Medicine and Health Sciences Commons^™

Is There Less Opioid Abuse In States Where Marijuana Has Been Decriminalized, Either For Medicinal Or Recreational Use? A Clin-Iq, Aaron M. Wendelboe, Richard Mathew, Tana Chongsuwat, Elizabeth Rainwater, Mark A. Wendelboe, Elizabeth Wickersham Md, Ann F. Chou

Journal of Patient-Centered Research and Reviews

Opioid use, abuse, and associated mortality have reached an epidemic level. In some states, cannabis is being used to treat chronic pain. To examine the hypothesis that medical marijuana legislation may reduce adverse opioid-related outcomes if patients substitute cannabis for opioids for pain management, we conducted a clinical inquiry (Clin-IQ). We searched Ovid MEDLINE, Ovid MEDLINE In-Process, and Embase for studies using the search terms marijuana, cannabis, legal, marijuana smoking, medical marijuana, opioid-related disorders, cannabis use, medical cannabis, legal aspect, and opiate addiction. We included population-based articles published from January 1, 2012, through December 5, 2018, that assessed the relationship …

I Live Alone But Don't Feel Alone: Social Isolation And Loneliness From The Patient Perspective, Julia Bedard-Thomas, Christian Gausvik, Jonathan Wessels, Saundra Regan, Keesha Goodnow, Anna Goroncy

Journal of Patient-Centered Research and Reviews

A growing homebound population may be at risk for social isolation and loneliness. Health-related social needs play a contributing role in these conditions. Research shows social isolation and loneliness are drivers of health outcomes. This pilot feasibility study seeks to explore patient-centered insight into perceptions of social isolation and loneliness in a homebound population. Eight participants were recruited from a home-based primary care practice within a family medicine residency program. One 30-minute semi-structured interview was completed in participants’ homes. The interview focused on loneliness and social isolation, using the 6-item De Jong Gerveld loneliness scale. Three qualitative analysts open-coded transcriptions …

Oral Fungal Microbiota: To Thrush And Beyond, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The oral microbiota is complex, multikingdom, interactive, and involves extensive biofilm formation. While dominated by bacteria, Candida is a frequent member of this microbiota; however, several other potentially pathogenic fungi (among around 100 identified species) appear to reside in some individuals, including Cryptococcus, Aspergillus, and Fusarium. Oral candidiasis may manifest as a variety of disease entities in normal hosts and in the immunocompromised. These include pseudomembranous candidiasis (thrush), hyperplastic or atrophic (denture) candidiasis, linear gingival erythema, median rhomboid glossitis, and angular cheilitis. The purpose of this review is to describe the oral fungal microbiota (ie, oral mycobiota), …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

House Calls Are Reaching The Tipping Point — Now We Need The Workforce, Thomas Cornwell

Journal of Patient-Centered Research and Reviews

Home-based primary care (HBPC) improves the lives of high-cost, frail, homebound patients and their caregivers while reducing costs by keeping patients at home and reducing the use of hospitals and nursing homes. Several forces are behind the resurgence of HBPC, including the rapidly aging population, advancements in portable medical technology, evidence showing the value of HBPC, and improved payments for HBPC. There are 2 million to 4 million patients who could benefit from HBPC, but only 12% are receiving it. The number of these patients is expected to double over the next two decades. This requires a larger and better …

Measuring Patients’ Perceptions Of Health Care Encounters: Examining The Factor Structure Of The Revised Patient Perception Of Patient-Centeredness (Pppc-R) Questionnaire, Bridget L. Ryan, Judith Belle Brown, Paul F. Tremblay, Moira Stewart

Journal of Patient-Centered Research and Reviews

Purpose: Given the ongoing desire to make health care more patient-centered and growing evidence supporting the provision of patient-centered care, it is important to have valid tools for measuring patient-centered care. The patient-centered clinical method (PCCM) is a conceptual framework for providing patient-centered care. A revision to the PCCM framework led to a corresponding need to enhance the Patient Perception of Patient-Centeredness (PPPC) questionnaire. The original PPPC was aligned with the components of the PCCM conceptual framework and developed to measure patient-centeredness from the patient’s perspective. The purpose of this study was to examine the factor structure of a revised …

Suffering In Silence: Is Gastroparesis Underdiagnosed?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this introduction to Volume 6, Issue 2, the editor-in-chief of the Journal of Patient-Centered Research and Reviews offers additional comment to the clinical review of diabetic gastroparesis authored by Farmer and colleagues (p. 148), regarding the problem of undiagnosed disease. Increased awareness of this entity and appropriate questioning regarding symptoms of diabetic gastroparesis in the primary care setting may prevent the “suffering in silence” experienced by many patients with this complication.

Variation And Change Over Time In Promis-29 Survey Results Among Primary Care Patients With Type 2 Diabetes, Juell Homco, Kristin Rodriguez, David R. Bardach, Elizabeth A. Hahn, Suzanne Morton, Daren Anderson, David Kendrick, Sarah Hudson Scholle

Journal of Patient-Centered Research and Reviews

Purpose: We sought to describe results of patient-reported outcome measures implemented among primary care patients with diabetes and explore factors associated with changes in scores over time.

Methods: Two organizations serving diverse patient populations collected the PROMIS-29 survey at baseline and 3-month follow-up for patients with type 2 diabetes. Bayesian regression analysis was used to examine the relationship between patient characteristics and changes in PROMIS-29 scores. Exploratory analyses assessed relationships between goal-setting and changes in scores.

Results: The study population reported substantially more problems with physical functioning (mean: 42.5 at Site 1 and 38.9 at Site 2) and pain interference …

Diabetic Gastroparesis: Perspectives From A Patient And Health Care Providers, Adam D. Farmer, Caroline E. Bruckner-Holt, Susanne Schwartz, Emma Sadler, Sri Kadirkamanthan

Journal of Patient-Centered Research and Reviews

Gastroparesis is defined as a delay in gastric emptying in the absence of mechanical obstruction in the stomach. Gastroparesis has a number of causes, including postsurgical, secondary to medications, postinfectious, idiopathic, and as a complication of diabetes mellitus, where it is underrecognized. The cardinal symptoms of diabetic gastroparesis are nausea, early satiety, bloating, and vomiting. Diabetic gastroparesis is more common in females and has a cumulative incidence of 5% in type 1 diabetes and 1% in type 2 diabetes. It is associated with a reduction in quality of life and exerts a significant burden on health care resources. The pathophysiology …

Confidential Care For Adolescents In The U.S. Health Care System, Priya R. Pathak, Adriana Chou

Journal of Patient-Centered Research and Reviews

In providing care for adolescents, maintaining confidentiality should be considered a human right and an evidence-based component of quality care. Unfortunately, complexities in the U.S. legal and health care systems have created a setting in which confidential care is inaccessible to many adolescent patients. Federal laws provide a minimum standard for confidentiality protections, but variations in state legislation relating to minor consent, special health care services, and confidentiality exemptions create large variability in adolescent confidentiality rights across the country. In certain contexts, such as consensual sexual activity, legal provisions may not align with professional ethical standards in adolescent care. In …

Defining Patient-Oriented Research For The Average Person (And Potential Research Partner), Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this introduction to the first issue of 2019, the editor-in-chief of Journal of Patient-Centered Research and Reviews offers additional context to the findings of Kaur and Pluye (p. 7), who methodically formalized an operational definition of patient-oriented research for the purposes of searching bibliographic databases. A possible succinct, lay definition of patient-oriented research for the average “person on the street” is proposed.