Economic Evaluations of Health Service Interventions Targeting Patients with Multimorbidities: A Scoping Literature Review.

Introduction: Multimorbid patients have been growing, leading to an exponential increase in healthcare costs and patterns of resource utilization. Despite the heightened interest toward integrated care programs as a response to the complex need of multimorbid patients, economic evaluations of these programs remain scarce. This work investigated the economic evaluations of service interventions targeting multimorbid patients, to identify the characteristics of these programs and the methods applied to their evaluation.

Understanding parental choices related to infant sleep practices in the United States using a mixed methods approach.

Background: This study aimed to gather information about parental practices, knowledge, and attitudes regarding infant sleep habits and environments, among families who practice non-recommended sleep practices.

Methods: We conducted one-on-one phone interviews with parents who had practiced non-recommended sleep methods with their infant and had or had not experienced an undesirable sleep event such as a fall. Interviews were recorded and coded with MAXQDA software.

Leveraging the postpartum period to reduce racial disparities in postpartum hypertension care.

Pregnancy provides a window of opportunity for management of hypertension care. Particularly in the postpartum period - the so-called "4th trimester" - individuals of Black race are at increased risk for hypertension-related morbidity and mortality. Telehealth interventions, such as remote blood pressure monitoring programs and virtual postpartum visits, can reduce racial disparities in the delivery of recommended care.

Assessing Compliance: Violations of WHO Code in Breast Milk Substitute Marketing, Ecuador.

Breast milk substitute (BMS) marketing significantly influences global infant feeding practices. Ecuador, like many countries, seeks to regulate these promotions under the WHO's International Code of Marketing of Breast-Milk Substitutes. This cross-sectional analysis assessed BMS marketing compliance with WHO's Code in Ecuador.

Cognitive considerations for adults with sickle cell disease completing the brief pain inventory.

Introduction: Accurate assessment of pain severity is important for caring for patients with sickle cell disease (SCD). The Brief Pain Inventory was developed to address limitations of previous pain-rating metrics and is available in a short form (BPI-SF). However, the BPI-SF is a self-report scale dependent on patient comprehension and interpretation of items.

Implementation of Machine Learning Applications in Health Care Organizations: Systematic Review of Empirical Studies.

Background: There is a growing enthusiasm for machine learning (ML) among academics and health care practitioners. Despite the transformative potential of ML-based applications for patient care, their uptake and implementation in health care organizations are sporadic. Numerous challenges currently impede or delay the widespread implementation of ML in clinical practice, and limited knowledge is available regarding how these challenges have been addressed.

Guideline concordance of electronic health record order sets for hospital-based treatment of alcohol withdrawal syndrome.

Background: Treatment of alcohol withdrawal syndrome (AWS) in hospitals is inconsistent. Electronic health record (EHR) order sets protocolize care.

Objective: We examined variation in AWS order sets across hospital organizations and their concordance with AWS guidelines.

Benefits and Adverse Events Associated With Extended Antibiotic Use for One Year Following Periprosthetic Joint Infection in Total Knee Arthroplasty: A Prospective Cohort Analysis.

Background: Periprosthetic joint infections (PJIs) are common and serious complications following knee and hip arthroplasty. Our previous retrospective study suggested extended antibiotics following debridement, antibiotics, and implant retention (DAIR) decreased failure rates and were not associated with increased adverse events (AEs) as compared to a standard 6 weeks of antibiotic therapy. Further, extended antibiotics beyond one year did not provide additional benefits.

The perpetual evidence-practice gap: addressing ongoing barriers to chronic pain management in primary care in three steps.

Background: Most management of chronic pain, a serious illness affecting the physical and psychological wellbeing of millions, occurs in primary care settings. Primary care practitioners (PCPs) attempt to provide evidence-based practices to treat chronic pain. However, there continues to be a gap between the care people receive and the evidence.

Breast-cancer specific comprehensive archive of Patient-Reported Outcome Measures (PROMs) for clinical research and clinical practice in oncology: Results from the PRO4All project.

Background: Inclusion of patient-reported outcomes (PROs) in oncology clinical trials is strongly recommended. However, selecting the most appropriate patient-reported outcome measures (PROMs) is not easy. This study aimed to develop a breast cancer (BC) specific comprehensive archive of PROMs.

Long-Term Use of Muscle Relaxant Medications for Chronic Pain: A Systematic Review.

Importance: Stricter opioid prescribing guidelines have increased prescriptions of skeletal muscle relaxants (SMRs) for chronic pain, but the efficacy of long-term use of SMRs for chronic pain is unknown.

Objective: To systematically review the effectiveness or efficacy of long-term use of SMRs for chronic pain.

Evidence Review: Two reviewers systematically searched Ovid MEDLINE, Embase (Ovid), Web of Science, CINAHL, and Cochrane through December 4, 2023.

Describing Adverse Pregnancy Events and Pregnancy-Associated Death Among Veterans.

Veterans who use VA pregnancy benefits may be at high risk for adverse pregnancy outcomes; however, little is known about rates of adverse pregnancy events or pregnancy-associated death among Veterans. We conducted a retrospective cohort study using VA national administrative data for Veterans ages 18-45 with at least one pregnancy outcome between October 2009 and September 2016 and a VA primary care visit within one year prior to pregnancy. We identified adverse events during pregnancy and up to 42 days after pregnancy and all-cause mortality within one year of pregnancy and compared prevalence of adverse events by Veteran race/ethnicity using adjusted logistic regression.

Implementing Change Through an Outpatient Antibiotic Stewardship Program.

Introduction: We sought to implement a multipronged behavioral intervention to reduce and tailor antibiotic use for 2 common urologic outpatient procedures.

Methods: This study was a nonblinded intervention study that consisted of a preintervention phase (November 2018-January 2019), an intervention phase (January 2020-December 2020) in which a multipronged behavioral intervention was implemented, and a postintervention phase (January 2021-March 2021). We examined antibiotic use for cystoscopy and transrectal prostate biopsy at 3 separate urologic outpatient clinics.

Association of Race and Ethnicity and Social Factors With Postpartum Primary Care or Cardiology Follow-Up Visits Among Individuals With Preeclampsia.

Background: Preeclampsia is associated with increased cardiovascular morbidity and death. Primary care or cardiology follow-up, in complement to routine postpartum obstetric care, provides an essential opportunity to address cardiovascular risk. Prior studies investigating racial differences in the recommended postpartum follow-up have incompletely assessed the influence of social factors.

Development and evaluation of scenario-based e-simulation for humanitarian health training: a mixed-methods action research study.

Objectives: This study aimed to develop and evaluate a scenario-based e-simulation (SBES) to address the limited avilability of accessible and practical training for humanitarian public health responders. The objectives included SBES customisation, effectiveness evaluation, and identifying learning-enhancing design elements.

Design: A university-based, mixed-methods action research design.

The barbershop paradigm: Community engagement for cardiovascular prevention.

Barbershops and beauty salons provide community-specific opportunities to engage in cardiovascular disease screening and prevention. This editorial articulates the advantages of what is termed the "barbershop paradigm," the community-engaged endeavor that leverages familiarity, trust, and stakeholder engagement to advance cardiovascular health. The authors summarize the neighborhood-based factors that contribute to cardiovascular health, and then identify the strategies implemented by and their specific advantages.

Electronic Health Record-Based Nudge Intervention and Axillary Surgery in Older Women With Breast Cancer: A Nonrandomized Controlled Trial.

Importance: Choosing Wisely recommendations advocate against routine use of axillary staging in older women with early-stage, clinically node-negative (cN0), hormone receptor-positive (HR+), and HER2-negative breast cancer. However, rates of sentinel lymph node biopsy (SLNB) in this population remain persistently high.

Objective: To evaluate whether an electronic health record (EHR)-based nudge intervention targeting surgeons in their first outpatient visit with patients meeting Choosing Wisely criteria decreases rates of SLNB.

Use and Cost of Low-Value Services Among Veterans Dually Enrolled in VA and Medicare.

Background: Over half of veterans enrolled in the Veterans Health Administration (VA) are also enrolled in Medicare, potentially increasing their opportunity to receive low-value health services within and outside VA.

Objectives: To characterize the use and cost of low-value services delivered to dually enrolled veterans from VA and Medicare.

Design: Retrospective cross-sectional.

Abortion After Pregnancy Occurrence with Contraceptive Use Among Veterans.

Many people report becoming pregnant while using contraception. Understanding more about this phenomenon may provide insight into pregnant people's responses to and healthcare needs for these pregnancies. This study explores the outcome (e.