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Intervention Stage Completion and Behavioral Health Outcomes: An Integrated Behavioral Health and Primary Care Randomized Pragmatic Trial.
Ann Fam Med
January 2025
Department of Family Medicine, University of Colorado, Denver, Colorado.
Purpose: We performed a pragmatic, cluster randomized controlled trial of a comprehensive practice-level, multistage practice transformation intervention aiming to increase behavioral health integration in primary care practices and improve patient outcomes. We examined associations between completion of intervention stages and patient outcomes across a heterogeneous national sample of primary care practices.
Methods: Forty-two primary care practices across the United States with colocated behavioral health and 2,945 patients with multiple chronic medical and behavioral health conditions completed surveys at baseline, midpoint, and 2-year follow-up.
Intensive care unit acquired weakness and physical rehabilitation in the ICU.
BMJ
January 2025
Division of Pulmonary and Critical Care Medicine, Department of Medicine; and Department of Physical Medicine and Rehabilitation. Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Approximately half of critically ill adults experience intensive care unit acquired weakness (ICUAW). Patients who develop ICUAW may have negative outcomes, including longer duration of mechanical ventilation, greater length of stay, and worse mobility, physical functioning, quality of life, and mortality. Early physical rehabilitation interventions have potential for improving ICUAW; however, randomized trials show inconsistent findings on the efficacy of these interventions.
View Article and Find Full Text PDFSupporting Unhealthy Substance use care Through a whole person Approach and user centered INtegration into primary care (SUSTAIN): Study protocol for a type 2 hybrid effectiveness-implementation trial.
J Subst Use Addict Treat
January 2025
Department of Family Medicine, University of Washington, United States of America.
Background: Unhealthy substance use (USU) is common and ranges from use above guideline-recommended levels to severe substance use disorder. USU results in substantial morbidity and mortality yet primary care practices rarely systematically screen, diagnose, and treat USU. Supporting Unhealthy Substance use care Through a whole person Approach and user centered INtegration into primary care (SUSTAIN) tests whether the implementation of a co-designed change package for USU improves patient function.
View Article and Find Full Text PDFElective Discontinuation of Larotrectinib in Pediatric Patients With TRK Fusion Sarcomas and Related Mesenchymal Tumors.
J Clin Oncol
January 2025
Children's Hospital of Philadelphia/University of Pennsylvania, Philadelphia, PA.
Larotrectinib is a highly selective tropomyosin receptor kinase (TRK) inhibitor with efficacy in children with TRK fusion tumors. We evaluated patient outcomes after elective discontinuation of larotrectinib in the absence of disease progression in a protocol-defined wait-and-see subset analysis of eligible patients where treatment resumption with larotrectinib was allowed if disease progressed. We also assessed the safety and efficacy of larotrectinib in all pediatric patients with sarcoma.
View Article and Find Full Text PDFPreliminary investigation of an artificial intelligence-based cognitive behavioral therapy training tool.
Psychotherapy (Chic)
January 2025
Lyssn.io, Inc.
We developed an asynchronous online cognitive behavioral therapy (CBT) training tool that provides artificial intelligence- (AI-) enabled feedback to learners across eight CBT skills. We sought to evaluate the technical reliability and to ascertain how practitioners would use the tool to inform product iteration and future deployment. We conducted a single-arm 2-week field trial among behavioral health practitioners who treat outpatients with psychosis.
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