National Institutes of Health pathways to prevention workshop: Improving rural health through telehealth-guided provider-to-provider communication.

Introduction: Rural communities often face chronic challenges of high rates of serious health conditions coupled with inadequate access to health care services-challenges exacerbated by the COVID-19 pandemic. One strategy with the potential to mitigate these problems is the increased use of telehealth technology. A feature of telehealth applications-collaboration between health care providers for consultation and other purposes-referred to herein as Rural Provider-to-Provider Telehealth (RPPT), introduces important expertise that may not exist locally in rural communities.

Quality of communication about medicines in United States hospitals: A national retrospective study.

Background: Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals.

A Multicenter Evaluation of Prolonged Empiric Antibiotic Therapy in Adult ICUs in the United States.

Objective: The purpose of this study is to determine the rate of prolonged empiric antibiotic therapy in adult ICUs in the United States. Our secondary objective is to examine the relationship between the prolonged empiric antibiotic therapy rate and certain ICU characteristics.

Design: Multicenter, prospective, observational, 72-hour snapshot study.

Correlates and economic outcomes of proton pump inhibitor use by routes in intensive care unit patients.

Objectives were to evaluate correlates, and economic outcomes of proton pump inhibitor (PPI) use by route in the intensive care unit from an institutional-payer perspective. A 13-month retrospective study of electronic medical records was conducted of 534 adult (≥19 year-old) intensive care unit patients receiving a PPI (39% enteral-only, 34% parenteral-only, 27% both-route) in a Midwest USA academic medical center. Possible cost-savings with sensitivity analysis were estimated as differences in drug costs (US dollars) between switch eligible parenteral and alternate enteral-PPI medication doses.

A registry study of the association of patient's residence and age with colorectal cancer survival.

Because of limited literature from rural states of the United States like Nebraska, we evaluated the association of patient's age, Office of Management and Budget residence-county categories (rural-nonmetro, micropolitan-nonmetro, urban), and significant interactions between confounding-variables with colorectal cancer (CRC) survival. This retrospective 1998-2003 study of 6561 CRC patients from the Nebraska Cancer Registry showed median patient survival in colon and rectal cancer in urban, rural and micropolitan counties were 33, 36, and 46 months and 41, 47, 49 months, respectively. In Cox proportional-hazards analyses, after adjusting for significant demographics (age, race, marital status in colon cancer; age, insurance status in rectal cancer), cancer stage, surgery and radiation treatments; 1) no-chemotherapy urban colon cancer patients had significantly shorter survival (rural vs urban; adjusted hazard ratio, HR: 0.

A retrospective evaluation of remote pharmacist interventions in a telepharmacy service model using a conceptual framework.

Objectives: This retrospective cross-sectional study evaluated a telepharmacy service model using a conceptual framework to compare documented remote pharmacist interventions by year, hospital, and remote pharmacist and across rural hospitals with or without an on-site rural hospital pharmacist.

Materials And Methods: Documented remote pharmacist interventions for patients at eight rural hospitals in the Midwestern United States during prospective prescription order review/entry from 2008 to 2011 were extracted from RxFusion(®) database (a home-grown system, i.e.

Correlates and Economic and Clinical Outcomes of an Adult IV to PO Antimicrobial Conversion Program at an Academic Medical Center in Midwest United States.

The study objectives were to evaluate the correlates and outcomes of a parenteral (IV) to oral (PO) antimicrobial conversion program at a Midwest US Academic Medical Center with the hypothesis that it will be associated with reduced drug costs. Patient-level data (n = 237; sex, race, admission source, admission status, admission severity, risk of mortality [relative expected, admission], and early death) were extracted from the Clinical Data Base/Resource Manager. Medication-level, drug-encounter data (n = 317; antibiotic/dose/route/frequency/duration, conversion status, 10-day IV/PO switch-eligibility criteria) were extracted from patient's hospital medical records.

Rural patients' access to mobile phones and willingness to receive mobile phone-based pharmacy and other health technology services: a pilot study.

Objective: This pilot study explores the patient-centered demand for mobile phone-based health (mobile health [m-health]) services in the rural United States by documenting rural patients' access to mobile phones and patients' willingness to receive m-health services.

Subjects And Methods: An anonymous institutional review board-approved survey was completed by patients visiting two rural pharmacies in Nebraska from August to October 2011. Patients who volunteered to complete the survey provided their demographic data, disease state information, health status, mobile phone access, and willingness to receive (in terms of using and giving time to) m-health services.

Evaluation of outcomes of intravenous to oral antimicrobial conversion initiatives: a literature review.

Inappropriate use of antimicrobial agents could result in antimicrobial resistance that could impact clinical cure outcomes (by increasing morbidity in terms of increased adverse events and risk of secondary and hospital-acquired infections and mortality) and increase costs to health care institutions. Thus, appropriate antimicrobial use has become vital for balancing patient safety and costs and is therefore a focus for health care institutions. This is often achieved through efforts of antimicrobial stewardship programs that include intravenous to oral conversion initiatives with clinical pharmacists playing an instrumental role in their development and implementation with medical staff approval.

Factors associated with primary hip arthroplasty after hip fracture.

Objectives: To determine patient, clinical, and hospital factors associated with receiving total hip arthroplasty (THA) and hemiarthroplasty (HA) in the United States.

Study Design: Retrospective, cross-sectional study.

Methods: Hospital discharge records with a principal diagnosis of hip fracture and primary hip arthroplasty or no surgery were identified from the 2009 Nationwide Inpatient Sample data set of the Healthcare Cost and Utilization Project.

Rurality and other factors associated with adherence to immunosuppressant medications in community-dwelling solid-organ transplant recipients.

Background: Data on immunosuppressant adherence of community-dwelling adult solid-organ transplant recipients (SOTRs) from rural populations in the United States are limited. Therefore, understanding the association of rurality and other factors of immunosuppressant adherence will help providers design and deliver patient-centered adherence enhancing interventions.

Objectives: The objective was to examine factors associated with a previously validated 4-item Immunosuppressant Therapy Adherence Scale (ITAS) score in community-dwelling adult SOTRs who received a transplant from an academic center in the Midwestern United States.

Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy.

Background: This study's purpose was twofold: (1) to establish adherence rates to a behavioral therapy (BT) sleep intervention and (2) to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer chemotherapy.

Methods: A randomized controlled trial began 48 h before the first of four chemotherapy treatments. Women with stages I-IIIA breast cancer (n = 113) received a BT sleep intervention composed of stimulus control, modified sleep restriction (MSR), relaxation therapy (RT), and sleep hygiene counseling components.

Patient-reported perceptions and safety behaviors in chemotherapy administration.

EVALUATION OF: Schwappach DL, Wernli M. Chemotherapy patients' perceptions of drug administration safety. J.

Age and rural residence effects on accessing colorectal cancer treatments: a registry study.

Objectives: To test the hypotheses that older patients with colorectal cancer (CRC) and rural patients are less likely to undergo surgery, radiation, and chemotherapy.

Study Design: Retrospective study.

Methods: A total of 6561 patients with CRC between January 1998 and December 2003 were identified by incident International Classification of Diseases for Oncology codes from the Nebraska Cancer Registry.

Clinical outcomes and nephrotoxicity associated with vancomycin trough concentrations during treatment of deep-seated infections.

Objective: Higher vancomycin concentrations are thought necessary for treatment of deep-seated methicillin-resistant Staphylococcus aureus (MRSA) infection, yet this may result in greater risk of nephrotoxicity. We evaluated the relationship of serum vancomycin trough concentration with clinical outcomes and nephrotoxicity for patients with deep-seated MRSA infection.

Methods: A retrospective cohort study evaluated adults with MRSA pneumonia, endocarditis or osteomyelitis who received vancomycin for > or = 5 days from June 2005 to June 2007.

Good research practices for measuring drug costs in cost-effectiveness analyses: Medicare, Medicaid and other US government payers perspectives: the ISPOR Drug Cost Task Force report--Part IV.

Objectives: Public programs finance a large share of the US pharmaceutical expenditures. To date, there are not guidelines for estimating the cost of drugs financed by US public programs. The objective of this study was to provide standards for estimating the cost of drugs financed by US public programs for utilization in pharmacoeconomic evaluations.

Rurality and other determinants of early colorectal cancer diagnosis in Nebraska: a 6-year cancer registry study, 1998-2003.

Background: There are no studies of rurality, and other determinants of colorectal cancer (CRC) stage at diagnosis with population-based data from the Midwest.

Methods: This retrospective study identified, incident CRC patients, aged 19 years and older, from 1998-2003 Nebraska Cancer Registry (NCR) data. Using federal Office of Management and Budget classifications, we grouped patients by residence in metropolitan, micropolitan nonmetropolitan, or rural nonmetropolitan counties (non-core based statistical areas).

Clinical practice patterns of managing low-risk adult febrile neutropenia during cancer chemotherapy in the USA.

Purpose: The purpose of the study was to determine oncologists' current practice patterns for antibiotic management of low-risk fever and neutropenia (FN) after chemotherapy.

Materials And Methods: A self-administered survey was developed to query management practices for low-risk FN patients and sent to 3,600 randomly selected American Society of Clinical Oncology physician members; hypothetical case scenarios were included to assess factors influencing decisions about outpatient treatment.

Results: Of 3,560 actively practicing oncologists, 1,207 replied (34%).

Antipsychotic use at adult ambulatory care visits by patients with mental health disorders in the United States, 1996-2003: national estimates and associated factors.

Objectives: This retrospective analysis was conducted to derive national estimates of typical, atypical, and combination (typical-atypical) antipsychotic use and to examine factors associated with their use at adult (age >>-18 years) ambulatory care visits by patients with mental health disorders in the United States.

Methods: Data on adult visits with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for a mental health disorder were extracted from the office-based National Ambulatory Medical Care Survey and the outpatient facilitybased National Hospital Ambulatory Medical Care Survey from 1996 through 2003. The visits were categorized according to whether use of a typical, atypical, or combination antipsychotic was mentioned (either prescribed, supplied, administered, ordered, or continued at the visits).

Epidemiology and characteristics of emergency departments visits by US adults with psychiatric disorder and antipsychotic mention from 2000 to 2004.

Background And Objective: There is limited research to acquaint clinicians and payers about antipsychotic use in psychiatric patients visiting United States (US) emergency departments (EDs). The study objective is to describe the epidemiology and compare characteristics of ED visits by adults > or = 18 years with psychiatric diagnoses and different types of antipsychotic.

Methods: Data for 2000-2004 adult ED visits were obtained from the National Hospital Ambulatory Medical Care Survey.

Current methodological approaches to the study of sleep disturbances and quality of life in adults with cancer: a systematic review.

In recent years, sleep disturbances and the health-related quality of life (QOL) experienced by adults with cancer, during and after cancer treatment, have received increasing attention in the scientific literature. The purpose of this paper was to systematically review current methodological approaches to the study of sleep disturbances and QOL in adults with cancer. Databases were searched to identify longitudinal studies of adults with cancer that measured sleep disturbances and QOL in the past 10 years.

Diagnosis and treatment of adult attention-deficit/hyperactivity disorder at US ambulatory care visits from 1996 to 2003.

Objective: To determine national-estimates and characteristics of United States (US) ambulatory care visits made by adults, aged 18 years or older, with attention-deficit hyperactivity disorder (ADHD) diagnosis, treatment patterns, and significant factors associated with adult-ADHD treatment.

Methods: Retrospective analyses were conducted of the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey over a combined 8-year period (1996-2003). Mental-health disorder (including ADHD) visits were identified using International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) diagnostic codes.