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Interventions for hand eczema

Author/s: 
Christoffers, W.A., Coenraads, P.J., Svensson, Å., Diepgen, T.L., Dickinson-Blok, J.L., Williams, H.C., Xia, J.

Abstract

BACKGROUND:

Hand eczema is an inflammation of the skin of the hands that tends to run a chronic, relapsing course. This common condition is often associated with itch, social stigma, and impairment in employment. Many different interventions of unknown effectiveness are used to treat hand eczema.

OBJECTIVES:

To assess the effects of topical and systemic interventions for hand eczema in adults and children.

SEARCH METHODS:

We searched the following up to April 2018: Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, AMED, LILACS, GREAT, and four trials registries. We checked the reference lists of included studies for further references to relevant trials.

SELECTION CRITERIA:

We included randomised controlled trials (RCTs) that compared interventions for hand eczema, regardless of handeczema type and other affected sites, versus no treatment, placebo, vehicle, or active treatments.

DATA COLLECTION AND ANALYSIS:

We used standard methodological procedures expected by Cochrane. Primary outcomes were participant- and investigator-rated good/excellent control of symptoms, and adverse events.

Keywords 
access Pruritus Inflammation Eczema/drug therapy

How to Excel at Access — and Why It Matters

Author/s: 
Mils, Terry

Health care spending in the United States totaled $3.3 trillion in 2016, more than double the amount spent in 2000. Twenty percent of the cost went toward physician services, with primary care accounting for approximately 7 percent.

These rising costs have real consequences for patients. A Kaiser Family Foundation survey found that, because of cost, 67 percent of the uninsured and 21 percent of the insured had forgone needed medical care. To address costs, payers are increasingly adopting reimbursement models that reward or penalize physicians based on their ability to keep costs down.

Now here’s the good news: When it comes to rising health care costs, we in primary care are not the main problem, but we are a key part of the solution. This article will explain how improving access to primary care can reduce costs and the steps practices should begin taking now.

Keywords 
primary health care access
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