MedicalResearch.com Interview with:
Mark W Ketterer PhD, ABPP
Henry Ford Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Ketterer: Reducing wasteful healthcare costs is a high priority For Medicare/Medicaid, Obamacare and all third party payors. Cognitive impairment (CI) is highly prevalent in patients with chronic illnesses identified as having high readmission rates by the Center for Medicare and Medicaid Services (1,2,3), such as Congestive Heart Failure (4,5), End Stage Renal Disease (6,7) and Chronic Obstructive Pulmonary Disease (8-14). CI is also a known prospective predictor of longer term admissions and deaths (15-18). Poor adherence is a frequent consequence of cognitive impairment (19,20), particularly when the family and/or patient have not yet recognized and intervened for the evolving problem, or the patient is not in a setting (e.g., Nursing Homes) that supervises medication administration
MedicalResearch.com: What should clinicians and patients take away from your report?
- Aggressive evaluation of heart failure patients for cognitive impairment.
- Involvement of family in maximizing adherence is better care, and more efficient care.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Ketterer: A randomly-assigned, controlled clinical trial of this intervention is warranted, needed and should be a high priority in healthcare research.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Ketterer: As currently constructed, our healthcare system neglects common behavioral causes of waste, misdiagnosis and treatment failure. Nonrecognition of cognitive impairment in heart failure patients is about 90%. This can be a catastrophic failure for a given patient, resulting in a preventable death.
Mark W. Ketterer, PhD; Jennifer Peltzer, PsyD; Usamah Mossallam, MD; Cathy Draus, RN; John Schairer, DO; Bobak Rabbani, MD; Khaled Nour, MD; Gayathri Iyer, MD; Michael Hudson, MD; and James McCord, MD –
Mark W Ketterer PhD, ABPP (2016). Unrecognized Cognitive Impairment in Heart Failure Patients Increases Costs and Readmissions