646 results match your criteria: "Center for Research on Health[Affiliation]"

Aim: To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence-based practices, from the perspectives of potential programme participants and deliverers.

Design: A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China.

Methods: We conducted individual semi-structured interviews with unit-level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype.

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Trends in Patient Representation in Low Back Pain Pharmacological Randomized Clinical Trials, 2011 to 2020: A Systematic Review.

J Pain

June 2024

Department of Epidemiology and Population Sciences, Stanford University School of Medicine, Stanford, California; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.

Low back pain (LBP) significantly affects global health, with associated detrimental outcomes such as physical impairment, emotional distress, and exacerbated mental health symptoms. This study evaluated the representation of marginalized groups, including racialized, gender minority, pregnant/lactating, and elderly individuals in randomized controlled trials for pharmacological interventions treating LBP from 2011 to 2020. We searched Embase, MEDLINE, and CINAHL in December 2021, and 139 studies were eligible.

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Background: Patients face well documented problems accessing methadone from opioid treatment programs (OTPs) in the U.S., yet addressing these barriers has proven difficult due in part to the sheer number of actors governing treatment, including state authorities.

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Background: The fear of taking away hope hinders clinicians' willingness to share serious news with patients with advanced disease. Unrealistic illness expectations, on the other hand, can complicate decision making and end-of-life care outcomes. Exploration of the association between hope and illness expectations can support clinicians in better communication with their patients.

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Rationale & Objective: Stigma contributes to ineffective treatment for pain among individuals with kidney failure on dialysis, particularly with buprenorphine pain treatment. To address stigma, we adapted a Design Sprint, an industry-developed structured exercise where an interdisciplinary group works over 5 days to clarify the problem, identify and choose a solution, and build and test a prototype.

Study Design: Adapted Design Sprint which clarified the problem to be solved, proposed solutions, and created a blueprint for the selected solution.

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Introduction: Sickle cell disease (SCD) is associated with vaso-occlusive events (VOEs) that can lead to disease complications, including early mortality. Given that similar inflammatory responses characterize VOE and traumatic injury, injured patients with SCD may be vulnerable to acute complications. This study is the first to examine whether traumatic injury is associated with increased severity of future VOEs.

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Background: Although accuracy of diagnosis codes for cirrhosis and chronic pancreatitis (CP) has been evaluated in multiple studies, none have focused on patients with alcohol use disorders (AUD). We evaluated the positive predictive value (PPV) for a verified diagnosis of cirrhosis and CP in AUD patients treated at a tertiary care center.

Methods: We performed a detailed review of electronic health records for AUD patients assigned ICD-9 or 10 codes for alcoholic cirrhosis (ALC) (n = 199), CP (n = 200), or both (n = 200).

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Article Synopsis
  • Depression negatively impacts adherence to direct-acting oral anticoagulants (DOACs) in patients with atrial fibrillation (AF), which can increase stroke risk.
  • A study analyzed data from over 101,000 individuals with AF, revealing that those with depression had 11% lower odds of adequate adherence and 12% lower odds of optimal adherence to DOACs compared to those without depression.
  • The study concluded that addressing depression in AF patients is important for enhancing medication adherence and potentially lowering stroke risk, but depression did not affect adherence to warfarin.
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Background: Preventing progression to moderate or severe opioid use disorder (OUD) among people who exhibit risky opioid use behavior that does not meet criteria for treatment with opioid agonists or antagonists (subthreshold OUD) is poorly understood. The Subthreshold Opioid Use Disorder Prevention (STOP) Trial is designed to study the efficacy of a collaborative care intervention to reduce risky opioid use and to prevent progression to moderate or severe OUD in adult primary care patients with subthreshold OUD.

Methods: The STOP trial is a cluster randomized controlled trial, randomized at the PCP level, conducted in 5 distinct geographic sites.

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Influence of patient trust in provider and health literacy on receipt of guideline-concordant chronic opioid therapy in HIV care settings.

J Opioid Manag

November 2023

Section of General Internal Medicine, Department of Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston Medical Center, Boston University School of Medicine; Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.

Article Synopsis
  • The study aimed to evaluate how health literacy and trust in healthcare providers affect communication and opioid monitoring in HIV-positive patients on chronic opioid therapy.
  • Researchers conducted a retrospective analysis of HIV-positive individuals in clinics in Boston and Atlanta, focusing on those who had received multiple opioid prescriptions.
  • Results showed that neither health literacy nor trust in providers significantly impacted important outcomes like the frequency of urine drug tests or having a treatment agreement regarding opioid use.
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Objective: Using continuous glucose monitoring (CGM), we examined patterns in glycemia during school hours for children with type 1 diabetes, exploring differences between school and non-school time.

Methods: We conducted a retrospective analysis of CGM metrics in children 7-12 years (n=217, diabetes duration 3.5±2.

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Rationale & Objective: To address the need for an intradialytic exercise program that is easily delivered in clinical setting, engaging and scalable, we developed a novel COMprehensive EXercise (COMEX) program based on input from patients receiving hemodialysis (HD), dialysis staff members and nephrologists. The objective of this study was to determine the feasibility, safety, and acceptance of COMEX during HD.

Study Design: Single-arm prospective pilot feasibility study.

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Article Synopsis
  • Education significantly influences lifetime cardiovascular disease (CVD) risk, making it a crucial factor for public health.
  • The study involved nearly 41,000 participants from various community-based cohort studies, analyzing how education levels relate to the risk of CVD events from 1985 to 2015.
  • Results indicated that individuals with less education (less than high school or high school completion) had a higher lifetime risk of CVD compared to college graduates, highlighting the importance of educational attainment in health outcomes.
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Importance: Few primary care (PC) practices treat patients with medications for opioid use disorder (OUD) despite availability of effective treatments.

Objective: To assess whether implementation of the Massachusetts model of nurse care management for OUD in PC increases OUD treatment with buprenorphine or extended-release injectable naltrexone and secondarily decreases acute care utilization.

Design, Setting, And Participants: The Primary Care Opioid Use Disorders Treatment (PROUD) trial was a mixed-methods, implementation-effectiveness cluster randomized clinical trial conducted in 6 diverse health systems across 5 US states (New York, Florida, Michigan, Texas, and Washington).

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Background Patients experience atrial fibrillation (AF) as a complex disease given its adversity, chronicity, and necessity for long-term treatments. Few studies have examined the experience of rural individuals with AF. We conducted qualitative assessments of patients with AF residing in rural, western Pennsylvania to identify barriers and facilitators to care.

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Article Synopsis
  • The study aimed to analyze how medication copayment affects adherence to hydroxychloroquine and immunosuppressants in patients with Systemic Lupus Erythematosus (SLE).
  • Using health claims data, researchers tracked 12,510 individuals over nearly a decade to understand the link between copayment amounts and treatment adherence rates.
  • Results indicated that higher copayments significantly reduced adherence to medications, emphasizing the need for healthcare systems to consider the financial burden of copayments to improve patient compliance.
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Caring for Patients With Opioid Misuse or Substance Use Disorders in Hospice: A National Survey.

J Palliat Med

February 2024

Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Opioid misuse and substance use disorders (SUDs) including opioid use disorder (OUD) are common and negatively impact quality of life. Hospice clinicians' experiences with these conditions have not been well described. We sought to explore hospice clinicians' knowledge, practices, and comfort caring for patients with opioid misuse (e.

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Objective: To identify antibiotic prescribing patterns at the time of foley catheter removal after radical prostatectomy and implement a multi-pronged behavioral intervention to standardize antibiotic use.

Methods: This was a single-institution study examining the prescribing of antibiotics at the time of foley catheter removal after radical prostatectomy. Pre-intervention data were collected retrospectively to establish baselines for antibiotic prescribing, patient characteristics, and urinary tract infection rates.

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Background: Shared decision-making (SDM) facilitates the participation of healthcare professionals and patients in treatment decisions. We conducted a scoping review to assess SDM's current status in mainland China, referencing the Ottawa Decision Support Framework (ODSF).

Methods: Our review encompassed extensive searches across six English and four Chinese databases, and various gray literature until April 30, 2021.

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Background: Therapeutic use of cannabis is common in the United States (up to 18.7% of Americans aged ≥12), and dispensaries in the US are proliferating rapidly. However, the efficacy profile of medical cannabis is unclear, and customers often rely on dispensary staff for purchasing decisions.

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Despite the acceleration in the use of digital health technologies across different aspects of the healthcare system, the full potential of real-world data (RWD) and real-world evidence (RWE) arising from the technologies is not being utilised in decision-making. We examine current national efforts and future opportunities to systematically use RWD and RWE in decision-making in five countries (Estonia, Finland, Germany, Italy and the United Kingdom), and then develop a framework for promotion of the systematic use of RWD and RWE. A review assesses current national efforts, complemented with a three-round consensus-building exercise among an international group of experts (1 = 44, 2 = 24, 3 = 24) to derive key principles.

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Background: An increasing interest in machine learning (ML) has been observed among scholars and health care professionals. However, while ML-based applications have been shown to be effective and have the potential to change the delivery of patient care, their implementation in health care organizations is complex. There are several challenges that currently hamper the uptake of ML in daily practice, and there is currently limited knowledge on how these challenges have been addressed in empirical studies on implemented ML-based applications.

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Background: Mental health (MH) care often exhibits uneven quality and poor coordination of physical and MH needs, especially for patients with severe mental disorders. This study tests a Population Health Management (PHM) approach to identify patients with severe mental disorders using administrative health databases in Italy and evaluate, manage and monitor care pathways and costs. A second objective explores the feasibility of changing the payment system from fee-for-service to a value-based system (e.

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Objectives: To analyze variations in blood profile, the extent of hematological disorders, and the impact of comorbidities and COVID-19 vaccination on blood profile parameters and their clinical value for prognostic of SARS-CoV-2 infection.

Methods: This cross-sectional study took place in Douala, Cameroon. A complete blood count and molecular detection of SARS-CoV-2 were performed on patients.

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