Black patients with hypertension are not being prescribed the appropriate medication for their condition. This conclusion is drawn from analysis of data on 658 patients enrolled in a collaborative NIH study conducted by researchers at the Visiting Nurse Service of New York and Weill Cornell Medical College.¹ The 658 patients, all of whom entered home care with uncontrolled hypertension, came from a variety of referral sources with different primary physicians.

It wasn’t that the patients were untreated—all but 5.5% of them had at least one prescription for hypertension. It’s that more than…

If you’ve got osteoarthritis of the knee severe enough to warrant total joint replacement it would seem counterintuitive to further stress the joint—and cause yourself more pain—by carrying out a regimented exercise program in the weeks prior to the operation.

Yet, in an admittedly small clinical trial, patients undergoing what’s called prehabilitation reported better quality of life three months post-surgery than the control group who had no prescribed exercise regimen.

The routine consisted of three 45-minute sessions a week beginning at about 8 weeks prior to surgery. One session was held at…

The Nurse-Family Partnership, a home visitation program for first-time mothers in 42 U.S. states and the Virgin Islands, has examined data for the state of Pennsylvania and found good results for its quit-smoking-in-the-last-trimester of pregnancy program.  The analysis also found that results varied according to local geography.

The NFP, which operates in 24 counties in Pennsylvania, intuitively theorized that it would be harder to succeed with its anti-smoking program in geographic areas where smoking is the community norm.

But intuition is not the same as evidence. So the NFP decided to investigate…

Approached properly, the frail elderly (mean age 80 years) are willing to accept and use a telehealth medication dispenser meant to ensure they receive the right drugs at the right time, according to a new report.

This study was not devised to test a particular brand of dispenser, but rather to test the concept that an automated dispenser, with home-nurse coordination, would be more satisfying and reliable than a compartmented dispenser box, also with nurse coordination.

The trial participants were recently discharged clients of three Medicare-certified home care agencies in Milwaukee. The…

A new Government-sponsored study estimates that almost 15% of Americans over the age of 70 have dementia, and that the cost to take care of them was somewhere between $157 billion and $215 billion in the year 2010 (of which Medicare paid the proportionally small sum of $11 billion).

In looking at how the money was dispersed, the researchers set up two categories: care purchased in the marketplace, and informal care given by family/friends.

In the purchased-care category, the largest single expenditure was for nursing homes, which cost $13,876 per patient in…

A new study will investigate whether children with dermatomyositis, an autoimmune disease marked by muscle weakness and fatigue, can benefit from a home exercise program of treadmill walking and strength training.

The hope is that such exercise will slow down muscle deconditioning from inactivity, which puts the children into an ever-descending spiral that inevitably results in the other damaging effects of a sedentary life. There is also a question as to whether the exercise program can reduce the systemic inflammation of the small blood vessels of muscle and skin—the hallmark of…

Most Americans say they want to die at home, and in the years between 2000 and 2009 the percentage of home deaths did in fact increase, while the percentage of in-hospital deaths decreased, according to a look-back at a random sample of 66-and-older Medicare fee-for-service patients.¹ During the same period, hospice use doubled.

Both sets of figures, while correct, are misleading. A closer look at the records tells a much different story. Because, while a smaller percentage of  patients actually died in the hospital, the percentage of patients hospitalized in their last…

Improving the quality of life of patients with Parkinson’s disease is a major goal of clinicians and researchers. And there is increasing interest in home as the site of the effort.  In a recently published 20-patient pilot study, semi-supervised home treadmill exercise, carried out four times a week for six weeks, has been found to be both feasible and safe.¹

While there was no difference in walking capacity between the treadmill group and control patients, the treadmill-walkers experienced significantly less fatigue, and reported better quality-of-life at six-week follow-up.

In another, ongoing,…

The Visiting Nurse Service of New York has reported additional research showing that continuity of care is an important factor in patient improvement. In previous research, the agency found that acute care patients seen by the same nurses had fewer visits to the emergency room, and that both these patients and physical therapy patients were less likely to be hospitalized within 60 days of VNSNY enrollment.

Now the agency has analyzed records on more than 16,000 of its patients, with a variety of medical diagnoses, who received home health aide services….

This year there’s been a mini-explosion in the number of research groups racing to determine whether whole body vibration machines (WBV), with a shaker plate that’s designed to amplify traditional exercise, can boost workout benefits in persons with chronic obstructive pulmonary disease (COPD).

Earlier this year, one group reported a significant improvement in six-minute walking ability for patients who did squats on a machine as compared to controls. But they were in-patients. Now, a different group is carrying out an in-home study of WBV.

In the new trial, patients will serve as…