We implemented a quality improvement project for diabetes care in a faculty-resident internal medicine practice, using the Chronic Care Model framework. We created a planned visit clinic, used a stepwise medication algorithm, and self-management support. The intervention was effective for patients with glycohemoglobin A1c levels 10 or above (P = .0075) when compared with usual care after adjusting for all significant predictors. Compliance with foot examinations increased by 72% (P < .0001) and pneumococcal vaccinations by 25% (P = .0115). We believe that the Chronic Care Model can be successfully integrated into faculty-resident practices and provides a model for further exploration into disease management education in academic settings.
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http://dx.doi.org/10.1097/JAC.0000000000000007 | DOI Listing |
JAMA Netw Open
January 2025
Transformative Health Systems Research to Improve Veteran Equity and Independence Center of Innovation, Veterans Affairs Providence Health Care System, Providence, Rhode Island.
Importance: Influenza vaccination remains the most important intervention to prevent influenza morbidity and mortality among nursing home residents. The additional effectiveness of recombinant influenza vaccine vs standard dose vaccines was demonstrated in outpatient older adults but has not been evaluated in nursing home populations.
Objective: To compare hospitalization rates among residents in nursing homes immunized with a recombinant vs a standard dose egg-based influenza vaccine.
JAMA Cardiol
January 2025
National Heart and Lung Institute, Imperial College London, United Kingdom.
Importance: Hypertension underpins significant global morbidity and mortality. Early lifestyle intervention and treatment are effective in reducing adverse outcomes. Artificial intelligence-enhanced electrocardiography (AI-ECG) has been shown to identify a broad spectrum of subclinical disease and may be useful for predicting incident hypertension.
View Article and Find Full Text PDFPsychol Serv
January 2025
Center for Health Equity Research and Promotion, Department of Veterans Affairs Pittsburgh Healthcare System.
Chronic insomnia is one of the most common health problems among veterans and can significantly impact health, function, and quality of life. Brief behavioral treatment for insomnia (BBTI), an adaptation of cognitive behavioral therapy for insomnia (CBT-I), was developed to help increase access to care outside of specialty settings. However, training providers alone is rarely sufficient, and implementation strategies are needed for successful uptake, adoption, and sustainable delivery of care.
View Article and Find Full Text PDFAdv Ther
January 2025
CSL Vifor, Glattbrugg, Switzerland.
Introduction: Chronic kidney disease-associated pruritus (CKD-aP) is a common, yet underdiagnosed condition among patients on hemodialysis. Considering the lack of established treatment pathways, we sought to evaluate the use of antidepressant, systemic antihistamines, or gabapentinoid medications among patients with CKD-aP in the year following pruritus assessment.
Methods: We included 6209 patients on hemodialysis in the analysis.
Am J Manag Care
December 2024
Panoramic Health, 850 W Rio Salado Pkwy, Ste 201, Tempe, AZ 85281. Email:
Objective: To determine whether an intensive value-based care educational program that includes a standardized end-stage renal disease (ESRD) transition pathway would improve the number of optimal starts within Kidney Contracting Entities (KCEs).
Study Design: Retrospective cohort study.
Methods: We recorded optimal starts, defined as the initiation of dialysis without a central venous catheter, and the initial modality type (hemodialysis vs peritoneal dialysis [PD]) in adult Medicare patients in a Comprehensive Kidney Care Contracting program.
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