and recommended practices to control use of antibiotics have been published, but the effect of these practices on antimicrobial resistance (AMR) rates in hospitals is unknown. The objective of this study was to examine relationships between antimicrobial use control strategies and AMR rates in a national sample of US hospitals.Design.Cross-sectional, stratified study of a nationally representative sample of US hospitals.Methods.A survey instrument was sent to the person responsible for infection control at a sample of 670 US hospitals. The outcome was current prevalences of 4 epidemiologically important, drug-resistant pathogens, considered concurrently: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, ceftazidime-resistant Klebsiella species, and quinolone (ciprofloxacin)-resistant Escherichia coli Five independent variables regarding hospital practices were selected from the survey: the extent to which hospitals (1) implement practices recommended in clinical practice guidelines and ensure best practices for antimicrobial use, (2) disseminate information on clinical practice guidelines for antimicrobial use, (3) use antimicrobial-related information technology, (4) use decision support tools, and (5) communicate to prescribers about antimicrobial use. Control variables included the hospitals' number of beds, teaching status, Veterans Affairs status, geographic region, and number of long-term care beds; and the presence of an intensive care unit, a burn unit, or transplant services. A generalized estimating equation modeled all resistance rates simultaneously to identify overall predictors of AMR levels at the facility.Results.Completed survey instruments were returned by 448 hospitals (67%). Four antimicrobial control measures were associated with higher prevalence of AMR. Implementation of recommended practices for antimicrobial use (P< .01) and optimization of the duration of empirical antibiotic prophylaxis (P<.01) were associated with a lower prevalence of AMR. Use of restrictive formularies (P = .05) and dissemination of clinical practice guideline information (P<.01) were associated with higher prevalence of AMR. Number of beds and Veterans Affairs status were also associated with higher AMR rates overall.Conclusions.Implementation of guideline-recommended practices to control antimicrobial use and optimize the duration of empirical therapy appears to help control AMR rates in US hospitals. A longitudinal study would confirm the results of this cross-sectional study. These results highlight the need for systems interventions and reengineering to ensure more-consistent application of guideline-recommended measures for antimicrobial use.

Sign in / Sign up

Export Citation Format

Share Document