Publications by authors named "Boucher N"
Purpose: To evaluate practice patterns and long-term complications of proliferative diabetic retinopathy (PDR) treatment outside DRCR's Protocol S.
Methods: A retrospective cohort study using Vestrum Health Retina Database included 26,632 treatment-naive eyes receiving anti-VEGF injections for PDR between 2016-2021. Primary outcomes were concordance with Protocol S, defined as four anti-VEGF injections within 14 weeks of baseline, and 6-month gaps in care, assessed via multivariable logistic regressions.
In this observational cohort study, incidence of intraocular inflammation following intravitreal injection in the Vestrum Health database was significantly lower with aflibercept 2-mg (EYLEA) prefilled syringes versus vials from 2020 to 2022 (P < 0.0001).
View Article and Find Full Text PDFPurpose: There are currently no best practice training methods with communication assistive devices (CAD) for individuals with deafblindness using a braille display notetaker connected to an iPhone. Therefore, to capture adoption and usability of braille CAD in clinic, the Technology development and evaluation model of Schulz et al. (2015) was applied.
View Article and Find Full Text PDFPurpose: Central retinal artery occlusion, also known as an eye stroke, results in visual impairment and functional challenges. Our study objectives were to identify meaningful measures and factors that indicate or enable successful recovery after eye stroke and to determine optimal processes to support research, including exploring barriers and facilitators to successful research participation.
Methods: We used qualitative methods including the 5Ts Framework (target population identification, team composition, time considerations, tips to accommodate older adults, tools for inclusive enrollment of older adults) to provide a guide to the development of the semi-structured interviews and to help facilitate the research process such as the set-up of interviews.
Background: Postdischarge contacts (PDCs) after hospitalization are common practice, but their effectiveness in reducing use of acute care after discharge remains unclear.
Purpose: To assess the effects of PDC on 30-day emergency department (ED) visits, 30-day hospital readmissions, and patient satisfaction.
Data Sources: MEDLINE, Embase, and CINAHL searched from 2012 to 25 May 2023.
Article Synopsis
- The study investigates risk factors for proliferative vitreoretinopathy (PVR), a common complication after retinal detachment surgery.
- A large patient database was analyzed, identifying systemic (like age, gender, and smoking) and ocular (such as trauma and previous eye conditions) factors that correlate with increased PVR risk.
- The findings emphasize the importance of considering these risk factors in surgical planning and treatment to prevent PVR in patients with retinal detachment.
Objectives: To explore and understand the sources and experiences of joy in caregiving among formal caregivers in Canadian long-term care (LTC).
Design: A qualitative study with interpretative descriptive design.
Setting And Participants: The participants consisted of 20 formal caregivers from a large public LTC home in British Columbia, Canada, focusing on those with at least 6 months of direct caregiving experience.
Purpose: To assess visual outcomes and rate of neovascular age-related macular degeneration (nAMD) development in eyes with geographic atrophy (GA).
Methods: Retrospective analysis of 18,712 eyes with GA using the CorEvitas Vestrum Health Retina Database.
Results: Mean age at index was 78.
To compare the modeled costs of the Protocol AC bevacizumab-first treatment protocol (with a switch to aflibercept for sub-responders) with real-world costs for treatment-naïve patients with diabetic macular edema (DME) over a 2-year period. Published data from the Diabetic Retinopathy Clinical Research Network (DRCR) Protocol AC bevacizumab-first arm (154 eyes) were used to model 2-year treatment costs. Real-world costs were modeled using data from the Vestrum Health electronic medical records database from a 2016 to 2018 cohort of treatment-naïve eyes with DME (n = 1062) treated with antivascular endothelial growth factor monotherapy.
View Article and Find Full Text PDFArticle Synopsis
- Geographic atrophy (GA) is a major cause of vision loss in patients with age-related macular degeneration (AMD), and existing treatments have limitations and risks.
- Researchers conducted a study using data from the Vestrum Health Retina Database to assess whether levodopa (L-DOPA) could lower the risk of developing new-onset GA in patients with non-neovascular AMD.
- The findings indicated that L-DOPA use was associated with a significantly lower likelihood of new-onset GA, suggesting it may be a beneficial factor in managing this condition.
Purpose: To examine rates of submacular hemorrhage in patients undergoing anti-vascular endothelial growth factor (VEGF) injections, comparing rates between specific anti-VEGF agents.
Design: Retrospective clinical cohort study.
Methods: All patients in the database from January 2015 to November 2023 with a diagnosis of neovascular age-related macular degeneration and accompanying submacular hemorrhage (SMH).
Background/objectives: Degenerative joint disease (DJD) of the TMJ can impact patients' quality of life and complicate orthodontic treatment. Stabilizing splints are a common conservative treatment in managing TMDs symptoms, although their long-term effects on condylar morphology are poorly studied. This study aimed to assess the impact of stabilizing splints on condyle morphology using cone-beam computed tomography (CBCT) in patients with various stages of DJD.
View Article and Find Full Text PDFOlder adults and people living with disabilities receive home- and community-based services (HCBS) from approximately 113,000 often under-resourced and inadequately supported direct service workers (e.g., personal care aides, direct support professionals, nurse aides) in North Carolina.
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- Canada legalized recreational cannabis in 2018, leading to more plant waste, especially roots, which are often thrown away but can be useful in medicine.
- A study analyzed the roots of a specific cannabis plant to see what good things they might have, using different methods to test their properties.
- The results showed that the roots had strong abilities to fight inflammation, kill bacteria, and protect cells, especially those grown in soil, making them potentially beneficial for health.
Inpatient clinicians' approach to diagnosis of urinary tract infections in older adults using the COM-B model: a qualitative assessment.
Antimicrob Steward Healthc Epidemiol
September 2024
Our interviews of inpatient clinicians (physicians, physician assistants) modeled after the Capability, Opportunity, and Motivation Model of Behavior model revealed opportunity and motivation as important drivers for overdiagnosis and overprescribing for asymptomatic bacteriuria in older adults. Understanding these barriers is an important step toward implementing age-friendly stewardship interventions.
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- The study aimed to evaluate the impact of the iHI-FIVES caregiver training program on the number of days Veterans spend away from home and the well-being of their family caregivers.
- Involvement included 898 Veterans from 8 medical centers, comparing data from before and after implementing the program through a randomized trial.
- Results indicated a 42% reduction in Veteran days not at home after joining iHI-FIVES, but no significant changes were found in caregiver well-being over the same period.
Introduction: We aimed to understand clinician views regarding gene therapy as a future treatment for Alzheimer's disease (AD) and potential barriers and facilitators to its use.
Methods: We interviewed ten clinicians who treat patients with AD. Clinicians helped design a semi-structured interview including the following domains: establishing understanding, cost/access, quality of life, and religion/spirituality.
Objectives: This review examines health care team-focused interventions on managing persistent or recurrent distress behaviors among older adults in long-term residential or inpatient health care settings.
Methods: We searched interventions addressing health care worker (HCW) knowledge and skills related to distress behavior management using Ovid MEDLINE, Elsevier Embase, and Ovid PsycINFO from December 2002 through December 2022.
Results: We screened 6,582 articles; 29 randomized trials met inclusion criteria.
Purpose: To examine the incidence and risk factors of proliferative vitreoretinopathy (PVR) in the patients who develop rhegmatogenous retinal detachment (RRD) in their fellow eye after having a prior RRD complicated by PVR.
Design: Multicenter, retrospective observational study.
Subjects: Eyes with retinal detachment and PVR between 2015 and 2023 were identified through the Vestrum Health Database.
Article Synopsis
- Family caregivers, who assist loved ones with daily living activities, often face challenges like stress and isolation, heightened during the COVID-19 pandemic.
- A study analyzed survey data from 422 caregivers, examining their experiences of loneliness before and during the pandemic using logistic regression and qualitative content analysis.
- The results showed no significant difference in loneliness levels between the two periods, with caregivers reporting coping skills developed through caregiving that helped them manage pandemic-related challenges.
Background: This study evaluated impact of anti-vascular endothelial growth factor (VEGF) treatment on proliferative diabetic retinopathy (PDR) development among patients with non-proliferative diabetic retinopathy (NPDR) in US real-world clinical practice.
Methods: This was a retrospective analysis of electronic medical records (Vestrum Health; January 2013 to June 2019) of eyes with baseline NPDR, without DME, and naïve to anti-VEGF treatment at index DR diagnosis. Eyes that received anti-VEGF and/or laser treatment over the course of study before development of PDR constituted the treated cohort while the remaining including those treated with laser constituted the anti-VEGF naïve cohort.
In a 2023 sequential explanatory mixed-methods study in four US states, we identified barriers and facilitators experienced by Vaccines for Children (VFC) program providers in reporting vaccination data to state immunization information systems (IISs). We found the following: VFC providers value accurate, robust, and widely used IISs. IIS reporting is easier with but does not require an electronic health record.
View Article and Find Full Text PDFBackground: Blood transcriptomic analysis is widely used to provide a detailed picture of a physiological state with potential outcomes for applications in diagnostics and monitoring of the immune response to vaccines. However, multi-species transcriptomic analysis is still a challenge from a technological point of view and a standardized workflow is urgently needed to allow interspecies comparisons.
Results: Here, we propose a single and complete total RNA-Seq workflow to generate reliable transcriptomic data from blood samples from humans and from animals typically used in preclinical models.