Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes.

Background: The Hispanic/Latino population has greater risk (estimated >50%) of developing type 2 diabetes (T2D) and developing it at a younger age. The American Diabetes Association estimates costs of diagnosed diabetes in 2017 was $327 billion; with medical costs 2.3x higher than patients without diabetes.

Erratum: Home Telemonitoring of Patients With Type 2 Diabetes: A Meta-Analysis and Systematic Review. Diabetes Spectrum 2022;35:118-128 (https://doi.org/10.2337/ds21-0023).

[This corrects the article DOI: 10.2337/ds21-0023.].

Home Telemonitoring of Patients With Type 2 Diabetes: A Meta-Analysis and Systematic Review.

Telehealth has emerged as an evolving care management strategy that is playing an increasingly vital role, particularly with the onset of the coronavirus disease 2019 pandemic. A meta-analysis of 20 randomized controlled trials was conducted to test the effectiveness of home telemonitoring (HTM) in patients with type 2 diabetes in reducing A1C, blood pressure, and BMI over a median 180-day study duration. HTM was associated with a significant reduction in A1C by 0.

Expanding Knowledge and Changing Attitudes About Poverty: An Interactive, Interprofessional Approach.

Background: Poverty negatively affects the lives and health of the poor. However, health professionals often have limited personal experience and receive little formal education on surviving under conditions of poverty in the United States, which may contribute to suboptimal patient care and outcomes.

Purpose: We conducted a 3-h, interactive, experiential poverty simulation workshop with an interprofessional group of pre-professional health students to increase their comprehension about the realities of poverty.

Acceptability of HIV testing for adolescents and young adults by delivery model: a systematic review.

HIV infections are prevalent among adolescents and young adults, of whom 44% remain unaware of their diagnosis. HIV screening presents numerous challenges including stigma, fear, and concerns about confidentiality, which may influence young people's acceptance of HIV screening and linkage to care differently from individuals in other age groups. It is imperative to understand which care delivery models are most effective in facilitating these services for youth.

Goals of care conversation education program: An intervention to help health care professionals break bad news to patients with advanced illness.

The purpose of the study was to measure the effectiveness of communication skills intervention results for healthcare professionals. A multi-site pretest-posttest survey assessing the efficacy of a Goals of Care conversation education program. The program aimed to educate healthcare professionals concerning having Goals of Care conversations with patients and families.

A Retrospective Study Analyzing the Lack of Symptom Benefit With Antimicrobials at the End of Life.

Background: Infections are common in terminally ill patients (pts), and although antibiotics are frequently prescribed, their benefit for symptom relief is not clear. Antimicrobials at the end of life (EOL) may increase the risk of antimicrobial resistance and infection. Our aim was to determine the frequency of symptom occurrence at the EOL when comparing pts who did or did not receive antibiotics (AB+ or AB-).

Preoperative Noninvasive Cardiac Testing in Older Adults with Hip Fracture: A Multi-Site Study.

Background/objectives: For older adults with acute hip fracture, use of preoperative noninvasive cardiac testing may lead to delays in surgery, thereby contributing to worse outcomes. Our study objective was to evaluate the preoperative use of pharmacologic stress testing and transthoracic echocardiogram (TTE) in older adults hospitalized with hip fracture.

Design: Retrospective chart review.

Developing and Piloting a Tool to Identify Food Insecurity in Older Adults.

Objective: The literature shows that food insecurity (FI) can negatively affect the trajectory of many chronic illnesses. FI can be acutely severe for older adults, but screening for FI is not regularly performed in the hospital setting. Our goal was to develop a tool to screen for FI upon hospital discharge to identify patients who may require community food resources.

A Randomized Controlled Trial Comparing Telehealth Self-Management to Standard Outpatient Management in Underserved Black and Hispanic Patients Living with Heart Failure.

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Opiate Prescribing in Hospitalized Older Adults: Patterns and Outcomes.

Background/objectives: Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults.

Design: Retrospective cohort study.

Percutaneous Feeding Tubes in Individuals with Advanced Dementia: Are Physicians "Choosing Wisely"?

Objectives: To evaluate physician knowledge and perceptions about the American Board of Internal Medicine/American Geriatrics Society (ABIM/AGS) Choosing Wisely recommendations regarding percutaneous endoscopic gastrostomy (PEG) in individuals with advanced dementia.

Design: Multicenter, mixed-mode, anonymous questionnaire.

Setting: Three tertiary and four community hospitals in New York.

Cardiac surgery nurse practitioner home visits prevent coronary artery bypass graft readmissions.

Background: We designed and tested an innovative transitional care program, involving cardiac surgery nurse practitioners, to improve care continuity after patient discharge home from coronary artery bypass graft (CABG) operations and decrease the composite end point of 30-day readmission and death.

Methods: A total of 401 consecutive CABG patients were eligible between May 1, 2010, and August 31, 2011, for analysis. Patient data were entered prospectively into The Society of Thoracic Surgeons database and the New York State Cardiac Surgery Reporting System and retrospectively analyzed with Institutional Review Board approval.

Do residents need end-of-life care training?

Objective: As medical education evolves, emphasis on chronic care management within the medical curriculum becomes essential. Because of the consistent lack of appropriate end-of-life care training, far too many patients die without the benefits of hospice care. This study explores the association between physician knowledge, training status, and level of comfort with hospice care referral of terminally ill patients.

Medical orders for life-sustaining treatment: is it time yet?

Objective: As the aging population faces complex end-of-life issues, we studied the intervals between long-term care admission and advance directive completion, and between completion and death. We also sought to determine the interdisciplinary team's compliance with documented wishes.

Method: A cross-sectional study of 182 long-term care residents in two facilities with and without completed medical orders for life-sustaining treatment (MOLST) in the New York Metropolitan area was conducted.

Medication reconciliation in continuum of care transitions: a moving target.

Objective: To study medication discrepancies in clinical transitions across a large health care system.

Design: Randomized chart review of electronic medical records and paper chart medication reconciliation lists across 3 transitions of care.

Settings And Participants: Subacute patient medication records were reviewed through 3 transition care points at a large health care system, including hospital admission to discharge (time I), hospital discharge to skilled nursing facility (SNF; time II) and SNF admission to discharge home or long term care (LTC; time III).

Ethnicity, race, and advance directives in an inpatient palliative care consultation service.

Objective: Although race and ethnic background are known to be important factors in the completion of advance directives, there is a dearth of literature specifically investigating the effect of race and ethnicity on advance directive completion rate after palliative care consultation (PCC).

Method: A chart review of all patients seen by the PCC service in an academic hospital over a 9-month period was performed. Data were compiled using gender, race, ethnicity, religion, and primary diagnosis.

A multisite validity study of self-reported anesthesia outcomes.

The purpose of this study was to assess the validity of a multisite anesthesia voluntary adverse event reporting process. A data validation methodology was used through medical chart review on live records at 3 facilities (N = 600). The per-item aggregated error rate among all 42 data items was 0.

The impact of remote patient monitoring (telehealth) upon Medicare beneficiaries with heart failure.

Objective: To study the impact of remote patient monitoring (RPM) upon the most frequent diagnosis in hospitalized patients over 65 years of age-heart failure (HF). We examined the effect of RPM on hospital utilization and Medicare costs of HF patients receiving home care.

Materials And Methods: Two studies were simultaneously conducted: A randomized and a matched-cohort study.

The impact of an end-of-life communication skills intervention on physicians-in-training.

The palliative medicine literature consistently documents that physicians are poorly prepared to help patients experience a "good death" and are often unaware of their ill patients' preferences for end-of-life care. The present study, enrolling 150 physicians, sought to improve their communication skills for end-of-life care. We found significant attitudinal changes and a greater degree of self-rated competence in delivering end-of-life care for those in the intervention group.

Knowledge and attitudes of health care workers regarding MOLST (Medical Orders for Life-Sustaining Treatment) implementation in long-term care facilities.

We studied the impact of knowledge and attitudes of physicians, nurses, and social workers in nursing facilities of the Medical Orders for Life Sustaining Treatment(MOLST)implementation. The results indicate that in the case of advance directives, knowledge influences care.