427 results match your criteria: "IDEAS Center[Affiliation]"

Background: Many patients with opioid use disorder (OUD) discontinue treatment prematurely, increasing their risk of opioid-related overdose and death. While patient-centered care is considered the gold standard in treating chronic illness, it may be practiced less frequently in the context of OUD care. Patient-provider communication can influence patients' care experiences, potentially having an impact on treatment retention and care decision-making.

View Article and Find Full Text PDF

Introduction: Neglected tropical diseases (NTDs) mainly affect underprivileged populations, potentially resulting in catastrophic health spending (CHS) and impoverishment from out-of-pocket (OOP) costs. This systematic review aimed to summarize the financial hardship caused by NTDs.

Methods: We searched PubMed, EMBASE, EconLit, OpenGrey, and EBSCO Open Dissertations, for articles reporting financial hardship caused by NTDs from database inception to January 1, 2023.

View Article and Find Full Text PDF

Growing importance of high-volume buprenorphine prescribers in OUD treatment: 2009-2018.

Drug Alcohol Depend

June 2024

RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA 15213, USA.

Background: We examined the number and characteristics of high-volume buprenorphine prescribers and the nature of their buprenorphine prescribing from 2009 to 2018.

Methods: In this observational cohort study, IQVIA Real World retail pharmacy claims data were used to characterize trends in high-volume buprenorphine prescribers (clinicians with a mean of 30 or more active patients in every month that they were an active prescriber) during 2009-2018. Very high-volume prescribing (mean of 100+ patients per month) was also examined.

View Article and Find Full Text PDF

Using the Delphi Process to Prioritize an Agenda for Care Transition Research for Patients With Substance Use Disorders.

Subst Use Addctn J

July 2024

Program of Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.

Medical hospitalizations are increasingly recognized as important opportunities to engage individuals with substance use disorders (SUD) and offer treatment. While a growing number of hospitals have instituted interventions to support the provision of SUD care during medical admissions, post-hospitalization transitions of care remain a challenge for patients and clinicians and an understudied area of SUD care. Evidence is lacking on the most effective and feasible models of care to improve post-hospitalization care transitions for people with SUD.

View Article and Find Full Text PDF

Objective: To determine how a large scale, multicomponent, pharmacy based intervention to reduce proton pump inhibitor (PPI) overuse affected prescribing patterns, healthcare utilization, and clinical outcomes.

Design: Difference-in-difference study.

Setting: US Veterans Affairs Healthcare System, in which one regional network implemented the overuse intervention and all 17 others served as controls.

View Article and Find Full Text PDF

Background & Aims: Alcohol-associated liver diseases (ALDs) and alcohol use disorder (AUD) pose a global health risk. AUD is underrecognized in the elderly, and the burden of AUD complications, including ALD, may increase with aging populations and rising alcohol intake. However, there is a lack of epidemiological evidence on AUD and ALD in the elderly.

View Article and Find Full Text PDF

Neighborhood Deprivation, Race and Ethnicity, and Prostate Cancer Outcomes Across California Health Care Systems.

JAMA Netw Open

March 2024

Department of Surgical and Perioperative Care, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California.

Importance: Non-Hispanic Black (hereafter, Black) individuals experience worse prostate cancer outcomes due to socioeconomic and racial inequities of access to care. Few studies have empirically evaluated these disparities across different health care systems.

Objective: To describe the racial and ethnic and neighborhood socioeconomic status (nSES) disparities among residents of the same communities who receive prostate cancer care in the US Department of Veterans Affairs (VA) health care system vs other settings.

View Article and Find Full Text PDF

Patients' Perspectives on Discontinuing Buprenorphine for the Treatment of Opioid Use Disorder.

J Addict Med

June 2024

From the Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR (JJW, AE, DW, SS, TIL, KM, BJM); School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR (JJW); Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT (AJG); Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT (AJG); Department of Psychiatry, Oregon Health & Science University, Portland, OR (TIL, BJM); and VA Office of Rural Health, Veterans Rural Health Resource Center, Portland, OR (TIL).

Objectives: Buprenorphine and other medications for opioid use disorder (OUD) are recommended as standard of care in the treatment of OUD and are associated with positive health and addiction-related outcomes. Despite benefits, discontinuation is common, with half of patients discontinuing in the first year of treatment. Addressing OUD is a major clinical priority, yet little is known about the causes of medication discontinuation from the patient perspective.

View Article and Find Full Text PDF

Background: To effectively promote vaccine uptake, it is important to understand which people are most and least inclined to be vaccinated and why. In this study, we examined predictors of COVID-19 vaccine uptake and reasons for non-vaccination.

Methods: We conducted an online English-language survey study in December-2020, January-2021, and March-2021.

View Article and Find Full Text PDF

Post-hospitalization Care Transition Strategies for Patients with Substance Use Disorders: A Narrative Review and Taxonomy.

J Gen Intern Med

April 2024

Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Greater Intermountain Node, National Institute on Drug Abuse Clinical Trial Network, Program of Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), , Salt Lake City, UT, USA.

Hospitalizations represent important opportunities to engage individuals with substance use disorders (SUD) in treatment. For those who engage with SUD treatment in the hospital setting, tailored supports during post-discharge transitions to longitudinal care settings may improve care linkages, retention, and treatment outcomes. We updated a recent systematic review search on post-hospitalization SUD care transitions through a structured review of published literature from January 2020 through June 2023.

View Article and Find Full Text PDF

Introduction: Initiation of medications for opioid use disorder (MOUD) within the hospital setting may improve outcomes for people who inject drugs (PWID) hospitalized because of an infection. Many studies used International Classification of Diseases (ICD) codes to identify PWID, although these may be misclassified and thus, inaccurate. We hypothesized that bias from misclassification of PWID using ICD codes may impact analyses of MOUD outcomes.

View Article and Find Full Text PDF

Introduction: Weight loss is recommended for individuals with obstructive sleep apnea (OSA) and overweight or obesity, but there is limited evidence to guide the selection of weight management strategies for patients who do not lose sufficient weight with diet and lifestyle changes. We evaluated the relationship between weight loss caused by pharmacologic or surgical interventions and subsequent improvement in OSA by the apnea-hypopnea index (AHI).

Methods: PubMed, Cochrane CENTRAL, and EMBASE were searched for randomized trials comparing pharmacologic or surgical obesity interventions to usual care, placebo, or no treatment in adults with OSA.

View Article and Find Full Text PDF

Amyloid-β aggregates activate peripheral monocytes in mild cognitive impairment.

Nat Commun

February 2024

Department of Biomedicine, Aarhus University, The Skou Building, Høegh-Guldbergs Gade 10, DK-8000, Aarhus C, Denmark.

Article Synopsis
  • The peripheral immune system influences neurodegenerative diseases like Alzheimer's by both protecting the brain and causing inflammation; however, the exact mechanisms are not fully understood.
  • Researchers found large Aβ aggregates in the plasma of patients with mild cognitive impairment, which are linked to early signs of Alzheimer's pathology and a decrease in certain monocytes.
  • The study identifies complement receptor 4 as a key player in interacting with amyloids, enhancing phagocytosis and lysosomal activity in microglia, and suggests that Aβ aggregates may help recruit immune cells into the brain, affecting the disease process.
View Article and Find Full Text PDF

The impact of a statewide insulin copay cap policy for insured patients with diabetes in Utah.

J Manag Care Spec Pharm

February 2024

Pharmacotherapy Outcomes Research Center, Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City.

Background: Insulin affordability is a huge concern for patients with diabetes in the United States. On March 30, 2020, Utah signed House Bill 207 into law, aimed at capping copayments for insulin at $30 for a 30-day supply. The bill was enacted on January 1, 2021.

View Article and Find Full Text PDF

Background: Substance use disorders (SUDs) are prevalent in the USA yet remain dramatically undertreated. To address this care gap, the Accreditation Council for Graduate Medical Education (ACGME) approved revisions to the Program Requirements for Graduate Medical Education (GME) in Internal Medicine, effective July 1, 2022, requiring addiction medicine training for all internal medicine (IM) residents. The Veterans Health Administration (VHA) is a clinical training site for many academic institutions that sponsor IM residencies.

View Article and Find Full Text PDF

The Addiction Health Services Research (AHSR) Conference has been held since 2002. This Conference brings together researchers, graduate students, policymakers, and treatment providers to focus improving the organization, distribution, and financing of healthcare resources for prevention/care of SUD. The AHSR 2023 Conference took place in New York City, October 18-20, and was hosted by the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH; cherishresearch.

View Article and Find Full Text PDF

Background: Buprenorphine is among the most effective treatments for opioid use disorder. Even though the federal government recently eliminated the waiver requirement and patient limits applicable to office-based buprenorphine treatment (OBBT), among other settings, some states may still have policies imposing requirements on OBBT providers not required by federal law.

Methods: We collected statutes and regulations from 50 US states and the District of Columbia (ie, 51 jurisdictions) between August 11 and November 30, 2022 using the Nexis Uni legal database and search terms related to OBBT counseling, dosage, and/or frequency of visits.

View Article and Find Full Text PDF

Mild traumatic brain injury, PTSD symptom severity, and behavioral dyscontrol: a LIMBIC-CENC study.

Front Neurol

January 2024

Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, United States.

Article Synopsis
  • - Behavioral dyscontrol is common among U.S. service members and veterans, especially after deployments, which can lead to conditions like PTSD and mild TBI (traumatic brain injury).
  • - The study analyzed data from over 1,800 service members and veterans to explore the relationship between the severity of PTSD symptoms, mild TBI due to deployment, and behavioral dyscontrol.
  • - Findings showed that both PTSD severity and deployment-related mild TBI are linked to behavioral dyscontrol, but the impact of mild TBI becomes less significant when PTSD symptoms are higher.
View Article and Find Full Text PDF

The reliable identification of skin and soft tissue infections (SSTIs) from electronic health records is important for a number of applications, including quality improvement, clinical guideline construction, and epidemiological analysis. However, in the United States, types of SSTIs (e.g.

View Article and Find Full Text PDF

The Electronic Health Record (EHR) contains information about social determinants of health (SDoH) such as homelessness. Much of this information is contained in clinical notes and can be extracted using natural language processing (NLP). This data can provide valuable information for researchers and policymakers studying long-term housing outcomes for individuals with a history of homelessness.

View Article and Find Full Text PDF
Article Synopsis
  • Decision aids (DAs) have been developed to help patients with atrial fibrillation (AF) make informed choices about stroke prevention, specifically through an encounter DA (EDA) and a patient DA (PDA) that have not previously been used together.
  • The development of these DAs involved iterative user-centered design, gathering feedback from both patients and experts to refine their effectiveness, resulting in significant improvements based on user needs.
  • While successful in enhancing shared decision making, the DAs are limited to online use and focus solely on anticoagulation options, which could potentially exclude those less familiar with technology.
View Article and Find Full Text PDF

Objective: Empirical estimates of the impact of healthcare expenditure on health outcome measures may inform the cost-effectiveness threshold (CET) for guiding funding decisions. This study aims to systematically review studies that estimated this, summarize and compare the estimates by country income level.

Methods: We searched PubMed, Scopus, York Research database, and [anonymized] for Reviews and Dissemination database from inception to 1 August 2023.

View Article and Find Full Text PDF