Associations Between Health Literacy and Medication Self-Management Among Community Health Center Patients with Uncontrolled Hypertension.

Purpose: Examine associations between health literacy and several medication self-management constructs among a population of adults with uncontrolled hypertension.

Patients And Methods: Cross-sectional study of health center patients from the Chicago area with uncontrolled hypertension enrolled between April 2012 and February 2015. Medication self-management constructs-applied to hypertension medications, chronic condition medications and all medications-included: 1) medication reconciliation, 2) knowledge of drug indications, 3) understanding instructions and dosing, and 4) self-reported adherence over 4 days (no missed doses).

Effect of Electronic Health Record-Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management: A Randomized Clinical Trial.

Importance: Complex medication regimens pose self-management challenges, particularly among populations with low levels of health literacy.

Objective: To test medication management tools delivered through a commercial electronic health record (EHR) with and without a nurse-led education intervention.

Design, Setting, And Participants: This 3-group cluster randomized clinical trial was performed in community health centers in Chicago, Illinois.

Penetrance of Hemochromatosis in HFE Genotypes Resulting in p.Cys282Tyr and p.[Cys282Tyr];[His63Asp] in the eMERGE Network.

Hereditary hemochromatosis (HH) is a common autosomal-recessive disorder associated with pathogenic HFE variants, most commonly those resulting in p.Cys282Tyr and p.His63Asp.

Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.

Background: Healthcare professionals are rapidly adopting electronic health records (EHRs). Within EHRs, seemingly innocuous menu design configurations can influence provider decisions for better or worse.

Objective: The purpose of this study was to examine whether the grouping of menu items systematically affects prescribing practices among primary care providers.

Patient knowledge and recall of health information following exposure to "facts and myths" message format variations.

Objective: To assess if exposure to varying "facts and myths" message formats affected participant knowledge and recall accuracy of information related to influenza vaccination.

Methods: Consenting patients (N=125) were randomized to receive one of four influenza related messages (Facts Only; Facts and Myths; Facts, Myths, and Refutations; or CDC Control), mailed one week prior to a scheduled physician visit. Knowledge was measured using 15 true/false items at pretest and posttest; recall accuracy was assessed using eight items at posttest.

Implementation of EHR-based strategies to improve outpatient CAD care.

Objectives: To evaluate the effects of a multifaceted quality improvement intervention during 2 time periods on 4 coronary artery disease [CAD] measures in 4 primary care practices. During the first phase, electronic reminders prompted physicians to order indicated medications or record contraindications and refusals (exceptions). In the second phase, physicians also received reports about their performance (including lists of patients not satisfying these measures), and financial incentives were announced.

Electronic health record-based patient identification and individualized mailed outreach for primary cardiovascular disease prevention: a cluster randomized trial.

Background: Many individuals at higher risk for cardiovascular disease (CVD) do not receive recommended treatments. Prior interventions using personalized risk information to promote prevention did not test clinic-wide effectiveness.

Objective And Design: To perform a 9-month cluster-randomized trial, comparing a strategy of electronic health record-based identification of patients with increased CVD risk and individualized mailed outreach to usual care.

Effects of standardized outreach for patients refusing preventive services: a quasiexperimental quality improvement study.

Objective: To determine the effect of standardized outreach on the receipt of preventive services for patients whose physicians record that the patient refused the service.

Study Design: Prospective observational study of a quality improvement intervention using a nonrandomly assigned comparator group.

Methods: Patients from a large internal medicine practice with recorded refusals to preventive services were included.

Changes in performance after implementation of a multifaceted electronic-health-record-based quality improvement system.

Background: Electronic health record (EHR) systems have the potential to revolutionize quality improvement (QI) methods by enhancing quality measurement and integrating multiple proven QI strategies.

Objectives: To implement and evaluate a multifaceted QI intervention using EHR tools to improve quality measurement (including capture of contraindications and patient refusals), make point-of-care reminders more accurate, and provide more valid and responsive clinician feedback (including lists of patients not receiving essential medications) for 16 chronic disease and preventive service measures.

Design: Time series analysis at a large internal medicine practice using a commercial EHR.

Frequency of inappropriate medical exceptions to quality measures.

Background: Quality improvement programs that allow physicians to document medical reasons for deviating from guidelines preserve clinicians' judgment while enabling them to strive for high performance. However, physician misconceptions or gaming potentially limit programs.

Objective: To implement computerized decision support with mechanisms to document medical exceptions to quality measures and to perform peer review of exceptions and provide feedback when appropriate.