Arizona County Approves Integrative Care Plan

From an article at Dr. Weil.com

In a vote that may ultimately boost acceptance of integrative medicine (IM) throughout the U.S., the Maricopa County Board of Supervisors unanimously agreed on Nov. 28, 2011, to allow the county’s employees and their dependents to receive primary care at an IM clinic scheduled to open in Phoenix, Ariz., in July of 2012. The Arizona Center for Integrative Medicine (AzCIM) will study patient outcomes to determine the effectiveness and costs of integrative versus conventional primary care within the county’s 13,000 employee system.

New Brief Outlines Strategies to Put Patients at the Center of Primary Care

From the press release

AHRQ has released a new brief, The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care, highlighting opportunities to improve patient engagement in primary care.  The brief focuses on involvement at three levels: the engagement of patients and families in their own care, in quality improvement activities in the primary care practice, and in the development and implementation of policy and research related to the patient-centered medical home (PCMH).  Strategies to Put Patients at the Center of Primary Care provides a clear and concise definition of the patient-centered medical home and outlines six strategies that can be used to support primary care practices in their efforts to engage patients and families.  This brief and other resources, including white papers and a searchable database of PCMH-related articles, is available from AHRQ’s online PCMH Resource Center at PCMH_Patients at the Center of Primary Care (PDF File, PDF Help).

Related articles

• Health-care model improves diabetes outcomes, health (eurekalert.org)
• More On The Synergies Between the Patient Centered Medical Home (PCMH) and Remote Telephonic Disease Management (diseasemanagementcareblog.blogspot.com)

Guided care reduces the use of health services by chronically ill older adults

Guided care reduces the use of health services by chronically ill older adults

From the March 14 2011 Science Daily news item

ScienceDaily (Mar. 14, 2011) — A new report shows that older people who receive Guided Care, a new form of primary care, use fewer expensive health services compared to older people who receive regular primary care.

Research published in the March 2011 edition of Archives of Internal Medicine ***found that after 20 months of a randomized controlled trial, Guided Care patients experienced, on average, 30 percent fewer home health care episodes, 21 percent fewer hospital readmissions, 16 percent fewer skilled nursing facility days, and 8 percent fewer skilled nursing facility admissions. Only the reduction in home health care episodes was statistically significant.

According to the study, Guided Care produced even larger reductions in a subset of patients who received their primary care from one well managed health system. Guided Care patients in Kaiser Permanente of the Mid Atlantic States experienced, on average, 52 percent fewer skilled nursing facility days, 47 percent fewer skilled nursing facility admissions, 49 percent fewer hospital readmissions, and 17 percent fewer emergency department visits; the differences for skilled nursing facility days and admissions were statistically significant….

More information about Guided Care is available at  twww.GuidedCare.org.
From the Web site…”Guided Care® is a new solution to the growing challenge of caring for older adults with chronic conditions and complex health needs. A Guided Care nurse, based in a primary care office, works with 2-5 physicians and other members of the care team to provide coordinated, patient-centered, cost-effective health care to 50-60 of their chronically ill patients. The Guided Care nurse conducts in-home assessments, facilitates care planning, promotes patient self-management, monitors conditions monthly, coordinates the efforts of all health care professionals, smoothes transitions between sites of care, educates and supports family caregivers, and facilitates access to community resources. ”

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Related Articles

• Guided Care improves physician satisfaction with patient/family communications (scienceblog.com)
• Chronic disease care poorer in nursing and residential homes under GP target scheme (eurekalert.org)
• Post Trauma Care: Better Chance Staying At Home (medicalnewstoday.com)

Adding pharmacists to docs’ offices helps patient outcomes, study shows

From a November 15, 2010 Eureka news alert

Adding pharmacists to the primary care team right in doctors’ offices may help patients with chronic diseases such as diabetes better manage associated risks, a new University of Alberta study had found. The blood pressure of patients with Type 2 diabetes dropped significantly when pharmacists were included in the on-site clinical examination and consulting process, the U of A study showed. Among 153 patients whose hypertension was inadequately controlled at the beginning of the study, the 82 who had advice from a pharmacist were more likely to reach blood pressure treatment targets recommended by the Canadian Diabetes Association. As well, the study showed that with input from pharmacists, the predicted 10-year risk of cardiovascular disease for patients with Type 2 diabetes will drop by three per cent. The results were reported online by Diabetes Care, and are scheduled to appear in the January 2011 issue of the journal. The study can currently be found online at http://diabetes.org/diabetescare. “Pharmacists can play a more active role in primary care and community clinics,” said Scot Simpson, lead author of the study. “We’ve already been actively collaborating on health care teams for years in hospitals.” Placing pharmacists in the doctor’s office instead of in a more traditional role at the neighbourhood pharmacy allows for a more collaborative frontline approach to medication management in primary care, Simpson said. “The doctors, nurses and pharmacists can directly discuss issues specific to any one patient, and by doing so, have the best outcome for the patient.” High blood pressure and other cardiovascular risk factors are common in people with diabetes, so effective management of medications is key to helping reduce the risk of heart attacks and stroke, Simpson added. ### For more information on the study contact: Scot Simpson, associate professor Faculty of Pharmacy and Pharmaceutical Sciences University of Alberta 780-492-7538 ssimpson@pharmacy.ualberta.ca

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