The American journal of managed care
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Cough serves a protective physiologic function as a vital defensive reflex preventing aspiration. However, exposure to viral infections or other triggers induces, in some individuals, a chronic cough (CC) that causes a significant symptomatic burden. ⋯ Currently, available therapeutic options for refractory CC are inadequate due to limited efficacy and frequently intolerable adverse effects. Current professional society guideline recommendations are discussed, and a promising pipeline of antitussive drugs in development is introduced, including purinergic 2X3 receptor antagonists, neurokinin-1 receptor antagonists, oral mixed ĸ-opioid receptor agonists/µ-opioid receptor antagonists, and voltage-gated sodium channel blockers.
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Severe asthma accounts for 5% to 10% of asthma cases. Despite this, patients with uncontrolled severe asthma consume significant healthcare resources. Approximately 40% of patients with severe asthma have uncontrolled disease. ⋯ Healthcare professionals need to consider phenotype and endotype to individualize patient treatment. As medications and hospitalizations are the largest drivers of asthma-related costs to health systems, choosing optimal therapies to reduce uncontrolled symptoms and exacerbations curbs cost. Successful disease management strategies are employed by managed care organizations that have a collaborative team to ensure patient access to biologics.
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To estimate the cost savings associated with a pedometer-based, web-mediated physical activity intervention in a cohort of US veterans with chronic obstructive pulmonary disease (COPD). ⋯ A pedometer-based, web-mediated physical activity intervention yielded substantial cost savings. Increased implementation of the intervention could markedly reduce the economic burden of COPD for payers and patients.
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The authors examine the origin, benefits, and challenges of pragmatic clinical trials to assess the ultimate value of this research design.
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Because physicians' decisions drive health care costs and quality, there is growing interest in applying behavioral economics approaches, including behavioral nudges, to influence physicians' decisions. This paper investigates adoption of behavioral nudges by health system-affiliated physician organizations (POs), types of nudges being used, PO leader perceptions of nudge effectiveness, and implementation challenges. ⋯ Nudge use remains limited in practice. Opportunities exist to expand use of nudges to influence physician behavior; however, expanding use of behavioral nudges will require PO investment of resources to support their construction and maintenance.