Aims: This study aimed to estimate the strength of association between prescriptions of glucose-dependent insulinotropic polypeptide (GIP) and/or glucagon-like peptide-1 receptor agonists (GLP-1 RA) and the incidence of opioid overdose and alcohol intoxication in patients with opioid use disorder (OUD) and alcohol use disorder (AUD), respectively. This study also aimed to compare the strength of the GIP/GLP-1 RA and substance use-outcome association among patients with comorbid type 2 diabetes and obesity.
Design: A retrospective cohort study analyzing de-identified electronic health record data from the Oracle Cerner Real-World Data.
Objective: This study evaluated the prevalence and incidence of opioid use disorder (OUD), rates of opioid overdose (OD), and rates of non-fatal (NF) OD in American Indian/Alaskan Native (AI/AN) populations.
Methods: We used de-identified patient data from Oracle Cerner Real-World Data™. Rates were estimated over time, and stratified by sex, age, marital status, insurance, and region.
Background: Diabetes is the eighth leading cause of death in the USA. Inequities driven by structural racism and systemic oppression have led to racial/ethnic disparities in diabetes prevalence, diagnosis, and treatment. Diabetes-self management training (DSMT), remote glucose monitoring (RGM), and tailored support from a community health worker (CHW) have the potential to improve outcomes.
View Article and Find Full Text PDFThe Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) screening tool has not previously been used to evaluate risk for gambling disorder (GD). We aimed to assess the level at which each specific substance involvement score (SSIS), measured by ASSIST, most optimally predicted GD among U.S.
View Article and Find Full Text PDFPurpose: Little is known about the relationship between learner load and pharmacist and pharmacy technician burnout. Therefore, the purpose of this study was to examine the association between burnout and the number of learners (residents, students, and new employees) assigned to pharmacists or pharmacy technicians.
Methods: A validated survey to measure burnout and professional fulfillment was administered to employees of a university health system's pharmacy service in 2019.
Introduction: While the relationship between various obstetric procedures and the onset of opioid use disorder (OUD) remains ambiguous, this study aims to elucidate the immediate and prolonged risks of OUD in women who have undergone procedures such as vaginal and cesarean deliveries, induced abortions, and treatments related to miscarriages and ectopic pregnancies.
Methods: Retrospective data ( = 632,872) from the Cerner Real-World Data™ for pregnant females (age 15-44) between January 2010 and March 2020 were used. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were used to compare odds of OUD for each obstetric outcome to normal vaginal delivery using multivariable logistic regression.
Introduction: Previous studies have not examined the association between asthma and opioid use disorder (OUD) in a comprehensive national sample of the U.S. population.
View Article and Find Full Text PDFBackground: Past research suggests associations between heavy alcohol use and later life dementia. However, little is known about whether opioid use disorder (OUD) and dementia share this association, especially among age groups younger than 65 years old.
Objective: Examine the association between OUD and Alzheimer's disease (AD) and dementia.
Background: Measurement is one of the critical ingredients to addressing the well-being of health care professionals. However, administering an organization-wide well-being survey can be challenging due to constraints like survey fatigue, financial limitations, and other system priorities. One way to address these issues is to embed well-being items into already existing assessment tools that are administered on a regular basis, such as an employee engagement survey.
View Article and Find Full Text PDFAfr Health Sci
March 2022
Background: Eswatini has the highest HIV prevalence in the world. One issue at the root of health in Eswatini is a lack of basic health knowledge among children and adolescents, which amplifies the likelihood of disease transmission and poor health outcomes.
Objectives: To address the lack of basic health education and to improve health knowledge, we developed and evaluated a medical education program to train shepherds (train-the-trainer) who are supporting children and adolescents at local CarePoints.
Purpose: To examine the prevalence of burnout, professional fulfillment, sleep impairment, and self-compassion within an academic medical center pharmacy department across varying job titles and practice settings.
Methods: In fall 2019, pharmacy staff completed a REDCap-based survey that consisted of a validated instrument relating to burnout, professional fulfilment, sleep-related impairment, and self-compassion. Burnout was measured by both single-item and extended 10-item questions on the survey.
Objectives: The rate of drug overdose deaths in the USA has more than tripled since the turn of the century, and rates are disproportionately high among the American Indian/Alaska Native (AI/AN) population. Little is known about the overall historical trends in AI/AN opioid-only and opioid/polysubstance-related mortality. This study will address this gap.
View Article and Find Full Text PDFObjective: To assess the risk of new-onset type 1 diabetes mellitus (T1D) diagnosis following COVID-19 diagnosis and the impact of COVID-19 diagnosis on the risk of diabetic ketoacidosis (DKA) in patients with prior T1D diagnosis.
Research Design And Methods: Retrospective data consisting of 27,292,879 patients from the Cerner Real-World Data were used. Odds ratios, overall and stratified by demographic predictors, were calculated to assess associations between COVID-19 and T1D.
Background And Objectives: The annual Accreditation Council for Graduate Medical Education (ACGME) survey evaluates numerous variables, including resident satisfaction with the training program. We postulated that an anonymous system allowing residents to regularly express and discuss concerns would result in higher ACGME survey scores in areas pertaining to program satisfaction.
Methods: One family medicine residency program implemented a process of quarterly anonymous closed-loop resident feedback and discussion in academic year 2012-2013.
Background: Restorative reproductive medicine (RRM) seeks to identify and correct underlying causes and factors contributing to infertility and reproductive dysfunction. Many components of RRM are highly suitable for primary care practice. We studied the outcomes amongst couples who received restorative reproductive medicine treatment for infertility in a primary care setting.
View Article and Find Full Text PDFBackground: The spread of the COVID-19 pandemic throughout the world presents an unprecedented challenge to public health inequities. People who use opioids may be a vulnerable group disproportionately impacted by the current pandemic, however, the limited prior research in this area makes it unclear whether COVID-19 and opioid use outcomes may be related, and whether other environmental and socioeconomic factors might play a role in explaining COVID-19 mortality. The objective of this study is to evaluate the association between opioid-related mortality and COVID-19 mortality across U.
View Article and Find Full Text PDFBackground: This study aimed to understand the prevalence of prediabetes (preDM) and diabetes mellitus (DM) in patients with cancer overall and by tumor site, cancer treatment, and time point in the cancer continuum.
Methods: This cohort study was conducted at Huntsman Cancer Institute at the University of Utah. Patients with a first primary invasive cancer enrolled in the Total Cancer Care protocol between July 2016 and July 2018 were eligible.
Background: Both opioid use and COVID-19 affect respiratory and pulmonary health, potentially putting individuals with opioid use disorders (OUD) at risk for complications from COVID-19. We examine the relationship between OUD and subsequent hospitalization, length of stay, risk for invasive ventilator dependence (IVD), and COVID-19 mortality.
Methods: Multivariable logistic and exponential regression models using electronic health records data from the Cerner COVID-19 De-Identified Data Cohort from January through June 2020.
Factors contributing to racial inequities in outcomes from coronavirus disease 2019 (COVID-19) remain poorly understood. We compared by race the risk of 4 COVID-19 health outcomes--maximum length of hospital stay (LOS), invasive ventilation, hospitalization exceeding 24 h, and death--stratified by Elixhauser comorbidity index (ECI) ranking. Outcomes and ECI scores were constructed from retrospective data obtained from the Cerner COVID-19 De-Identified Data cohort.
View Article and Find Full Text PDFBackground: Pregnant women are potentially a high-risk population during infectious disease outbreaks such as COVID-19, because of physiologic immune suppression in pregnancy. However, data on the morbidity and mortality of COVID-19 among pregnant women, compared to nonpregnant women, are sparse and inconclusive. We sought to assess the impact of pregnancy on COVID-19 associated morbidity and mortality, with particular attention to the impact of pre-existing comorbidity.
View Article and Find Full Text PDFBackground: Faculty and trainee well-being at academic medical centers is a nationwide concern. In response, the University of Utah Health created a system-wide provider wellness program that used individual faculty champions who were empowered to 1) examine the unique needs of their department or division using a lens of quality improvement, 2) design projects to address well-being, and 3) measure impact of projects addressing well-being. One team used a feedback tool to attempt to improve the well-being of Family Medicine faculty by better understanding challenges and developing a roadmap for action.
View Article and Find Full Text PDFBackground And Objectives: The Accreditation Council for Graduate Medical Education (ACGME) requires all residents be trained in quality improvement (QI), and that they produce scholarly projects. While not an ACGME requirement, residents need leadership skills to apply QI knowledge. We developed the Skills-based Experiential Embedded Quality Improvement (SEE-QI) curriculum to integrate training in QI, leadership, and scholarship.
View Article and Find Full Text PDFInt J Environ Res Public Health
August 2020
With the emergence of the novel SARS-CoV-2 and the disease it causes; COVID-19, compliance with/adherence to protective measures is needed. Information is needed on which measures are, or are not, being undertaken. Data collected from the COVID Impact Survey, conducted by the non-partisan and objective research organization NORC at the University of Chicago on April, May, and June of 2020, were analyzed through weighted Quasi-Poisson regression modeling to determine the association of demographics, socioeconomics, and health conditions with protective health measures taken at the individual level in response to COVID-19.
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