An app for aspirin, an antidote for opioids: 2 of the 6 topics in our slide show of notable studies on the Web.
New App Guides Aspirin Use for Cardiovascular Disease.
The Aspirin-Guide app, a new evidence-based clinical decision support tool, helps clinicians decide which patients are candidates for the use of low-dose aspirin in the primary prevention of atherosclerotic cardiovascular disease and which patients are at too great a risk for bleeding. Created by clinicians at Boston’s Brigham and Women’s Hospital, the app calculates a patient’s 10-year CVD and bleeding risk scores based on individual risk factors.
JAMA Internal Medicine, June 20, 2016
Help Older Patients Who Need Help With Medications.
A new brief measurement tool, the Older Adults Medication Assist Scale, was developed to identify seniors who would potentially need help taking medications. Based on a representative sample of community-dwelling older adults, characteristics associated with need for help were age 80 years and older, being male, living with others, having 4 or more chronic conditions, and impaired cognitive or functional status. Clinicians can use the predictive tool to assist with medication management.
Journal of the American Geriatrics Society, June 20, 2016
Naloxone Coprescribed with Opioids in Primary Care is Win-Win.
Unintentional overdose involving opioid analgesics is now a leading cause of injury-related death. Researchers evaluated the feasibility and impact of co-prescribing naloxone for primary care patients taking long-term opioids for chronic pain. There were 47% fewer opioid-related ED visits per month (overdose, fall, medication requests) in the 6 months after naloxone was provided. The results support the addition of naloxone to long-term opioid regimens.
Annals of Internal Medicine, June 28, 2016
High-quality End-of-Life Care Needed for Illnesses Other Than Cancer.
Efforts to improve end-of-life care have focused primarily on patients with cancer, but high-quality care is critical for patients with other illnesses. In a retrospective cross-sectional study, family-reported quality of end-of-life care was significantly better for patients with cancer or dementia than for those with end-stage renal disease, cardiopulmonary failure, or frailty, largely because of higher rates of palliative care consultation and do-not-resuscitate orders.
JAMA Internal Medicine, June 26, 2016
Clerical Burden of EHRs Leads to Physician Burnout.
Physicians' satisfaction with their electronic health records and computerized physician order entry was generally low in a large national study. Those who used EHRs and CPOE were less satisfied with the amount of time they spent on clerical tasks and were at higher risk for professional burnout. The results remained after adjusting for age, sex, specialty, practice setting, and hours worked per week.
Mayo Clinic Proceedings, Article in press
Cardiovascular Mortality Decline Has Slowed Down.
The decline of all CVD, heart disease, and stroke mortality rates has decelerated substantially since 2011. HD mortality had declined at a much greater rate than cancer mortality during the first decade of the 21st century, and it appeared that cancer would overtake HD as the leading cause of death. If the trend continues, American Heart Association and the Million Hearts Initiative goals for lowering the burden of CVD may not be reached. Authors call for “continued vigilance and innovation” to improve CVD prevention.
JAMA Cardiology, June 29, 2016
Recent medical news around the Web is worth a closer look. We selected 6 studies of note to primary care and summarized them in the slides above. Topics include: a new app to identify patients appropriate for aspirin use to prevent CVD; a brief scale to identify older patients who may need help with medications; coprescription of naloxone with opioids for chronic pain, and high-quality end-of-life care for illnesses other than cancer.Find links to studies/abstracts below.