Who was at risk for COVID-19 late in the US pandemic? Insights from a population health machine learning model.

Notable discrepancies in vulnerability to COVID-19 infection have been identified between specific population groups and regions in the USA. The purpose of this study was to estimate the likelihood of COVID-19 infection using a machine-learning algorithm that can be updated continuously based on health care data. Patient records were extracted for all COVID-19 nasal swab PCR tests performed within the Providence St.

Effects of Safety Zone Implementation on Perceptions of Safety and Well-being When Caring for COVID-19 Patients.

Background: In March 2020, the caseload of patients positive for COVID-19 in hospitals began increasing rapidly, creating fear and anxiety among health care workers and concern about supplies of personal protective equipment.

Objectives: To determine if implementing safety zones improves the perceptions of safety, well-being, workflow, and teamwork among hospital staff caring for patients during a pandemic.

Methods: A safety zone process was implemented to designate levels of contamination risk and appropriate activities for certain areas.

Standardization of thyroid ultrasound reporting in the community setting decreases biopsy rates.

Objective: With the rising incidence of thyroid cancer, a standardized approach to the evaluation of thyroid nodules is essential. Despite the presence of multiple national guidelines detailing evaluation and management of these nodules, significant variability exists in the information that is collected and reported to clinicians from diagnostic imaging. The aim of this study was to evaluate the impact of thyroid ultrasound standardization on thyroid cancer detection in a community practice setting.

A model of disparities: risk factors associated with COVID-19 infection.

Background: By mid-May 2020, there were over 1.5 million cases of (SARS-CoV-2) or COVID-19 across the U.S.

Association of a Multimodal Educational Intervention for Primary Care Physicians With Prescriptions of Buprenorphine for Opioid Use Disorders.

Importance: Opioid use disorder (OUD) is a public health crisis in the United States, but only 5% of US physicians have obtained a Drug Addiction Treatment Act (DATA) waiver to prescribe buprenorphine to treat OUD. Increasing the number of primary care physicians (PCPs) who have obtained the waiver and are able to treat patients with OUD is of utmost importance.

Objective: To determine whether a multimodal educational intervention of PCPs is associated with an increase in the number of buprenorphine waivers obtained and patients initiated into treatment in a primary care setting.

Analysis of 340 Patients with Solid Pseudopapillary Tumors of the Pancreas: A Closer Look at Patients with Metastatic Disease.

Introduction: Current literature addressing the treatment of solid pseudopapillary neoplasms (SPNs) of the pancreas is limited, particularly for patients with distant metastases. We aimed to define predictive indicators of survival in a large series of patients and assess the outcome of patients with distant metastases.

Methods: The National Cancer Database was queried for patients diagnosed with SPNs of the pancreas between 1998 and 2011.

Management of Primary Hyperparathyroidism: Can We Do Better?

The failure to follow national guidelines in management of various diseases has been previously established. We sought to quantify primary care providers' familiarity with primary hyperparathyroidism as it affects adherence to the 2009 National Institute of Health (NIH) consensus recommendations in treatment of primary hyperparathyroidism. A large primary care group was surveyed to determine their familiarity with the 2009 NIH consensus recommendations for management of primary hyperparathyroidism (PHPT).

Multidisciplinary COPD disease management program: impact on clinical outcomes.

Objectives: We hypothesized performance improvement interventions would improve COPD guideline-recommended care and decrease COPD exacerbations in primary care clinic practices.

Methods: We initiated a performance improvement project in 12 clinics to improve COPD outcomes incorporating physician education, case management, web-based decision support (CareManager(TM)), and performance feedback. We collected baseline and one-year follow up data on 242 patients who had COPD with acute exacerbations.

Treatment strategies for primary hyperparathyroidism: what is the cost?

Primary hyperparathyroidism (HPT) contributes to the onset of many chronic conditions. Although parathyroidectomy is the only definitive treatment, observation remains a valid option. Over a 3-year span, a major health plan was queried for HPT and benign parathyroid neoplasm.

Prevalence of diagnosed sleep apnea among patients with type 2 diabetes in primary care.

Background: Although up to 90% of patients with type 2 diabetes mellitus (T2DM) have obstructive sleep apnea (OSA), the rate at which primary care providers diagnose OSA in patients with diabetes has not been assessed.

Methods: A retrospective, population-based, multiclinic study was performed to determine the proportion of patients with T2DM managed in primary care clinics who were given a diagnosis of OSA and to identify factors associated with an OSA diagnosis. Electronic health records of adult patients with a diagnosis of T2DM were reviewed for a coexisting diagnosis of OSA, and the diagnostic prevalence of OSA was compared with the expected prevalence.

Integrating telehealth technology into a clinical pharmacy telephonic diabetes management program.

Background: Use of home monitoring technologies can enhance care coordination and improve clinical outcomes in patients with diabetes and other chronic diseases. This study was designed to explore the feasibility of incorporating a telehealth system into an existing telephonic diabetes management program utilizing clinical pharmacists.

Methods: This observational study was conducted at three Providence Medical Group primary care clinics.

Team-based care approach to cholesterol management in diabetes mellitus: two-year cluster randomized controlled trial.

Background: Creative, cost-effective interventions to improve the quality of care of chronic illnesses are needed. This study was designed to evaluate the impact of remote physician-pharmacist team-based care on cholesterol levels in patients with diabetes mellitus (DM).

Methods: This 2-year prospective, cluster randomized controlled trial was conducted within the Providence Primary Care Research Network in Oregon.

The impact of a physician-directed health information technology system on diabetes outcomes in primary care: a pre- and post-implementation study.

Purpose: To determine the impact of a physician-directed, multifaceted health information technology (HIT) system on diabetes outcomes.

Methods: A pre/post-interventional study.

Setting And Participants: The setting was Providence Primary Care Research Network in Oregon, with approximately 71 physicians caring for 117 369 patients in 13 clinic locations.

Effect of patient medication cost share on adherence and glycemic control.

Purpose: To evaluate the effect of patient cost-sharing on oral diabetes medication adherence and glycemic control.

Design: Retrospective observational study.

Methodology: Medical and pharmacy claims from a managed care plan and electronic medical records (EMR) from a large physician organization in Oregon were used to identify a cohort with diabetes.

A randomized controlled trial of team-based care: impact of physician-pharmacist collaboration on uncontrolled hypertension.

Objective: Evaluate the effectiveness of collaborative management of hypertension by primary care-pharmacist teams in community-based clinics.

Study Design: A 12-month prospective, single-blind, randomized, controlled trial in the Providence Primary Care Research Network of patients with hypertension and uncontrolled blood pressure.

Methods: As compared to usual primary care, intervention consisted of pharmacy practitioners participating in the active management of hypertension in the primary care office according to established collaborative treatment protocols.

Oral antidiabetic medication adherence and glycemic control in managed care.

Objective: To evaluate adherence to oral diabetes medications (ODMs) in patients with type 2 diabetes and the impact of ODM adherence on glycemic control.

Study Design: Retrospective observational study.

Methods: Medical and pharmacy claims from a managed care plan in Oregon were used to identify adults with diabetes who newly initiated ODM therapy (n = 2741); a subset of this cohort linked to electronic health records was used to evaluate the relationship between adherence and glycemic control (n = 249).

Effect of patient withdrawal on a study evaluating pharmacist management of hypertension.

Study Objectives: To examine potential threats to internal and external study validity caused by differential patient withdrawal from a randomized controlled trial evaluating pharmacist management of hypertension, to compare the characteristics of patients who withdrew with those of patients who completed the study, and to identify characteristics that predispose patients to withdraw from hypertension management.

Design: Prospective, randomized, comparative study.

Setting: Network of primary care clinics.