Medicine and Health Sciences Commons^™

Cost Analysis Of Implementing An Exercise Program For Fall And Fracture Prevention In Older Adults On Proton Pump Inhibitor Therapy, Thomas Adam Wichelmann, Nhan Dang, David H. Kruchko, Sufyan Abdulmujeeb, Eli D. Ehrenpreis

Journal of Patient-Centered Research and Reviews

Purpose: Falls have significant financial impact. Proton pump inhibitor (PPI) therapy is associated with an increased risk of falls and fractures. Exercise programs have been shown to decrease risk of falls in the elderly population and are recommended by the U.S. Preventive Services Task Force for patients over age 65 to reduce falls. Our study aimed to explore the potential financial benefit of implementing three different Centers for Disease Control and Prevention-recommended exercise-based interventions for fall prevention (Tai Chi, Stepping On, and Otago Exercise Program) in ≥ 65-year-old patients on PPI therapy.

Methods: A Markov model was developed to predict …

Should Health Systems Share Genetic Findings With At-Risk Relatives When The Proband Is Deceased? Interviews With Individuals Diagnosed With Lynch Syndrome, Jessica Ezzell Hunter, Jennifer L. Schneider, Alison J. Firemark, James V. Davis, Sara Gille, Pamala A. Pawloski, Su-Ying Liang, Victoria Schlieder, Alanna Kulchak Rahm

Journal of Patient-Centered Research and Reviews

Purpose: Genetic information has health implications for patients and their biological relatives. Death of a patient before sharing a genetic diagnosis with at-risk relatives is a missed opportunity to provide important information that could guide interventions to minimize cancer-related morbidity and mortality in relatives.

Methods: We performed semi-structured interviews with individuals diagnosed with Lynch syndrome at 1 of 4 health systems to explore their perspectives on whether health systems should share genetic risk information with relatives following a patient’s death. An inductive, open-coding approach was used to analyze audio-recorded content, with software-generated code reports undergoing iterative comparative analysis by a …

A Moment Of Reflection As We Move Forward, Bruce Morgenstern

Journal of Patient-Centered Research and Reviews

The newly appointed editor-in-chief of the Journal of Patient-Centered Research and Reviews reflects on the original editorial mission of the journal and its continuing commitment to publish patient-centered scholarly works that exhibit respect for each patient’s values and preferences; coordinated and integrated care; patient and family education; alleviation of pain, fear, and anxiety; continuity through care-site transitions; and access to care. The reasoning behind the pursuit of well-developed patient-centered care models, through the dissemination of peer-reviewed research findings and patient perspectives, has only been reinforced since the journal’s launch in 2014.

Patient Perspectives On Opioid Risk Discussions In Primary Care, Stephanie A. Hooker, Inih J. Essien, Caitlin M. Borgert-Spaniol, Rebecca C. Rossom, Anthony W. Olson, Katrina M. Romagnoli, Leif I. Solberg

Journal of Patient-Centered Research and Reviews

Purpose: Both patients and clinicians have described discussions of potential opioid risks as challenging. This study’s goal was to understand patient perspectives on discussing opioid risks with primary care clinicians (PCCs).

Methods: Patients identified to be at elevated risk for problems with opioids (ie, opioid use disorder [OUD] diagnosis, taking a medication for OUD, or having ≥ 3 opioid prescriptions in the last year) were recruited from an integrated, Upper Midwest health system to participate in semi-structured qualitative interviews. Interview questions aimed to better understand patient views on conversations about opioid risks with PCCs and perceptions of OUD screening and …

Conference Proceedings: Select Abstracts Presented At Advocate Aurora Scientific Day 2022

Journal of Patient-Centered Research and Reviews

The abstracts published in this supplement were presented at the 48th annual Advocate Aurora Scientific Day on May 25, 2022. This scholarly symposium provides a closed forum for sharing preliminary results from research studies conducted by faculty physicians and nurses, fellows, residents, scientists, and other health professionals associated with U.S. Midwest-based health system Advocate Aurora Health, publisher of the Journal of Patient-Centered Research and Reviews.

Parent And Child Anxiety Evaluated During An Early Period Of The Covid-19 Pandemic: A Mixed-Methods Study, Karla M. Abela, Darlene Acorda, Stanley Cron, Geri Lobiondo-Wood

Journal of Patient-Centered Research and Reviews

Purpose: The objective of this study was to explore parent and child anxiety during the pandemic. Unlike previous pandemics, measures implemented to prevent the transmission of the SARS-CoV-2 virus have been much more limiting.

Methods: An explanatory convergent mixed-methods design was used to describe anxiety of children 9–17 years of age and their parents during August–October 2020. Adult and child versions of State-Trait Anxiety Inventory (STAI) were used to examine levels as measured on STAI’s state-anxiety subscale. Web-based interviews with a subset of patients were conducted qualitatively to analyze anxiety-related themes.

Results: A total of 188 parents …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

Partnering To Advance Health Equity And A Welcome Opportunity To Gather: Proceedings From The 28th Annual Conference Of The Health Care Systems Research Network, Robert T. Greenlee

Journal of Patient-Centered Research and Reviews

In April 2022, the Health Care Systems Research Network (HCSRN) — a consortium of 20 research institutions affiliated with large health systems spread across the United States (and one in Israel) — held its 28th annual conference in Pasadena, California, with 275 researchers, health care colleagues, and external academic partners in attendance. With a conference theme of “Promoting Collaboration and Partnerships to Advance Health Equity,” the scientific program was assembled by a multisite planning committee with input from representatives of informal local host Kaiser Permanente Southern California. Objectives of the annual conference are to showcase scientific findings from HCSRN projects …

Real-World Third Covid-19 Vaccine Dosing And Antibody Response In Patients With Hematologic Malignancies, Michael A. Thompson, Sigrun Hallmeyer, Veronica E. Fitzpatrick, Yunqi Liao, Michael P. Mullane, Stephen C. Medlin, Kenneth Copeland, James L. Weese

Journal of Patient-Centered Research and Reviews

Purpose: This study sought to describe the changes in immune response to a third dose of either Pfizer’s or Moderna’s COVID-19 mRNA vaccine (3V) among patients with hematologic malignancies, as well as associated characteristics

Methods: This retrospective cohort study analyzed pre-3V and post-3V data on 493 patients diagnosed with hematologic malignancies across a large Midwestern health system between August 28, 2021, and November 1, 2021. For antibody testing, S1 spike antigen of the SARS-CoV-2 virus titer was used to determine serostatus.

Results: Among 493 participants, 274 (55.6%) were seropositive both pre- and post-3V (+/+) while 115 (23.3%) seroconverted to positive …

Virtual Behavioral Health Treatment Satisfaction And Outcomes Across Time, Mindy R. Waite, Sara Diab, James Adefisoye

Journal of Patient-Centered Research and Reviews

Purpose: The COVID-19 pandemic continues to have major and long-lasting impacts on health care delivery and mental health. As health care shifted to telehealth, legislation was adjusted to expand telehealth allowances, creating a unique opportunity to elucidate outcomes. The aim of this study was to assess long-term patient and clinician satisfaction and outcomes with virtual behavioral health.

Methods: Data were obtained over 16 months from surveys to patients and clinicians receiving/providing virtual treatment. Outcomes data also were collected from medical records of adults receiving in-person and virtual behavioral health treatment. Data were summarized using descriptive statistics. Groups were compared using …

Abstracts From The 2022 Health Care Systems Research Network (Hcsrn) Annual Conference

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is comprised of 20 health systems with embedded research units. The network’s annual conference serves as a forum for research teams from member institutions to disseminate scientific findings, explore new collaborations, and share insights about conducting research in real-world care delivery settings. Abstracts accepted for presentation at HCSRN 2022 are published in this supplement of Journal of Patient-Centered Research and Reviews, the official journal of HCSRN’s annual conference proceedings.

Is Home Blood Pressure Monitoring Effective At Controlling Hypertension In African American Patients? A Clin-Iq, Rebecca Nye, Wilhelm Lehmann, Deborah Simpson

Journal of Patient-Centered Research and Reviews

African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Associations Between Residential Greenspace, Socioeconomic Status, And Stroke: A Matched Case-Control Study, Heloise Cheruvalath, Jennifer Homa, Maharaj Singh, Paul Vilar, Amin Kassam, Richard A. Rovin

Journal of Patient-Centered Research and Reviews

Purpose: Studies have shown increased residential greenspace is associated with improved outcome following stroke. This study sought to determine if residential greenspace is an independent stroke risk factor.

Methods: A retrospective 1:4 matched case-control study involving 1174 stroke and 4696 control patients over a 3-year period from Milwaukee County, Wisconsin, was conducted. Greenspace was determined using normalized difference vegetation index (NDVI) for a 250-meter radius surrounding a subject’s residence. The area deprivation index (ADI) for the census block tract of a subject’s residence was obtained from the Neighborhood Atlas® (University of Wisconsin School of Medicine and Public Health). …

Responding To Sexual Abuse In Health Care: Development Of A Guide For Patients, Tristan Mcintosh, Heidi Walsh, Meredith Parsons, Erin D. Solomon, Jessica Mozersky, James M. Dubois

Journal of Patient-Centered Research and Reviews

This report details the development of a stakeholder- and evidence-informed online resource guide for patients that provides information to raise awareness about sexual abuse in health care, the value of chaperones, and options for responding to sexual abuse. The guide was developed to reflect lessons learned from 10 years of researching physician wrongdoing (ie, sexual violations, improper prescribing, and unnecessary invasive procedures), a 5-year National Institutes of Health-funded mixed-methods study of 280 cases of egregious wrongdoing in medicine, and an expert working group. Focus groups were conducted with 22 patients from diverse backgrounds to obtain feedback on the acceptability of …

Electrocardiogram-Based Machine Learning Emulator Model For Predicting Novel Echocardiography-Derived Phenogroups For Cardiac Risk-Stratification: A Prospective Multicenter Cohort Study, Heenaben B. Patel, Naveena Yanamala, Brijesh Patel, Sameer Raina, Peter D. Farjo, Srinidhi Sunkara, Márton Tokodi, Nobuyuki Kagiyama, Grace Casaclang-Verzosa, Partho P. Sengupta

Journal of Patient-Centered Research and Reviews

Purpose: Electrocardiography (ECG)-derived machine learning models can predict echocardiography (echo)-derived indices of systolic or diastolic function. However, systolic and diastolic dysfunction frequently coexists, which necessitates an integrated assessment for optimal risk-stratification. We explored an ECG-derived model that emulates an echo-derived model that combines multiple parameters for identifying patient phenogroups at risk for major adverse cardiac events (MACE).

Methods: In this substudy of a prospective, multicenter study, patients from 3 institutions (n = 727) formed an internal cohort, and the fourth institution was reserved as an external test set (n = 518). A previously validated patient similarity analysis model was used …

Stroke Network Of Wisconsin (Snow) Scale Predicts Large Vessel Occlusion Stroke In The Prehospital Setting, Kessarin Panichpisal, Sarah Erpenbeck, Paul Vilar, Reji P. Babygirija, Maharaj Singh, M. Riccardo Colella, Richard A. Rovin

Journal of Patient-Centered Research and Reviews

Purpose: In previous trials, the Stroke Network of Wisconsin (SNOW) scale accurately predicted large vessel occlusion (LVO) stroke in the hospital setting. This study evaluated SNOW scale performance in the prehospital setting and its ability to predict LVO or distal medium vessel occlusion (DMVO) in patients suspected of having acute ischemic stroke (AIS), a scenario in which transport time to an endovascular treatment-capable facility (ECSC) is critical.

Methods: All potential AIS patients with last-known-well time of ≤ 24 hours were assessed by Milwaukee County Emergency Medical Services for LVO using SNOW. Patients with a positive SNOW score were transferred to …

Association Of Natural Waterways And Legionella Pneumophila Infection In Eastern Wisconsin: A Case-Control Study, Hannah M. William, Kayla Heslin, Jessica J. F. Kram, Caroline P. Toberna, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Preliminary research has suggested possible associations between natural waterways and Legionella infection, and we previously explored these associations in eastern Wisconsin using positive L. pneumophila serogroup 1 urine antigen tests (LUAT) as diagnostic. This case-control study was a secondary analysis of home address data from patients who underwent LUAT at a single eastern Wisconsin health system from 2013 to 2017. Only zip codes within the health system’s catchment area that registered ≥ 3 positive cases and ≥ 50 completed tests, as well as geographically adjacent zip codes with ≥ 2 positive cases and ≥ 50 tests, were included. A 1:3 …

Clinical Characteristics, Risk Factors, And Outcomes Among A Large Midwestern U.S. Cohort Of Patients Hospitalized With Covid-19 Prior To Vaccine Availability, Viviana Zlochiver, Ana Cristina Perez Moreno, Michael Peterson, Khalil Odeh, Ashley Mainville, Katherine Busniewski, Jon Wrobel, Mohamed Hommeida, Blair Tilkens, Payal Sharma, Hlu Vang, Sara Walczak, Fekadesilassie Moges, Kritika Garg, A. Jamil Tajik, Suhail Q. Allaqaband, Tanvir Bajwa, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

Purpose: The COVID-19 pandemic posed unprecedented demands on health care. This study aimed to characterize COVID-19 inpatients and examine trends and risk factors associated with hospitalization duration, intensive care unit (ICU) admission, and in-hospital mortality.

Methods: This retrospective study analyzed patients with SARS-CoV-2 infection hospitalized at an integrated health system between February 2, 2020, and December 12, 2020. Patient characteristics and clinical outcomes were obtained from medical records. Backward stepwise logistic regression analyses were used to identify independent risk factors of ICU admission and in-hospital mortality. Cox proportional hazards models were used to evaluate relationships between ICU admission and in-hospital …

Vitamin D Level Testing In An Urban Midwest Clinic: To Test Or Not To Test?, Daniel Mundt, Marianne Klumph, Kayla Heslin, Wajih Askar

Journal of Patient-Centered Research and Reviews

Vitamin D deficiency (VDD) is significantly higher among urban populations in the U.S. Midwest, with African Americans being disproportionately affected. There is ongoing debate surrounding who and how often individuals should be screened for VDD. This study aimed to understand the prevalence of VDD, associated risk factors, and discrepancies in testing at an urban-based internal medicine residency clinic. Data were retrospectively collected on all adult patients seen by the clinic during 2018 and descriptive statistical analysis performed. Among 3976 total patients (mean age: 53 years), 18% (n = 698) had vitamin D levels analyzed, with deficiency found in 71% of …

Seroprevalence Of Covid-19 Igg Antibody In Resident And Fellow Physicians In Milwaukee, Wisconsin: Analysis Of A Cross-Sectional Survey, Dennis J. Baumgardner, Alexander Schwank, Jessica J. F. Kram, Wilhelm Lehmann, Jacob Bidwell, Tricia La Fratta, Kenneth Copeland

Journal of Patient-Centered Research and Reviews

Purpose: Medical trainees are likely at differential risk of exposure to COVID-19 per respective clinical activity. We sought to determine the seroprevalence of COVID-19 antibody (Ab) among resident and fellow physicians with varying degrees of exposure to COVID-19.

Methods: A cross-sectional study of Milwaukee-based resident and fellow physicians, encompassing December 2019–June 2020, was conducted. Relevant variables of interest were ascertained by survey and payroll data, and Abbott ARCHITECT Ab test (index cut-off of ≥ 1.4) was performed. Descriptive statistics were generated, with 95% CI calculated for the study’s primary outcome of seroprevalence.

Results: Among survey respondents (92 of 148, 62%), …

Differences In Health-Related Outcomes And Health Care Resource Utilization In Breast Cancer Survivors With And Without Type 2 Diabetes, Susan Storey, Zuoyi Zhang, Xiao Luo, Megan Metzger, Amrutha Ravali Jakka, Kun Huang, Diane Von Ah

Journal of Patient-Centered Research and Reviews

Purpose: Up to 74% of breast cancer survivors (BCS) have at least one preexisting comorbid condition, with diabetes (type 2) common. The purpose of this study was to examine differences in health-related outcomes (anemia, neutropenia, and infection) and utilization of health care resources (inpatient, outpatient, and emergency visits) in BCS with and without diabetes.

Methods: In this retrospective cohort study, data were leveraged from the electronic health records of a large health network linked to the Indiana State Cancer Registry. BCS diagnosed between January 2007 and December 2017 and who had received chemotherapy were included. Multivariable logistic regression and generalized …

Prevalence Of Mental Health Conditions Among 6078 Individuals With Down Syndrome In The United States, Anne Rivelli, Veronica Fitzpatrick, Sagar Chaudhari, Laura Chicoine, Gengjie Jia, Andrey Rzhetsky, Brian Chicoine

Journal of Patient-Centered Research and Reviews

Findings from a recent study of the largest documented cohort of individuals with Down syndrome (DS) in the United States described prevalence of common disease conditions and strongly suggested significant disparity in mental health conditions among these individuals as compared with age- and sex-matched individuals without DS. The retrospective, descriptive study reported herein is a follow-up to document prevalence of 58 mental health conditions across 28 years of data from 6078 individuals with DS and 30,326 age- and sex-matched controls. Patient data were abstracted from electronic medical records within a large integrated health system. In general, individuals with DS had …

Prevalence Of Endocrine Disorders Among 6078 Individuals With Down Syndrome In The United States, Anne Rivelli, Veronica Fitzpatrick, Danielle Wales, Laura Chicoine, Gengjie Jia, Andrey Rzhetsky, Brian Chicoine

Journal of Patient-Centered Research and Reviews

Findings from a recent study describing prevalence of common disease conditions in the largest documented cohort of individuals with Down syndrome (DS) in the United States strongly suggested significant disparity in endocrine disorders among these individuals when compared with age- and sex-matched individuals without DS. This retrospective, descriptive study is a follow-up report documenting prevalence of 21 endocrine disorder conditions, across 28 years of data, from 6078 individuals with DS and 30,326 age- and sex-matched controls, abstracted from electronic medical records within a large integrated health system. Overall, individuals with DS experienced higher prevalence of adrenal insufficiency and Addison’s disease; …

A Fond Farewell, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this From the Editor introduction to Volume 9, Issue 1, the retiring editor-in-chief of Journal of Patient-Centered Research and Reviews recalls the history and initial aims of JPCRR, discusses the contents of articles in the current issue, and says good-bye.

Patient Satisfaction With Care Is Associated With Better Outcomes In Function And Pain 1 Year After Lumbar Spine Surgery, Björn Knutsson, Bakir Kadum, Ted Eneqvist, Sebastian Mukka, Arkan S. Sayed-Noor

Journal of Patient-Centered Research and Reviews

Purpose: There has been increasing interest in patient-reported experience measures (PREMs) to evaluate the patient experience and satisfaction with care. We conducted a prospective multicenter cohort study to determine any association between patients’ satisfaction of care and their outcomes 1 year after lumbar spine surgery.

Methods: Satisfaction with care was recorded through telephone interviews and a standardized questionnaire. Baseline data collection (300 patients) and 1-year follow-up (209 patients) were conducted through The Swedish National Register for Spine Surgery (Swespine). Exposures were patient experiences, health care professional (HCP) attitudes, shared decision-making, and overall satisfaction with care. Associations were evaluated using adjusted …

A Physical Therapy Mobility Checkup For Older Adults: Feasibility And Participant Preferences From A Discrete Choice Experiment, Dalerie Lieberz, Hannah Borgeson, Steven Dobson, Lindsey Ewings, Karen Johnson, Kori Klaysmat, Abby Schultz, Rachel Tasson, Alexandra L. Borstad

Journal of Patient-Centered Research and Reviews

Purpose: Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment.

Methods: Adults over 55 years of age were recruited from the community. In the study’s first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the …

Bridging The Patient Engagement Gap In Research And Quality Improvement Utilizing The Henry Ford Flexible Engagement Model, Heather A. Olden, Sara Santarossa, Dana Murphy, Christine C. Johnson, Karen E. Kippen

Journal of Patient-Centered Research and Reviews

Purpose: This paper was intended to share a flexible engagement model (FEM) for organizing a structure to obtain patient input regarding health care operations and research, provide greater detail on recruitment, retention, and dissemination strategies, and demonstrate successes and potential applications in other health care settings.

Methods: Utilizing a pragmatic approach, the Patient-Engaged Research Center (PERC) at Henry Ford Health System developed the FEM, a 7-step process to introduce interested patients/caregivers to the patient advisor program and to follow up with placements. PERC developed a meeting evaluation to measure participant satisfaction. Retention and dissemination methods to keep participants …

Prevalence Of Infectious Diseases Among 6078 Individuals With Down Syndrome In The United States, Veronica Fitzpatrick, Anne Rivelli, Sagar Chaudhari, Laura Chicoine, Gengjie Jia, Andrey Rzhetsky, Brian Chicoine

Journal of Patient-Centered Research and Reviews

A recent disease prevalence study of the largest documented Down syndrome (DS) cohort in the United States strongly suggested significant disparity in general infectious disease conditions among individuals with DS versus those without DS. In this follow-up retrospective analysis, we explored these differences in greater detail by calculating prevalence of 52 infectious diseases, across 28 years of data among 6078 individuals with DS and 30,326 age- and sex-matched controls, abstracted from electronic medical records within a large Midwestern health system. We found that the DS cohort had higher prevalence of pneumonias (including aspiration, viral, bacterial, pneumococcal, and unspecified/atypical); otitis externa; …