Measuring to Improve Medication Reconciliation in a Large Subspecialty Outpatient Practice.

Background: To assess performance in medication reconciliation (med rec)-the process of comparing and reconciling patients' medication lists at clinical transition points-and demonstrate improvement in an outpatient setting, sustainable and valid measures are needed.

Methods: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs), and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR).

Improving asthma care in rural primary care practices: a performance improvement project.

Introduction: Rural areas are often underserviced health areas, lack specialty care services, and experience higher levels of asthma-related burden. A primary care, asthma-focused, performance improvement program was provided to a 6-county, rural-frontier region in Colorado to determine whether asthma care practices could be enhanced to become concordant with evidence-based asthma care guidelines.

Methods: A pre-post, quasi-experimental design was used.

Heterogeneity of response to asthma controller therapy: clinical implications.

Purpose Of Review: Patients with asthma exhibit heterogeneous responses to all classes of asthma medication. This review examines clinical characteristics, biomarkers of inflammation, and genetic polymorphisms associated with treatment responsiveness in studies of adults and children with asthma, with an emphasis on inhaled corticosteroids and leukotriene modifiers.

Recent Findings: Recent clinical studies extended previous observations of associations between biomarkers of allergic inflammation and responsiveness to inhaled corticosteroids, and between cigarette smoke exposure and responsiveness to montelukast.

Airway fibroblasts exhibit a synthetic phenotype in severe asthma.

Background: Platelet-derived growth factor (PDGF) may have a significant role in airway remodeling in asthma, because it is a powerful inductor of many airway fibroblast activities such as collagen synthesis.

Objective: To determine whether PDGF is a significant contributor to airway remodeling in patients with asthma by enhancing airway fibroblast procollagen I expression.

Methods: Six normal controls without asthma, 10 subjects with mild to moderate asthma, and 5 subjects with severe asthma underwent bronchoscopy with endobronchial biopsy.

Winter air pollution and disease parameters in advanced chronic obstructive pulmonary disease panels residing in Denver, Colorado.

Background: Ambient pollution might worsen chronic obstructive pulmonary disease (COPD).

Objective: We explored the associations of pollution to pulmonary function, rescue medication, and symptoms over 2 winters in 2 panels of subjects with advanced COPD in Denver, Colorado.

Methods: Subjects measured lung function and recorded symptoms and rescue medications.

Survival of individuals receiving long-term mechanical ventilation.

The reports published to date support the concept that LTMV can extend life for patients with respiratory insufficiency, particularly adults and children with neuromuscular and chest wall diseases. The impact of LTMV on survival in patients with obstructive lung diseases, such as COPD and bronchiectasis, is less clear and deserves further study. For all disease states, research is needed to determine the characteristics of patients who are most likely to benefit from LTMV and whether one method of ventilation is superior to another.