Commentaries: Myocardial Injury After Noncardiac Surgery Linked With Higher 1-Year Mortality – TCTMD (free) AND Perioperative Myocardial Injury After Noncardiac Surgery – American College of Cardiology, Latest in Cardiology (free)
Related commentaries: Women harmed because vaginal mesh regulation ‘not fit for purpose’ – The Guardian (free) AND Vaginal mesh operations for prolapse should be banned, watchdog to say – The Guardian (free)
Readmissions After Revascularization Procedures for Peripheral Arterial Disease: A Nationwide Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Burden of Readmission High in PAD Patients Following Revascularization – TCTMD (free) AND 1 in 6 Patients Undergoing Peripheral Arterial Revascularization Readmitted Within 30 Days – Physician’s First Watch (free) AND 1 in 6 Readmitted After Peripheral Revascularization – MedPage Today (free registration required)
Commentaries: Clinician denial of certain patient requests linked with decreased satisfaction – 2 Minute Medicine (free) AND Denial of some patient requests, but not others, associated with decreased patient satisfaction, study finds – ACP Internist (free) AND Patient satisfaction surveys are worthless – Physician’s Weekly (free)
Editorial: Overlapping Surgery—Perspectives From the Other Side of the Table (free)
Commentaries: Study: Overlapping surgeries boost complication risks – Becker’s Hospital Review (free) AND Does Overlapping Surgery Increase Complication Risk After Hip Surgery? – The JAMA Network (free)
Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery – JAMA (link to abstract – $ for full-text)
Commentaries: Delaying Surgery for Hip Fracture for More Than One Day Associated with Small Increased Risk of Death – The JAMA Network (free) AND Delaying Hip Fracture Surgery for 1 Day Tied to Higher Mortality Risk – Physician’s First Watch (free) AND Emergency Hip Surgery Best Done Within 24 Hours – Medscape (free registration required)
The Value-Based Payment Modifier: Program Outcomes and Implications for Disparities – Annals of Internal Medicine (link to abstract – $ for full-text)
Related: The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care: A Systematic Review – Annals of Internal Medicine (free) AND Value-Based Purchasing: Time for Reboot or Time to Move On? by Ashish K. Jha, MD – The JAMA Forum (free)
Original article: Comprehensive geriatric assessment for older adults admitted to hospital – Cochrane Library (free summary – $ for full-text) AND News Release: Comprehensive geriatric assessment for older adults admitted to hospital (free)
Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control – Antimicrobial Resistance & Infection Control (free)
Related document: Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosain health care facilities – World Health Organization (free)
European guidelines on perioperative venous thromboembolism prophylaxis (free PDF articles):
Position Paper: Patient Safety in the Office-Based Practice Setting – American College of Physicians (free PDF)
Commentaries: ACP says patient safety must be improved in office-based practice setting – American College of Physicians, via EurekAlert (free) AND ACP: Recommendations for Improving Patient Safety in Ambulatory Settings – MPR (free)
How Hospitals Are Using Patient-Reported Outcomes to Improve Care – Harvard Business Review (a few articles per month are free)
Original article: Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis – The Lancet Infectious Diseases (link to abstract – $ for full-text)
Commentaries: 12 key points to remember: Standards for Inpatient Electrocardiographic Monitoring – American College of Cardiology, Latest in Cardiology (free) AND AHA updates practice standards for electrocardiographic monitoring – ACP Hospitalist (free)
Association of Patient Frailty With Increased Morbidity After Common Ambulatory General Surgery Operations – JAMA Surgery (link to abstract – $ for full-text)
Commentaries: Frailty Associated With Increased Risk of Complications Following Common, Outpatient Operations – The JAMA Network (free) AND Frailty tied to higher risk of complications with common surgeries – Reuters (free) AND Frailty linked to higher rate of perioperative morbidity – OnMedica (free)
Related guideline: Healthcare Personnel Attire in Non-Operating-Room Settings – Infection Control and Hospital Epidemiology (free) AND Commentaries: Goodbye to the Doctor’s White Coat? – The New York Times (10 articles per month are free) AND New infection control recommendations could make white coats obsolete – ScienceDaily (free) AND Should Doctors Still Be Allowed to Wear White Coats? You Decide – HIV and ID Observations (free)
Discontinuing Inappropriate Medication Use in Nursing Home Residents: A Cluster Randomized Controlled Trial – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Deprescribing Intervention Improves Nursing Home Care – Medscape (free registration required) AND Multistep tool is effective for discontinuing inappropriate medication use in the nursing home setting – MedicalXpress (free)
Original article: Keeping Children Safe: a multicentre programme of research to increase the evidence base for preventing unintentional injuries in the home in the under-fives – Programme Grants for Applied Research (free)
Outcomes In Two Massachusetts Hospital Systems Give Reason For Optimism About Communication-And-Resolution Programs – Health Affairs (link to abstract – $ for full-text)
Commentaries: After medical error, apology goes a long way – Stanford University Medical Center, via ScienceDaily (free) AND Conflict Resolution Program: ‘Cause for Optimism’ – MedPage Today (free registration required)
“Concurrent bariatric operations occurred infrequently, but when they did, there was no observable increased risk for adverse perioperative outcomes compared with non-concurrent operations”.
Editorial: Telephone first consultations in primary care (free)
Commentaries: Phone-first GP consults ‘no panacea for reducing workload’ – OnMedica (free) AND No evidence to support claims that telephone consultations reduce GP workload or hospital referrals – University of Cambridge (free)
Related study: Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending – Health Affairs (link to abstract – $ for full-text) AND Commentaries: Telehealth Doctor Visits May Be Handy, But Aren’t Cheaper Overall – NPR (free) AND Are Virtual Doctor Visits Really Cost-Effective? Not So Much, Study Says – Health News Florida (free)
Impact of Transitional Care Services for Chronically Ill Older Patients: A Systematic Evidence Review – Journal of The American Geriatrics Society (link to abstract – $ for full-text)
Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) – Gut (free)
Commentary: Standards for Upper GI Endoscopy Released – Medscape (free registration required)
Original article: Interventions to improve hand hygiene compliance in patient care – Cochrane Library (link to abstract – $ for full-text)
Original article: Comprehensive geriatric assessment for older adults admitted to hospital – Cochrane Library (link to abstract – $ for full-text)
“Older patients are more likely to be alive and in their own homes at follow-up if they received comprehensive geriatric assessment on admission to hospital”.
Related article: Weekends affect mortality risk and chance of discharge in critically ill patients: a retrospective study in the Austrian registry for intensive care – Critical Care (free) AND Commentary: “Weekend effects” in intensive care units – On Medicine (free)
Implementing a Health System–wide Patient Blood Management Program with a Clinical Community Approach – Anesthesiology (link to abstract – $ for full-text)
Original article: Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer – Cochrane Library (link to abstract – $ for full-text)
“Urinary and sexual quality of life-related outcomes appear similar”.
11 Drugs You Should Seriously Consider Deprescribing – Medscape Slideshow (free registration required)
Related: Canadian Deprescribing Network (CaDeN) (free) AND CaDeN Deprescribing Guidelines and Algorithms (free) AND Deprescribing guidelines for the elderly – Ontario Pharmacy Evidence Network (free) AND Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline – Canadian Family Physician (free) AND Too Many Meds? America’s Love Affair With Prescription Medication – Consumer Reports (free) AND Patient often prescribed potentially futile drugs in their final months of life – Science Daily AND The Challenge of Polypharmacy: From Rhetoric to Reality – Royal Pharmaceutical Society and Royal College of General Practitioners Partnership (free PDF) Current and future perspectives on the management of polypharmacy – BMC Family Practice (free)
Should kids be sedated for dental work? – The New York Times (10 articles per month are free)
Original article: Comprehensive Geriatric Assessment for Prevention of Delirium After Hip Fracture: A Systematic Review of Randomized Controlled Trials – Journal of The American Geriatrics society (link to abstract – $ for full-text)
Commentaries: Less than half of mothers place sleeping infants supine – 2 Minute Medicine (free) AND Most moms aren’t putting babies to sleep safely, study says – CNN (free) AND Less Than Half of Mothers Report Always Putting Babies to Sleep in Supine Position – Physician’s First Watch (free) AND Parents still failing to put babies to sleep on their backs – Reuters (free)
Placing infants in the supine position for sleep reduces the risk of sudden unexpected infant death and has been recommended by the American Academy of Pediatrics since 2005. Nevertheless, in this survey only 43,7% of mothers placed their infants exclusively in supine position for sleep.
Related article: Use of placebo controls in the evaluation of surgery: systematic review – The BMJ (free)
“With evidence mounting that many minor operations owe their success to the placebo effect, is it time to call a halt to some routine procedures?”
Commentaries: Smokers hospitalized for heart attacks often don’t get cessation drugs – Reuters (free) AND Smokers Hospitalized for CHD Rarely Receive Cessation Pharmacotherapy During Hospitalization – American College of Cardiology, Latest in Cardiology (free)
Acute Kidney Injury After Computed Tomography: A Meta-analysis – Annals of Emergency Medicine (link to abstract – $ for full-text)
Commentary: When kidneys are injured, CT contrast isn’t the culprit – Health Imaging (free)
Compared with noncontrast CT, contrast-enhanced CT was not significantly associated with either acute kidney injury, need for renal replacement therapy, or all-cause mortality.
Analysis – Too much medicine: Mapping the drivers of overdiagnosis to potential solutions – The BMJ (free)
Related: Overdiagnosis, ethics, and trolley problems: why factors other than outcomes matter – The BMJ (free) AND The overdiagnosis community targets solutions – The BMJ (free) AND Are expanding disease definitions unnecessarily labelling women with polycystic ovary syndrome? – The BMJ (free) AND When technology creates uncertainty: pulse oximetry and Overdiagnosis of hypoxaemia in bronchiolitis – The BMJ (free)
A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentaries: Study Shows 54 Percent Drop in CAUTIs Among Nursing Home Residents – Infection Control Today (free) AND AHRQ safety program helps cut catheter infections by more than 50% among nursing home patients, JAMA study shows – Healthcare Finance (free) AND Implementing technical and socioadaptive bundles may decrease catheter-associated urinary tract infections in nursing homes – 2 Minute Medicine (free) AND Nursing homes cut urinary tract infections in half through focused effort on catheter care – Michigan University, via EurekAlert (free)
An Automated, Pharmacist-Driven Initiative Improves Quality of Care for Staphylococcus aureus Bacteremia – Clinical Infectious Diseases (link to abstract – $ for full-text)
Commentaries: Automating antimicrobial stewardship – ACP Hospitalist (free) AND Automated intervention aids treatment of Staph aureus bacteremia – CIDRAP (free)
The American College of Radiology developed 3 new guidance documents and revised 32 others to advance the science of radiology and improve the quality of service to patients
FDA Safety Alert: Liquid-filled Intragastric Balloon Systems: Letter to Healthcare Providers – Potential Risks (free)
Commentaries: Five People Die After Using Weight Loss Balloons for Obesity – Time (free) AND FDA Warns of Gastric Balloon Deaths – MedPage Today (free registration required) AND Five Deaths Tied to Intragastric Balloons, FDA Says – Medscape (free registration required)
Commentaries: C-Section Delivery Associated with Increased Risk of Complications from Hysterectomy – The JAMA Network (free) AND C-Section Now, Hysterectomy Complications Later? – MedPage Today (free registration required)
This systematic review and meta-analysis mostly of observational studies suggests early breastfeeding initiation is associated with increased survival. The authors acknowledge that there are many reasons for delayed breastfeeding initiation that may confound the relationship between breastfeeding initiation and mortality, but remember that randomized trials would not be considered ethical, so we must rely on high quality observational data. Based on their analysis, the authors suggest the implementation of programs that emphasize the importance of early initiation of breastfeeding, in addition to promoting exclusive breastfeeding.
Use of Alternative Medicine for Cancer and Its Impact on Survival – Journal of the National Cancer Institute (link to abstract – $ for full-text)
Commentary: Use of alternative medicine hastens death of cancer patients – Edzard Ernst (free) AND Cancer Survival Takes a Hit with Alternative Medicine – MedPage Today (free) AND Using Alternative Medicine Only for Cancer Linked to Lower Survival Rate – Yale Cancer Center, via NewsWise (free) AND ‘Alternative Medicine’ for Cancer Ups Death Risk – Medscape (free registration required)
“A best estimate is that U.S. costs of hypnotic harms to healthcare systems are on the order of $55 billion, but conceivably might be as low as $10 billion or as high as $100 billion”.
Alternatives to hospital admission for people aged over 65 years can be safe and reduce costs across a range of acute and chronic conditions.
See more on “Deprescribing” in our May 8th issue (see #7), May 9th issue (see #4) and May 15th issue (see #2), and also a related article on Current and future perspectives on the management of polypharmacy
“Experts explain the causes and solutions for common mistakes in diagnosis”.
Oral fluoroquinolones and risk of secondary pseudotumor cerebri syndrome – Neurology (link to abstract – $ for full-text)
Commentary: Fluoroquinolones May Up Risk of PTCS, a Rare But Serious Condition – MPR (free) (RT @AmeshAA see Tweet)
New issue with series of articles exploring strategies clinicians need to know to respond to adverse outcomes.
Commentaries: Emergency Visits Common After Hysterectomy, Study Finds – Medscape (free registration required) AND ~10 Percent Present to ER After Hysterectomy for Benign Disease – Physician’s Briefing (free)
“Risk factors include younger age, higher parity, Medicare or self-pay insurance, postoperative pain” (from Physician’s Briefing)
American College of Surgeons (ACS) 2017 Quality and Patient Safety Conference: Enhanced recovery pathway for colorectal surgical patients improves outcomes, reduces cost – ACS, via EurekAlert (free)
Related guideline: Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons (free)
“Successful protocol shortens hospital stays, reduces patients’ risk of complications, and cuts costs up to $11,000 per procedure”
Witch Metrics in Hospital Quality Should Patients Pay Attention To? – The New York Times (10 articles per month are free)
Viewpoint: Sharing Knowledge for Health Care – JAMA Internal Medicine (free)
Related: Editorial: Sharing Medicine – A JAMA Internal Medicine Series (free) AND
Other “Sharing Medicine” articles: Sharing as the Future of Medicine – JAMA Internal Medicine (free) AND Shared Decision Making: The Importance of Diagnosing Preferences – JAMA Internal Medicine (free)
2017 ACS Quality and Safety Conference: “Strong for Surgery” Shows Promise in Reducing Smoking Rates for Patients Facing Surgery – American College of Surgeons, via NewsWise (free)
“Study suggests big drop in smoking rates when surgeons help patients quit before their operations”.
Use of Prescription Smoking Cessation Medications After Myocardial Infarction Among Older Patients in Community Practice – JAMA (link to abstract – $ for full-text)
Commentaries: Stop-Smoking Meds Underused in Post-MI Setting – MedPage Today (free registration required) AND Heart attack patients don’t adhere to smoking cessation prescriptions – Cardiovascular Business (free) AND Heart attack patients missing out on smoking cessation drugs – Reuters Health (free)
Invited Commentary: Fluoroquinolone restriction to control fluoroquinolone-resistant Clostridium difficile (free)
See article’s Algorithms and Protocols (free)
Commentary: 3 steps to restore patient trust in overlapping surgeries – FierceHealthcare (free)
This interesting viewpoint discusses the practice of scheduling overlapping surgeries, in which a qualified practitioner finishes noncritical parts of the first operation while the primary surgeon moves to the next surgery.
Effectiveness of Pharmacist Intervention to Reduce Medication Errors and Health-Care Resources Utilization After Transitions of Care: A Meta-analysis of Randomized Controlled Trials – Journal of Patient Safety (link to abstract – $ for full-text)
Source: Hospital Medicine Virtual Journal Club (free resource to find articles of interest)
Pharmacist transition of care intervention seems to be an effective strategy to reduce medication errors after hospital discharge and to reduce subsequent emergency room visits.
“Each year, the proliferation of substandard and falsified medicines puts the lives of millions of people – particularly those living in developing countries – at risk”
Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update. Comparative Effectiveness Review – Agency for Healthcare Research and Quality (free report and summary)
See also: Executive summary (free PDF)
Source: ACP Journal Wise ($ resource to find articles of interest)
Comprehensive review on the evidence regarding thromboembolism prophylaxis in major orthopedic surgery.
Original article: Effect of laminar airflow ventilation on surgical site infections: a systematic review and meta-analysis – The Lancet Infectious Diseases (link to abstract – $ for full-text)
In this large cohort clindamycin, doxycycline, quinolones, macrolides, and phenoxymethylpenicillin were associated with congenital malformations. Amoxicillin, cephalosporins, and nitrofurantoin were not associated with birth defects.
Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery – British Journal of Surgery (link to abstract – $ for full-text)
Source: ACP Journal Club ($ resource to find articles of interest)
In this RCT, a comprehensive preoperative geriatric assessment and optimization before vascular surgery was associated with shorter length of hospital stay, lower incidence of complications, and patients were less likely to be discharged to a higher level of dependency.
Source: Hospital Medicine Virtual Journal Club (free resource to find articles of interest)
Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons (free)
Association of delay of urgent or emergency surgery with mortality and use of health care resources: a propensity score–matched observational cohort study – Canadian Medical Association Journal (free)
Source: STAT News Newsletter
“Delayed operating room access for emergency surgery was associated with increased risk of inhospital mortality, longer length of stay and higher costs”.
Longitudinal Patterns of Medication Nonadherence and Associated Health Care Costs – Inflammatory Bowel Diseases (link to abstract – $ for full-text)
In this small study, patients with increasing nonadherence over time demonstrate more than a 3-fold increase in costs compared with adherent patients.
Pictograms, Units and Dosing Tools, and Parent Medication Errors: A Randomized Study – Pediatrics (link to abstract – $ for full-text)
Commentaries: Most Parents Give Kids Wrong Doses – MedPage Today (free registration required) AND Proper tools may help prevent medicine errors at home – Reuters (free)
Commentaries: Proton pump inhibitors associated with raised mortality – OnMedica (free) AND Longtime use of heartburn drugs linked to increased risk of death – NewsMedical (free) AND People taking heartburn drugs could have higher risk of death, study claims – The Guardian (free) AND Some heartburn drugs linked with higher risk of death – CBS News (free) AND PPIs Linked to Higher Risk for Death – Medscape (free registration required)
In a large observational study, PPI use was associated with increased mortality (HR 1.25; CI 1.23 to 1.28). PPIs were also associated with increased risk compared to H2 blockers (HR 1.24; CI 1.21 to 1.27). See more on the trade-offs of PPI therapy in our July 3rd issue (see #10)
Redesigning Care for High-Cost, High-Risk Patients – Harvard Business Review (a few articles per month are free) (RT @pash22 see Tweet)
Related: Designing a High-Performing Health Care System for Patients with Complex Needs: Ten Recommendations for Policymakers – The Commonwealth Fund (free) AND Caring for High-Need, High-Cost Patients — An Urgent Priority – New England Journal of Medicine (Free) AND Multimorbidity: clinical assessment and management – NICE Guideline (free) AND Multimorbidity in Older Adults with Cardiovascular Disease – American College of Cardiology, Latest in Cardiology (Free full text) AND Focusing on High-Cost Patients — The Key to Addressing High Costs? – NEJM Catalyst (free) AND Richard Smith: The challenge of high need, high cost patients – The BMJ Blogs (free) AND Playbook: Better Care for People with Complex Needs – Institute for Healthcare Improvement (free)
Source: PracticalReviews ($)
See related article on the effect of multicomponent nonpharmacologic interventions to prevent delirium in abdominal surgery in our May 25th issue (see #5)
Delirium-friendly preprinted postoperative orders executed by regular nursing staff resulted in a significant reduction in postoperative delirium.
Viewpoint: Monitoring Medical Devices: Missed Warning Signs Within Existing Data – JAMA (free)
Related: The lap band for weight loss is a tale of medicine gone wrong – VOX (free) Reoperation and Medicare Expenditures After Laparoscopic Gastric Band Surgery – JAMA Surgery (link to abstract – $ for full-text) AND Safety, Effectiveness of Gastric Banding Called Into Question – Medscape (free registration required) AND 1 In 5 Gastric Band Surgeries Require Corrective Operations – American Council on Science and Health (free)
The authors use the example of gastric band surgery to discuss how available data may be used more appropriately for earlier detection of problems in the safety of medical devices.
This viewpoint suggests a more selective use of contact precautions for the control of endemic pathogens.
Source: EvidenceAlerts (free resource to find articles of interest)
In this meta-analysis including 19 randomized trials, probiotics given within 2 days of the first antibiotic dose (more effective than if started later) reduced the risk of Clostridium difficile infection (CDI) by >50% in hospitalized adults. 1 case of CDI would be prevented for every 23−144 patients treated with probiotics when antibiotics are started. “There was no convincing evidence of superior efficacy for any of the tested probiotic formulations, delivery methods (drink or capsule), or probiotic doses”.
The JAMA Network – For the Media: How Many Adverse Events Are Reported to FDA for Cosmetics, Personal Care? (free)
Commentaries: More Health Problems Reported With Hair And Skin Care Products – NPR (free) AND The Hidden Dangers of Makeup and Shampoo – TIME (a few articles per month are free)
Necessity is the mother of invention: an innovative hospitalist-resident initiative for improving quality and reducing readmissions from skilled nursing facilities – Journal of Community Hospital Internal Medicine Perspectives (free) (RT @HMVJC see Tweet)
In this model of care, a hospitalist-led team, including the resident on the geriatrics rotation, followed patients discharged from the hospital to the skilled nursing facility, leading to significant decrease in readmission rates.
This study compared two different approaches to measure adverse events, the “Trigger Tool system” and the “Two-stage review”
Value-Based Care Alone Won’t Reduce Health Spending and Improve Patient Outcomes – Harvard Business Review (a few articles per month are free) (RT @pash22 see Tweet)
“We believe that value-based care, implemented using lean principles and in conjunction with an ongoing, community-wide effort to address social determinants of health, can reduce health spending and deliver on the promise of better health”
“Untrained bystander CPR had better outcomes when given telephone advice from EMS services to perform continuous CPR, rather than interrupted CPR with rescue breaths”. For trained EMS professionals, “it is possible that there is little or no difference between the two approaches”.
Related report from UK: Each Baby Counts – Royal College of Obstetricians and Gynaecologists (free PDF) Each Baby Counts Homepage (free resources) AND Reducing baby deaths and brain injuries during childbirth – BBC News (free)
Every year, 2.7 million babies die in the first 28 days of life. 75% of these deaths are preventable.
“The practice of radiology is unsafe and needs to change says, Giles Maskell” (RT see Tweet)
The possible benefits of applying the “Lean” approach to oncology care delivery.
Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management: A Scientific Statement for Healthcare Professionals From the American Heart Association (free)
News Release: Healthcare providers should individualize patient education (free)
AHA statement: Doctors’ orders should include tailored health education for patients (free)
Commentary: Sharpening the Focus on Therapeutic Patient Education and Self-management (free)
Top Ten Things to Know: Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management (free PDF)
Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis – The Lancet Infectious Diseases (link to abstract – $ for full-text)
Commentaries: Antibiotic Stewardship Programs Linked to Lower Rates of Drug-Resistant Infections – Physician’s First Watch (free) AND Review ties stewardship to sharp drop in resistant bacteria – CIDRAP (free)
Surgeon-level variation in complications among surgeons was nearly twice as great for Minimally Invasive Colectomy than for Open Colectomy, implying a need for improved training in adoption of minimally invasive techniques.
Why overtreatment and overdiagnosis can be bad for your health – CBC Radio (free text and audio)
2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty (free)
Press release: New Guideline Aims to Reduce Infections in Total Hip & Knee Replacement Patients (free)
Commentaries: New medication guidelines for rheumatic disease patients having joint replacement – Hospital for Special Surgery, via EurekAlert (free) AND New Guidelines Issued on Antirheumatic Drugs for Patients Undergoing Knee or Hip Replacement – Physician’s First Watch (free)
New Choosing Wisely List: American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question (free)
Commentary: NOAC Doses: Just Stick to the Label – MedPage Today (free registration required)
“Among the 1,473 patients with a renal indication for dose reduction, 43.0% were potentially overdosed, which was associated with a higher risk of major bleeding”
Association of Adverse Events With Antibiotic Use in Hospitalized Patients – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentary: Antibiotic-Associated Adverse Events Common – Medscape (free registration required)
Related: 11 Things the Health Care Sector Must Do to Improve Cybersecurity – Harvard Business Review (a few articles per month are free) AND Eric D Perakslis: Cyber security modeled as infection prevention and control in the healthcare delivery setting – The BMJ Opinion (free) AND Healthcare Seen Highly Vulnerable to Cyberattack – MedPage Today (free registration required)
Handshake-free zone in a neonatal intensive care unit: Initial feasibility study – American Journal of Infectious Control (link to abstract – $ for full-text)
Commentaries: Hospitals Could One Day Be Handshake-Free Zones To Prevent The Spread Of Disease – WBGH News (free) AND Handshake-Free Zone: Stopping the Spread of Germs in the Hospital – Medscape (free registration required) AND Handshake-Free Zones Target Spread Of Germs In The Hospital – NPR Health News (free)
Commentaries: Quickly reporting cancer complications may boost survival – STAT News (free) AND If This Were a Drug, the Price Would Be $100,000 – Medscape (free registration required) AND How a simple tech tool can help cancer patients live longer – The Washington Post (free)
“For surveillance of cancer, digital tracking of patient-generated data improves survival”. “The cost of digital tracking is very low and > 5 months median survival improvement is more than cancer drugs that cost > $100,000” (RT @EricTopol see Tweets and Answers)
News release: How to Effectively Engage Patients in Patient Safety: New Guide available (free)
Perspectives: Changing the narratives for patient safety – World Health Organization (free)
Commentary: New Guidance Focuses on Best Injection Practices for Diabetes – Medscape (free registration required)
Related guideline: New Insulin Delivery Recommendations – Mayo Clinic Proceedings (free)
See also a recent study showing high complication rates of laparoscopic gastric band surgeries in our May 23rd issue (see #7)
Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery: A Cluster Randomized Clinical Trial – JAMA Surgery (free) (RT @PreetiNMalani see Tweet)
Multicomponent nonpharmacologic interventions, including orienting communications, oral and nutritional assistance, and early mobilization reduced postoperative delirium by 56% and length of stay by 2 days.
Reoperation and Medicare Expenditures After Laparoscopic Gastric Band Surgery – JAMA Surgery (link to abstract – $ for full-text)
Commentaries: Following gastric band surgery, device-related reoperation common, costly – Science Daily (free) AND Safety, Effectiveness of Gastric Banding Called Into Question – Medscape (free registration required) AND 1 In 5 Gastric Band Surgeries Require Corrective Operations – American Council on Science and Health (free)
Evidence for the treatment of pressure ulcers reviewed.
See related study on the use of Medications of Questionable Benefit at the End of Life in our April 10th issue, see #8 and Deprescribing guidelines for elderly in our May 8th issue, see #4.
“Nearly half of older adults in Sweden take 10 or more medications in their last months of life” (from Science Daily)
Commentaries: Meta-Analysis: Just a Week of NSAID Use Tied to Increased Heart Attack Risk – Journal Watch (free) AND Common painkillers linked to increased risk of heart attack, study says – CNN (free) All NSAIDs Linked to Increased MI Risk – Medscape (free registration required)
Another study suggesting NSAIDs may be associated with increased cardiovascular risk.
Postmarket Safety Events Among Novel Therapeutics Approved by the US Food and Drug Administration Between 2001 and 2010 – JAMA (link to abstract – $ for full-text)
Commentaries: Nearly 1 In 3 Recent FDA Drug Approvals Followed By Major Safety Actions – Scientific American (free) AND One in Three Newly Approved Drugs Has Safety Issues – MedPage Today (free registration required) AND Safety Events Common in Newly Approved Drugs – Medscape(free registration required) AND New safety risks detected in one-third of FDA-approved drugs – The Washington Post (free) (RT @EricTopol see Tweet) AND One-Third Of New Drugs Had Safety Problems After FDA Approval – NPR Health News (free)
*Newer is not always better.
Invited commentary: Surgical Site Infection Prevention – What We Know and What We Do Not Know – JAMA Surgery (free)
Commentary: ‘Long-Awaited’ CDC Guidelines on SSI Prevention Released – Medscape (free registration required)
Editor’s Choice: Give patients access to their medical records – The BMJ, by Fiona Godlee, editor in chief (free)
Patients are being empowered in decisions regarding their health care, and this is probably a tendency for the future.
“How frequently should indwelling urinary catheters be changed? Are catheter washouts effective? Which type of catheter reduces rates of urinary tract infection?”. This post look at the evidence regarding urinary catheter care.
Original article: Non-steroidal anti-inflammatory drug use is associated with increased risk of out-of-hospital cardiac arrest: a nationwide case–time–control study – European Heart Journal – Cardiovascular Pharmacotherapy (free)
Source: Common Nursery Products Send Thousands of Children to Hospitals – The New York Times (10 articles per month are free) (RT @CMichaelGibson)
Baby carriers, mattresses, strollers, high chairs, changing tables, bath seats and other ordinary nursery products lead to injuries and emergency room visits for 66,000 children a year in U.S.
Relationship between hospital ward design and healthcare-associated infection rates: a systematic review and meta-analysis – Antimicrobial Resistance & Infection Control (RT @brhospitalist and @PreetiNMalani see Tweet)
Single-patient rooms and easily accessible hand rub dispensers located near the patient’s bed are the most effective measures.
Mortality Trends After a Voluntary Checklist-based Surgical Safety Collaborative – Annals of Surgery (link to abstract – free PDF available)
Sources: Global Health NOW Newsletter (free) AND South Carolina Hospitals Saw Surgery Deaths Drop After Implementing WHO Checklist – AJMC News (free) AND A simple checklist prevents deaths after surgery, a large new study suggests – The Washington Post (a few articles per month are free)
See also: WHO Surgical Safety Checklist – World Health Organization (free) AND A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population – New England Journal of Medicine (free)
Corticosteroids, even if used for short periods of time, seems to be associated with significant morbidity and mortality. In this retrospective cohort with 1.5 million adults, the incidence of acute adverse events (sepsis, venous thromboembolism, fracture) increased by twofold to fivefold above background rates.
See also: ACP: Stop Saddling Docs With Administrative Tasks – MedPage Today (free registration required)
“It’s time for all those involved in the healthcare industry to reevaluate and reduce the administrative task burden placed on clinicians” (from MedPage commentary above).
Going Under the Knife, With Eyes and Ears Wide Open – New York Times (free access to 10 articles per month)
“More and more surgeries are being performed with the patient awake and looking on, for financial and medical reasons”.