Outcomes of Age-Friendly Health Systems: Return to Clinic After 4Ms Care Delivery.

The Age-Friendly Health System (AFHS) movement continues to grow in the United States as more health systems implement the 4Ms framework. Despite this growth, there are relatively few studies that evaluate outcomes related to AFHS implementation. This study assessed patient satisfaction with AFHS by analyzing the rate at which patients returned to the clinic for future health care, serving as a measure of quality.

A concept analysis of the recurrence-related to diabetic foot ulcers.

Background And Purpose: There is inconsistency and lack of conceptual clarity regarding the concept of "recurrence" in diabetes-related foot ulcers. Therefore, the purpose of this concept analysis is to analyze the concept of recurrence-related to diabetes-related foot ulcer after the healing of a previous foot ulcer.

Method: The Rodger's evolutionary concept analysis method was employed to analyze the concept of recurrence in diabetes-related foot ulcers.

Incident Epilepsy Among US Medicare Beneficiaries, 2019: Differences by Age, Sex, and Race/Ethnicity.

Background And Objectives: Epilepsy is common among older adults, but previous incident studies have had limited ability to make comparisons across key subgroups. We aimed to provide updated epilepsy incidence estimates among older adults, comparing across age, sex, and race/ethnicity.

Methods: Using a random sample of 4,999,999 US Medicare beneficiaries older than 65 years, we conducted a retrospective cohort study of epilepsy incidence using administrative claims for 2016-2019.

Exploring the Congruence of actigraphy and the Pediatric Autism Insomnia rating Scale.

Objective/background: Insomnia is common in children with autism spectrum disorder (ASD). We recently developed and validated the 21-item Pediatric Autism Insomnia Rating Scale (PAIRS). This report explores the associations and agreements between actigraphy and PAIRS.

Capturing the care of complex community-based health center patients: A comparison of multimorbidity indices and clinical classification software.

Objective: To compare morbidity burden captured from multimorbidity indices and aggregated measures of clinically meaningful categories captured in primary care community-based health center (CBHC) patients.

Data Sources And Study Setting: Electronic health records of patients seen in 2019 in OCHIN's national network of CBHCs serving patients in rural and underserved communities.

Study Design: Age-stratified analyses comparing the most common conditions captured by the Charlson, Elixhauser, and Multimorbidity Weighted (MWI) indices, and Classification Software Refined (CCSR) and Chronic Condition Indicator (CCI) algorithms.

Evaluation of education initiatives to increase delivery of age-friendly care in retail clinics.

Background: The Age-Friendly Health Systems model, encompassing four key elements (4Ms)-What Matters, Medication, Mentation, Mobility-is integral to delivering high-quality care to older adult patients. In May 2020, the MinuteClinic at CVS implemented the 4Ms model in all 1100+ store locations nationwide. To prepare healthcare providers to deliver 4Ms care, educational modules were developed to provide an understanding of the gerontology principles that support the 4Ms model of care.

Excess prevalence of preexisting chronic conditions in older adults with incident epilepsy.

Objective: Prior studies have examined chronic conditions in older adults with prevalent epilepsy, but rarely among those with incident epilepsy. Identifying the chronic conditions with which older adults present at epilepsy incidence assists with the evaluation of disease burden in this patient population and informs coordinated care development. The aim of this study was to identify preexisting chronic conditions with excess prevalence in older adults with incident epilepsy compared to those without.

Medication Adherence of Older Adults with Hypertension: A Systematic Review.

Objective: Hypertension (HTN) significantly increases the risk of stroke and heart disease, which are the leading causes of death and disability globally, particularly among older adults. Antihypertensive medication is a proven treatment for blood pressure control and preventing complications. However, medication adherence rates in older adults with HTN are low.

Understanding the Utility of Less Than Six-Month Prognosis Using Administrative Data Among U.S. Nursing Home Residents With Cancer.

Background: There is a dearth of studies evaluating the utility of reporting prognostication among nursing home (NH) residents with cancer.

Objective: To study factors associated with documented less than six-month prognosis, and its relationship with end-of-life (EOL) care quality measures among residents with cancer.

Methods: The Surveillance, Epidemiology, and End Results linked with Medicare, and the Minimum Data Set databases was used to identify 20,397 NH residents in the United States with breast, colorectal, lung, pancreatic, or prostate cancer who died between July 2016 and December 2018.

Post-Traumatic Distress and Symptom Experience in Patients With Head and Neck Cancer-Related Tracheostomy and Family Caregivers.

Objectives: To describe post-traumatic distress and identify associated factors in patients with head and neck cancer-related tracheostomy and their family caregivers.

Sample & Setting: This observational study assessed 22 patients with surgically managed head and neck cancer-related tracheostomy and 17 family caregivers at a comprehensive cancer center.

Methods & Variables: Instruments included the Impact of Event Scale-Revised, the Memorial Symptom Assessment Scale, and the Patient-Reported Outcomes Measurement Information System Depression 6a Short Form scale.

Using Neural Networks Algorithm in Ischemic Stroke Diagnosis: A Systematic Review.

Objective: To evaluate the evidence of artificial neural network (NNs) techniques in diagnosing ischemic stroke (IS) in adults.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was utilized as a guideline for this review. PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text were searched to identify studies published between 2018 and 2022, reporting using NNs in IS diagnosis.

Investigating the Influence of Periodontal Disease on the Association Between Complex Multimorbidity and Health: A Cross-Sectional Study.

Aims And Objectives: The aim of this study was to evaluate whether periodontal disease (PD) moderates the association between complex multimorbidity (MM) and fair/poor general health in a US representative sample of older individuals.

Materials And Methods: This study identified 937 participants who were at least 60 years of age from the 2013-2014 National Health and Nutrition Examination Survey. A multivariable logistic regression model was used to estimate the association between complex MM (including chronic conditions, functional limitations, and geriatric syndromes) and self-reported fair/poor general health.

Aggressive end-of-life care across gradients of cognitive impairment in nursing home patients with metastatic cancer.

Background: Studies examining end-of-life (EOL) care in older cancer patients are scarce, and prior studies have not accounted for gradients of cognitive impairment (COG-I). We examine EOL care patterns across COG-I gradients, hypothesizing that greater COG-I severity is associated with lower odds of receiving aggressive EOL care.

Methods: Using data from the linked Surveillance Epidemiology and End Results (SEER) -Medicare -Minimum Data Set (MDS) 3.

Cancer burden in women with HIV on Medicaid: A nationwide analysis.

Background: Cancer is the leading cause of death in people living with HIV. In the United States, nearly 1 in 4 people living with HIV are women, more than half of whom rely on Medicaid for healthcare coverage.

Objective: The objective of this study is to evaluate the cancer burden of women living with HIV on Medicaid.

Patterns of Diagnostic Evaluation and Determinants of Treatment in Older Patients With Non-transfusion Dependent Myelodysplastic Syndromes.

Background: Older patients with myelodysplastic syndromes (MDS), particularly those with no or one cytopenia and no transfusion dependence, typically have an indolent course. Approximately, half of these receive the recommended diagnostic evaluation (DE) for MDS. We explored factors determining DE in these patients and its impact on subsequent treatment and outcomes.

The Arthroplasty Surgeon Growth Indicator: A Tool for Monitoring Supply and Demand Trends in the Orthopaedic Surgeon Workforce from 2020 to 2050.

Background: Orthopaedic practices in the U.S. face a growing demand for total joint arthroplasties (TJAs), while the orthopaedic workforce size has been stagnant for decades.

Incidence of Aggressive End-of-Life Care Among Older Adults With Metastatic Cancer Living in Nursing Homes and Community Settings.

Importance: Nearly 10% of the 1.5 million persons residing in nursing homes (NHs) have received or will receive a diagnosis of cancer. Although aggressive end-of-life (EOL) care is common among community-dwelling patients with cancer, little is known about such patterns of care among NH residents with cancer.

Identifying Factors Associated with Periodontal Disease Using Machine Learning.

Objective: This study aimed to identify combinations of chronic conditions associated with the presence and severity of periodontal disease (PD) after accounting for a series of demographic and behavioral characteristics in a nationally representative sample of US adults.

Materials And Methods: A cross-sectional study of the 2013-2014 National Health and Nutrition Examination Survey ( = 4555). Outcome measure: PD using clinical attachment loss (measured as none, mild, moderate, or severe).

Prevalence of multimorbidity combinations and their association with medical costs and poor health: A population-based study of U.S. adults.

Background: Multimorbidity is common, but the prevalence and burden of the specific combinations of coexisting disease has not been systematically examined in the general U.S. adult population.

High-risk diagnosis combinations in patients undergoing interhospital transfer: a retrospective observational study.

Background: There is limited research on individual patient characteristics, alone or in combination, that contribute to the higher levels of mortality in post-transfer patients. The purpose of this work is to identify significant combinations of diagnoses that identify subgroups of post-interhospital transfer patients experiencing the highest levels of mortality.

Methods: This was a retrospective cross-sectional study using structured electronic health record data from a regional health system between 2010-2017.

Achievement of age-friendly health systems committed to care excellence designation in a convenient care health care system.

Objective: To describe the implementation of the age-friendly health systems (AFHS) 4Ms Framework, an evidence-based framework to assess and act on "What Matters, Medication, Mentation and Mobility to deliver Age-Friendly health care for patients 65 and older", to achieve the Institute for Health care Improvement (IHI) Committed to Care Excellence recognition in a convenient care health system and test two novel implementation strategies.

Setting: The study was conducted in over 1100 convenient care clinics in 35 states and DC. MinuteClinics are located in community-based retail pharmacies in rural, suburban, and urban areas and staffed with approximately 3300 nurse practitioners and physician associates.

Variation in and Factors Associated With US County-Level Cancer Mortality, 2008-2019.

Importance: The association between cancer mortality and risk factors may vary by geography. However, conventional methodological approaches rarely account for this variation.

Objective: To identify geographic variations in the association between risk factors and cancer mortality.

Combinations of chronic conditions, functional limitations and geriatric syndromes associated with periodontal disease.

Objective: To identify complex multimorbid conditions, including chronic conditions, functional limitations and geriatric syndromes, associated with the presence and severity of periodontal disease (PD), after accounting for a series of demographic and behavioural characteristics.

Design: This cross-sectional study used secondary data from a nationally representative sample, classification and regression tree analysis and random forest identified combinations of specific conditions constituting complex multimorbidity associated with the presence and severity of PD.

Setting: US National Health and Nutritional Examination Survey (2013-2014).

Clustering of Social Determinants of Health Among Patients.

Introduction/objectives: Many health systems screen patients for social determinants of health and refer patients with social needs to community organizations for assistance. Understanding how social determinants cluster together may help guide assistance programs.

Methods: This study examined patients screened by The MetroHealth System in Cleveland, Ohio for 9 social determinants, including food insecurity, financial strain, transportation limitations, inability to pay for housing or utilities, intimate partner violence, social isolation, infrequent physical activity, daily stress, and lack of internet access.

Sociodemographic and clinical factors associated with receipt of biomarker testing in patients with metastatic colorectal cancer.

Background: Standard clinical practice and national guidelines dictate somatic testing of metastatic colorectal cancer (mCRC) tumors to guide appropriate therapy; however, previous studies suggest that not all patients are tested. The objective of this study was to investigate potential differences in testing for mCRC by demographic and clinical factors.

Methods: We performed a retrospective review of de-identified patient data derived from electronic health records (EHRs) of 25,469 patients diagnosed with mCRC between the years 2013 and 2020.