Geriatric Care Issues: An American and an International Perspective.

As the global population ages, there is an opportunity to benefit from the increased longevity of a healthy older adult population. Healthy older individuals often contribute financially to younger generations by offering financial assistance, paying more in taxes than benefits received, and providing unpaid childcare and voluntary work. Governments must address the challenges of income insecurity, access to health care, social isolation, and neglect that currently face elderly adults in many countries.

Conducting medication safety research projects in a primary care physician practice-based research network.

Objective: To describe a roadmap for developing a practice-based research network (PBRN) through the experience of conducting medication safety research projects in a primary care physician PBRN.

Setting: Southern Primary-care Urban Research Network (SPUR-Net) in Houston, Tex., from 2000 to 2007.

Development of a Web-based quarterly profile of providers in ATP III study.

A Web-based programmed lipid management reminder system has been developed to evaluate physician compliance with the National Cholesterol Education Program's Third Report of the Adult Treatment Panel Guidelines in primary care clinics. The system builds a knowledge-based database from an EMR database first, then generates quarterly profiles of providers and sends the profiles with a reminder letter to each participated physicians by email every quarter to help primary care providers to improve the quality of their care.

EM clustering analysis of diabetes patients basic diagnosis index.

Cluster analysis can group similar instances into same group and different instances into different groups. It assigns classes to samples without known the classes in advance. EM clustering algorithm can find number of distributions of generating data and build "mixture models".

Development of a Web-based diabetes patient management tool.

A Web-based programmed lipid management reminder system has been developed to evaluate physician compliance with the National Cholesterol Education Program's Third Report of the Adult Treatment Panel Guidelines in primary care clinics. The system builds a knowledge-based database from an EMR database first, then generates quarterly profiles of providers and sends the profiles with a reminder letter to each participated physicians by email every quarter to help primary care providers to improve the quality of their care.

Stress perceptions in community clinic: a pilot survey of patients and physicians.

This pilot survey of 103 patients and 17 physicians in an urban family medicine clinic gathered information pertinent to the design of a feasible stress intervention for patients bothered by stress, but who did not have a psychiatric diagnosis. Among patients, 45% reported being excessively bothered by stress in the preceding month, with the chief stressors being job (70% reporting), financial worries (58%) and family concerns (50%). Patients reported a variety of problems perceived to be related to stress, such as headaches, insomnia, eating control, and gastrointestinal symptoms.

Collaborative drug therapy management services and reimbursement in a family medicine clinic.

Purpose: The legislative and regulatory issues surrounding the reimbursement of pharmacists for cognitive services are reviewed and billing practices for a pharmacist-physician collaborative drug therapy management service (DTMS) in a family medicine clinic are examined. A case study is offered to illustrate the real-world application of these practices.

Summary: As regimens of prescription medications have become more complex and the potential for adverse drug reactions and interactions has increased, the need for individualized optimal drug therapy and drug-therapy experts has grown.

A wireless mobile health-related quality of life assessment.

Self-administered waiting room questionnaires are popular tools for gathering health information from patients, but they require optical scanning or manual data entry to obtain survey results. The application described here eliminates those extra steps by inputting the results into a remote database directly through wireless connection, and the assessment can be finished easily anywhere in the clinic through a mobile platform. A measure of health-related quality of life, the SF-8 Health Survey, was used in developing this application for using in the clinical setting.

Urea breath testing and analysis in the primary care office.

The 13C-urea breath test provides accurate, noninvasive diagnosis of active Helicobacter pylori infection and can document posttherapy cure. This study evaluated point-of-care testing with onsite sample analysis with the use of a desktop infrared spectrophotometer. Ambulatory patients (N=320) underwent 13C-urea breath testing, and breath samples were analyzed immediately by clinic staff with no prior breath testing experience.