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Clinical Accuracy Spoken Here
COPD: Controversial Corticosteroid Use

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, corticosteroids may be considered in the patient with moderate- to-severe airflow compromise with persistent symptoms while on optimal bronchodilator therapy. Corticosteroids are not intended for long-term use in the otherwise stable patient. Inhaled corticosteroids are frequently prescribed for maintenance therapy in COPD patients, which is not in keeping with GOLD recommendations.

COPD: Module C, Pharmacologics www.athenaforum.com

Obesity Management: Measurements

Methods of assessing body fat are:

  • Body Mass Index (BMI) – a tool used to assess obesity

  • Waist circumference (WC) – measures abdominal obesity (linked to increased risk of obesity related diseases). It is useful for case managers to note that decreases in waist size may provide a more vivid indication of weight loss

  • Waist-to-Hip Ratio (WTH) – waist circumference divided by hip circumference. Waist-to-height ratio (WHtR) – waist circumference should not exceed half of the height.

Obesity Management, Module B, Assessment and Complications
Excellence in Case Mgmnt
UM: Appropriate LOC?

The most popular form of UR in hospitals today involves the application of guidelines to determine the appropriateness of a hospital admission or continued stay. These criteria are generally applied by case managers to information contained in the medical record to determine whether the hospital admission and each subsequent day and service provided are "appropriate" or "inappropriate" at a specific level of care (LOC). Information is captured demonstrating that the use of the acute care setting is justified. On the surface, this process appears to be benign. In reality, the challenges can be overwhelming.

[Reference: UM: Module A, Standards and Regulations of UM]
In the Headlines . . .
Clinical Trial Finds Commonly Used 3-Drug IPF Regimen Harmful

The National Heart, Lung, and Blood Institute (NHLBI) has stopped one arm of a three arm multi-center, clinical trial studying treatments for the lung-scarring disease idiopathic pulmonary fibrosis (IPF) for safety concerns. The trial found that people with IPF receiving a triple-drug therapy consisting of prednisone, azathioprine, and N-acetylcysteine (NAC) had worse outcomes than those who received placebos or inactive substances. [NIH News, 10.21.11]

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The look of confidence
  CM Excellence® Series: 
  » Principles of Case
  » Patient Advocacy
  » Utilization Management
  » Discharge Planning
  » Hospital Revenue Cycle

  Clinical Series: 
  » Asthma
  » Behavioral Health
  » Colorectal Cancer
  » COPD
  » CV Risk: Stroke & MI
  » Diabetes
  » EOL & Palliative
  » GI Disorders
  » Heart Failure
  » Multiple Sclerosis
  » Obesity Management
  » Pain Management
  » Rheumatoid Arthritis
  » Women’s Health



Cathy Wright Cathy Wright, BSN, RN
Clinical Editor
Athena Forum


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