Fragmented Ambulatory Care and Medication Count among Older Adults.

This nationwide cross-sectional study explored the relationship between ambulatory care fragmentation and medication use in older US adults, examining variations by chronic conditions and race. Utilizing data from the 2003-2016 REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study linked with fee-for-service Medicare claims, the authors analyzed care fragmentation (measured by the reversed Bice-Boxerman Index) and medication counts through a 2-week in-person prescription inventory. They employed negative binomial regression, adjusting for potential confounders, and conducted subgroup analyses based on chronic conditions and race.

Social Determinants of Health and 30-Day Readmission After Acute Myocardial Infarction in the REGARDS Study.

Background: Social determinants of health (SDOH) may influence 30-day readmission or emergency department (ED) use following acute myocardial infarction (AMI) hospitalizations. Understanding this relationship will promote the development of interventions and policies to reduce readmissions.

Objectives: The aim of the study was to test associations between SDOH and readmission after AMI.

Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10-Year Atherosclerotic Cardiovascular Risk Prediction.

Background: We compared the atherosclerotic cardiovascular disease (ASCVD) risk prediction performance of the American Heart Association's Predicting Risk of Cardiovascular Disease Events (PREVENT) Base and PREVENT Full equations (includes urine albumin/creatinine ratio, glycated hemoglobin, and social deprivation index) with the pooled cohort equations (PCEs).

Methods: We included adults, aged 40 to 75 years, with no history of ASCVD, diabetes, or statin use in 2009 from Kaiser Permanente Southern California and followed up through 2019. ASCVD was defined as myocardial infarction, fatal coronary heart disease, and fatal and nonfatal ischemic stroke.

Patient Perceptions of Provider Race Concordance and Quality of Chronic Illness Care.

Background: Black people are more likely to have hypertension and report lower quality of care than White people. Patient-provider race concordance could improve perceived quality of care, potentially lessening disparities.

Objective: Investigate the association between patient-provider race concordance and patient-perceived quality of chronic disease care, as measured by the Patient Assessment of Chronic Illness Care (PACIC) scale.

Dietary Inflammatory Score and Incident Heart Failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.

Background: Inflammation plays a key role in the development of heart failure (HF), and diet is a known modifiable factor that modulates systemic inflammation. The dietary inflammatory score (DIS) is a tool that quantifies the inflammatory components of diet. We sought to determine whether the DIS is associated with incident HF events.

Examining Healthy Lifestyles as a Mediator of the Association Between Socially Determined Vulnerabilities and Incident Heart Failure.

Background: Increased burden of socially determined vulnerabilities (SDV), which include nonmedical conditions that contribute to patient health, is associated with incident heart failure (HF). Mediators of this association have not been examined. We aimed to determine if a healthy lifestyle mediates the association between SDV and HF.

Patient perspectives on educational needs in scleroderma-interstitial lung disease.

Background: Systemic sclerosis is a chronic and rare connective tissue disease with multiorgan effects, including interstitial lung disease (ILD). Navigating systemic sclerosis-interstitial lung disease presents a challenge for patients due to the gaps in patient education, which can impact patient health and quality of life. This study utilized the nominal group technique to identify priority knowledge gaps among patients with systemic sclerosis-interstitial lung disease and inform future educational interventions and research.

The Cumulative Burden of Social Risk Factors and 10-Year Change in Quality of Life.

Background: Social risk factors are linked to adverse health outcomes, but their total impact on long-term quality of life is obscure. We hypothesized that a higher burden of social risk factors is associated with greater decline in quality of life over 10 years.

Methods: We examined associations between social risk factors count and decline >5 points in (i) physical component summary, and (ii) mental component summary scores from the Short Form-12 among Black and White participants in the Reasons for Geographic and Racial Differences in Stroke study (n = 14 401).

Changes in Medication Complexity and Post-Hospitalization Outcomes in Older Adults Hospitalized for Heart Failure.

Introduction: Medication regimen complexity may be an important risk factor for adverse outcomes in older adults with heart failure. However, increasing complexity is often necessary when prescribing guideline-directed medical therapy at the time of a heart failure hospitalization. We sought to determine whether increased medication regimen complexity following a heart failure hospitalization was associated with worse post-hospitalization outcomes.

Bridging Gaps in Cervical Cancer Care: A Web-Based Intervention to Improve Knowledge and Follow-up.

Objectives: Contributors to disparities and worse cervical cancer outcomes include limited education and loss to follow-up after an abnormal Pap smear. Effective interventions are necessary to engage diverse populations. The authors piloted an intervention to assess acceptability, knowledge uptake, and follow-up.

Risk-enhancing factors and social determinants of health in risk assessment for atherosclerotic cardiovascular disease.

Background: The Pooled Cohort Equations (PCEs) do not accurately estimate atherosclerotic cardiovascular disease (ASCVD) risk in certain populations. The 2018 AHA/ACC cholesterol guideline identified risk-enhancing factors as a supplement to PCEs-based risk assessment. However, the role of each risk-enhancing factor in ASCVD risk assessment has not been well quantified.

Associations among claims-based care fragmentation, self-reported gaps in care coordination, and self-reported adverse events.

Background: Fragmentation of care (that is, the use of multiple ambulatory providers without a dominant provider) may increase the risk of gaps in communication among providers. However, it is unclear whether people with fragmented care (as measured in claims) perceive more gaps in communication among their providers. It is also unclear whether people who perceive gaps in communication experience them as clinically significant (that is, whether they experience adverse events that they attribute to poor coordination).

Training of Peer Coaches to Assist Individuals with Knee Osteoarthritis Prepare and Recover From Total Knee Replacement.

Objective: The objective of this study is to outline the training of peer coaches in the Moving Well intervention, which was designed to reduce anxiety, depression, and pain catastrophizing in patients before and after total knee replacement (TKR).

Methods: Selected peer coaches had a history of knee osteoarthritis (KOA), a TKR of 12 months or more before training, and were 60 or older. Training was primarily conducted virtually, with a later addition of one in-person session.

Development and initial validation of a disease-specific instrument to measure health-related quality of life in hypersensitivity pneumonitis.

Rationale And Objective: Disease-specific health-related quality of life (HRQOL) instruments enable us to capture domains that are most relevant to specific patient populations and are useful when a more individualised approach to patient assessment is desired. In this study, we assessed the validity and reliability of the first instrument specifically developed to measure HRQOL in hypersensitivity pneumonitis (HP).

Methods: A 39-item HP-HRQOL instrument and several anchors were collected from a cohort of patients with HP.