The American journal of managed care
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Secure messaging and phone encounters are becoming widespread to increase patient access to providers between ambulatory care visits. Although these encounters have the potential to improve the control of diabetes risk factors,we know little about their content in relation to traditional in-person visits. ⋯ In this system, patients with diabetes reported significantly fewer risk factor discussions during between-visit encounters compared with in-person visits. These results suggest potential missed opportunities for proactive support of risk factor management.
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An optimal treatment approach to rheumatoid arthritis (RA) is guided by the American College of Rheumatology (ACR) 2012 recommendations. RA should be diagnosed early in the disease process and treatment should be commensurate with the degree of disease activity and the presence or absence of predictors of poor prognosis. The Agency for Healthcare Research and Quality (AHRQ) has recently provided a comparative review of medication for RA. The treatment of RA with conventional disease-modifying antirheumatic drugs and biologic agents, including tumor necrosis factor (TNF) inhibitors and non-TNF biologics (abatacept, rituximab, tocilizumab) will be discussed in the context of the ACR recommendations and the AHRQ review.
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Cost-effectiveness analyses compare the value of different treatment strategies, given that one strategy is more effective but also more costly than the other. The results are often used as a pharmacoeconomic basis to support a particular treatment strategy. ⋯ Most published cost-effectiveness analyses regarding antiviral treatment of hepatitis B or hepatitis C reported favorable results. These results may suggest that researchers only attempt cost-effectiveness studies when there is a high likelihood of positive results. Regardless of the explicit cause of the bias, more awareness and scrutiny are needed when utilizing cost-effectiveness studies in decision making.