Effect of Integrating Patient-Generated Digital Data Into Mental Health Therapy: A Randomized Controlled Trial.

Objective: The authors sought to determine whether providing summaries of patients' social media and other digital data to patients and their clinicians improves patients' health-related quality of life (HRQoL) measured by the RAND 36-Item Short Form Health Survey (SF-36).

Methods: The authors randomly assigned 115 adults receiving outpatient mental health therapy to usual care or to periodic sharing of summaries of their digital data with their clinician providing psychosocial therapy. The study was conducted October 2020-December 2021.

Development of a patient-centered text message-based platform for the self-management of interstitial cystitis/bladder pain syndrome symptoms.

Objective: To develop a patient-centered text message-based platform that promotes self-management of symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS).

Methods: Adult women with IC/BPS interested in initiating a first- or second-line treatments per American Urological Association guidelines (recategorized as "behavioral/non-pharmacologic treatments" and "oral medicines" in the 2022 version) participated in rapid cycle innovation consisting of iterative cycles of contextual inquiry, prototype design and development. We delivered treatment modules and supportive messages using an algorithm-driven interactive messaging prototype through a HIPAA-compliant texting platform.

Characterizing Responses to COVID-19 Vaccine Promotion on TikTok.

Purpose: The Alabama Department of Public Health (ADPH) sponsored a TikTok contest to improve vaccination rates among young people. This analysis sought to advance understanding of COVID-19 vaccine perceptions among ADPH contestants and TikTok commenters.

Approach: This exploratory content analysis characterized sentiment and imagery in the TikTok videos and comments.

Pharmacists' role in detection and evaluation of adverse drug reactions: Developing proactive systems for pharmacosurveillance.

Purpose: To identify current challenges in detection of medication-related symptoms, and review technology-based opportunities to increase the patient-centeredness of postmarketing pharmacosurveillance to promote more accountable, safer, patient-friendly, and equitable medication prescribing.

Summary: Pharmacists have an important role to play in detection and evaluation of adverse drug reactions (ADRs). The pharmacist's role in medication management should extend beyond simply dispensing drugs, and this article delineates the rationale and proactive approaches for pharmacist detection and assessment of ADRs.

Evaluation of an Automated Text Message-Based Program to Reduce Use of Acute Health Care Resources After Hospital Discharge.

Importance: Posthospital contact with a primary care team is an established pillar of safe transitions. The prevailing model of telephone outreach is usually limited in scope and operationally burdensome.

Objective: To determine whether a 30-day automated texting program to support primary care patients after hospital discharge is associated with reductions in the use of acute care resources.

Patterns of Prenatal Care Delivery and Obstetric Outcomes before and during the COVID-19 Pandemic.

Objective: Health care providers and health systems confronted new challenges to deliver timely, high-quality prenatal care during the coronavirus disease 2019 (COVID-19) pandemic as the pandemic raised concerns that care would be delayed or substantively changed. This study describes trends in prenatal care delivery in 2020 compared with 2018 to 2019 in a large, commercially insured population and investigates changes in obstetric care processes and outcomes.

Study Design: This retrospective cohort study uses de-identified administrative claims for commercially insured patients.

A Randomized Trial of Behavioral Nudges Delivered Through Text Messages to Increase Influenza Vaccination Among Patients With an Upcoming Primary Care Visit.

Purpose: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates.

Design: Randomized, controlled trial.

Setting: Two health systems in the Northeastern US between September 2020 and March 2021.

Real-Time Measurement of Patient Reported Outcomes and Opioid Use Following Urologic Procedures using Automated Text Messaging.

Objective: To evaluate opioid consumption and patient-reported pain intensity following urologic procedures.

Methods: Adult patients were consented following a urologic procedure, and data was collected through postoperative day 28 in a large tertiary care academic health system. An automated text messaging platform was used to collect patient reported pain intensity, ability to manage pain, and opioid use measured in oxycodone 5mg tablet equivalents.

Using an Electronic Health Record and Deficit Accumulation to Pragmatically Identify Candidates for Optimal Prescribing in Patients With Type 2 Diabetes.

Objective: Despite guidelines recommending less stringent glycemic goals for older adults with type 2 diabetes, overtreatment is prevalent. Pragmatic approaches for prioritizing patients for optimal prescribing are lacking. We describe glycemic control and medication patterns for older adults with type 2 diabetes in a contemporary cohort, exploring variability by frailty status.

Identifying Medication-Related Intents From a Bidirectional Text Messaging Platform for Hypertension Management Using an Unsupervised Learning Approach: Retrospective Observational Pilot Study.

Background: Free-text communication between patients and providers plays an increasing role in chronic disease management, through platforms varying from traditional health care portals to novel mobile messaging apps. These text data are rich resources for clinical purposes, but their sheer volume render them difficult to manage. Even automated approaches, such as natural language processing, require labor-intensive manual classification for developing training data sets.

Effect of Text Messaging and Behavioral Interventions on COVID-19 Vaccination Uptake: A Randomized Clinical Trial.

Importance: COVID-19 vaccine uptake among urban populations remains low.

Objective: To evaluate whether text messaging with outbound or inbound scheduling and behaviorally informed content might increase COVID-19 vaccine uptake.

Design, Setting, And Participants: This randomized clinical trial with a factorial design was conducted from April 29 to July 6, 2021, in an urban academic health system.

Patient and clinician nudges to improve symptom management in advanced cancer using patient-generated health data: study protocol for the PROStep randomised controlled trial.

Introduction: Patients with advanced cancers often face significant symptoms from their cancer and adverse effects from cancer-associated therapy. Patient-generated health data (PGHD) are routinely collected information about symptoms and activity levels that patients either directly report or passively record using devices such as wearable accelerometers. The objective of this study was to test the impact of an intervention integrating remote collection of PGHD with clinician and patient nudges to inform communication between patients with advanced cancer and their oncology team regarding symptom burden and functional status.

Hospital Discharge on Enteral Nutrition is Associated with Increased Hospital Readmissions.

Enteral nutrition (EN) delivered via an enteric access device is employed to correct severe malnutrition and feed patients with pathology restricting oral intake, and is often initiated in the hospital. There are limited data on the clinical outcomes of patients discharged from the hospital on EN. We sought to assess whether discharge with enteral nutrition (DCEN) was independently associated with increased hospital readmissions and to assess the frequency of DCEN in our hospital.

Primary Care Appointment Completion Rates and Telemedicine Utilization Among Black and Non-Black Patients from 2019 to 2020.

To understand how differences in primary care appointment completion rates between Black and non-Black patients changed in 2020 within the context of the COVID-19 pandemic and when telemedicine utilization peaked. We conducted a retrospective cohort study using the electronic health record from January 1 to December 31, 2020, among all adults scheduled for a primary care appointment within a large academic medical center. We used mixed-effects logistic regression to estimate adjusted appointment completion rates for Black patients compared with those for non-Black patients in 2020 as compared with those in 2019 within four time periods: (1) prepandemic (January 1, 2020, to March 12, 2020), (2) shutdown (March 13, 2020, to June 3, 2020), (3) reopening (June 4, 2020, to September 30, 2020), and (4) second wave (October 1, 2020, to December 31, 2020).

A Brief Educational Intervention to Increase ED Initiation of Buprenorphine for Opioid Use Disorder (OUD).

Background: Despite the evidence in support of the use of buprenorphine in the treatment of OUD and increasing ability of emergency medicine (EM) clinicians to prescribe it, emergency department (ED)-initiated buprenorphine is uncommon. Many EM clinicians lack training on how to manage acute opioid withdrawal or initiate treatment with buprenorphine. We developed a brief buprenorphine training program and assessed the impact of the training on subsequent buprenorphine initiation and knowledge retention.

Patient Experience and Satisfaction in Online Reviews of Obstetric Care: Observational Study.

Background: The quality of care in labor and delivery is traditionally measured through the Hospital Consumer Assessment of Healthcare Providers and Systems but less is known about the experiences of care reported by patients and caregivers on online sites that are more easily accessed by the public.

Objective: The aim of this study was to generate insight into the labor and delivery experience using hospital reviews on Yelp.

Methods: We identified all Yelp reviews of US hospitals posted online from May 2005 to March 2017.

Assessment of Patient-Reported Naloxone Acquisition and Carrying With an Automated Text Messaging System After Emergency Department Discharge in Philadelphia.

Importance: A central tenet of harm reduction and prevention of opioid overdose deaths is the distribution and use of naloxone. Patient-centered methods that investigate naloxone acquisition and carrying can guide opioid overdose education and naloxone distribution efforts.

Objective: To assess patients' self-reported naloxone acquisition and carrying after an emergency department (ED) encounter using automated text messaging.

Testing Digital Methods of Patient-Reported Outcomes Data Collection: Prospective Cluster Randomized Trial to Test SMS Text Messaging and Mobile Surveys.

Background: Health care delivery continues to evolve, with an effort being made to create patient-centered care models using patient-reported outcomes (PROs) data. Collecting PROs has remained challenging and an expanding landscape of digital health offers a variety of methods to engage patients.

Objective: The aim of this study is to prospectively investigate two common methods of remote PRO data collection.

Effect of a Default Order vs an Alert in the Electronic Health Record on Hepatitis C Virus Screening Among Hospitalized Patients: A Stepped-Wedge Randomized Clinical Trial.

Importance: Hepatitis C virus (HCV) screening has been recommended for patients born between 1945 and 1965, but rates remain low.

Objective: To evaluate whether a default order within the admission order set increases HCV screening compared with a preexisting alert within the electronic health record.

Design, Setting, And Participants: This stepped-wedge randomized clinical trial was conducted from June 23, 2020, to April 10, 2021, at 2 hospitals within an academic medical center.

In Search of Reliability: Expert-Informed Training Methods for Conducting Observational Coding of Cognitive Behavioral Therapy Fidelity.

Background: Observational coding is the gold standard for measuring treatment fidelity; however, the intensive training needed for reliable and valid measurement has not been carefully scrutinized. A systematic review concluded there is a lack of information in published studies on how to approach training raters, and the available content suggests widely variable approaches are taken across research teams. The quality and comparability of the data produced from these treatment fidelity measures is undermined by heterogeneous training approaches occurring both within and between coding teams.

A 680,000-person megastudy of nudges to encourage vaccination in pharmacies.

Encouraging vaccination is a pressing policy problem. To assess whether text-based reminders can encourage pharmacy vaccination and what kinds of messages work best, we conducted a megastudy. We randomly assigned 689,693 Walmart pharmacy patients to receive one of 22 different text reminders using a variety of different behavioral science principles to nudge flu vaccination or to a business-as-usual control condition that received no messages.

Consumer Willingness to Share Personal Digital Information for Health-Related Uses.

Importance: Consumers routinely generate digital information that reflects on their health.

Objective: To evaluate the factors associated with consumers' willingness to share their digital health information for research, health care, and commercial uses.

Design, Setting, And Participants: This national survey with an embedded conjoint experiment recruited US adults from a nationally representative sample, with oversampling of Black and Hispanic panel members.

Causes of readmissions for patients discharged on enteral nutrition.

Background And Aims: Patients discharged with enteral nutrition (EN) through an enteral access device (DCENs) are noted to have increased hospital readmissions, but data on the readmission causes are limited. We assessed the proportion of these readmissions attributed to EN and determined the contributing factors to readmissions.

Methods: Using electronic health record data, we conducted a retrospective cohort study of all hospital encounters in an academic, urban hospital from July 2017 to December 2019 with discharge with EN to find all unplanned readmissions at the same hospital within 90 days.