Public Health Commons^™

Prevalence Of Potentially Inappropriate Medications In People Living With Hiv: A Systematic Review And Meta-Analysis, Mustapha Muhammed Abubakar, Abdulmuminu Isah, Ruth Jeminiwa, Ibraheem Abioye, Ismaeel Yunusa, Mohammed Abba-Aji, Osagie Kenneth Cole, Jamila Sani, Mukhtar Ijaiya, Chukwuemeka Nwachuya, Yusuf Ibrahim, Mustapha Usman, Duke Daniels, Oluwaseun Samuel Ilugbuhi, Blessing Onyinye Ukoha-Kalu

College of Pharmacy Faculty Papers

BACKGROUND: Potentially inappropriate medications (PIM) are associated with adverse health outcomes. The use of PIM among persons living with HIV (PLHIV) could be more problematic due to peculiarities such as antiretroviral toxicity and drug-disease interactions. However, PIM among PLHIV continues to receive little attention. Therefore, we aimed to systematically review and estimate the prevalence of PIM among PLHIV.

METHODS: We searched the PubMed, Scopus, and Web of Science databases to identify relevant studies from 1 January 2014 to 30 June 2024. Studies included were peer-reviewed articles that determined PIM prevalence using validated explicit or implicit tools and provided statistical information …

Efficacy Of Medical-Legal Partnerships To Address Health-Harming Legal Needs: A Systematic Review Of Experimental Studies In The Field, Jemima John, Thomas Murphy, Emily Zientek, Winston Liaw, Odinakachukwu Dimgba, Thien-An Nguyen, Catherine Burnett, Mary Aitken, Shreela Sharma

Faculty, Staff and Student Publications

Background: Despite the documented success of medical-legal partnerships (MLPs), there is a dearth of robust experimental-based research on their efficacy. This review synthesizes the findings of MLP interventions and identifies opportunities for MLP expansion in vulnerable communities.

Methods: Articles were eligible if they tested the experimental effects of an MLP intervention on health-harming legal needs (HHLNs) and had full text for review. Two reviewers independently screened articles for inclusion and assessed the quality (risk of bias) of each study.

Results: Seven studies were eligible. Populations were largely women, of color, and of lower socioeconomic status. All studies demonstrated positive effects …

A Practical Primer On How To Detect And Treat Depression In Ckd, L Parker Gregg, Lynnel Goodman, Ella Q Carroll, S Susan Hedayati

Faculty, Staff and Students Publications

Detection and management of depression have special considerations in people with kidney disease. Screening should be done every 6-12 months using a self-reported questionnaire. Clinicians should rule out symptoms from medical conditions such as dialysis inadequacy or hypothyroidism and confirm the presence of sadness or anhedonia. Sertraline has shown limited efficacy and an increased risk for adverse effects such as gastrointestinal symptoms, so cautious, gradual dose titration is warranted. Cognitive behavioral therapy has potential benefit for depressive symptoms in people with kidney disease. Current trials are evaluating behavioral activation therapy. Physical activity has many benefits and likely improves depression.

Co-Designing A Patient-Facing Version Of A Mental Healthcare Pathway For People Receiving Dialysis, Alexandra Albers, Charlotte Berendonk, Julie Robison, Richard Sawatzky, Loretta Lee, Monika Bolin, Jeff Costley, Sandy Johnstone, Kevin Kemp, Justin Leroux, May Tourangeau, Sabiha Zaman, Kara Schick-Makaroff

Patient Experience Journal

A Community Advisory Committee comprised of nine members with lived experience of kidney failure, identified the need for a patient-facing version of a mental healthcare pathway for people receiving dialysis in Alberta, Canada. Recognizing that healthcare tools to support person-centred care practices should be available in lay language, our team (comprised of Community Advisors and healthcare clinicians and researchers) co-designed a patient-facing pathway: “Your Journey: Coping with and Adjusting to Dialysis.” The Provincial Pathways Unit provided a template for the pathway, and the content was adapted through multiple online and in-person meetings with the Community Advisors. Adaptations were informed by …

Leading Through Partnership: Development Of A Hospital-Wide Family-Centered Care Collaborative, Jessica T. Fry, Naomi Shapiro, Barbara Lawlor Burke, Kalee Ryan, Kerri Z. Machut

Patient Experience Journal

Though it has been widely recognized that systematic patient and family engagement plays a critical role in strengthening the provision of family-centered pediatric healthcare, significant gaps in knowledge remain regarding how to develop and build a successful model of engagement. As a group of pediatric health care professionals invested in improving the patient and family-centered care provided by our children’s medical center, we saw the opportunity for family and organizational collaboration as a needed “first step” in model development. In this case study, we describe our institutional journey to build connections and resources though the development of a Family Centered …

Virtual Nurse Discharge: Improving Patient And Nurse Experience, Dina Flihan, Christine Odell, Stacey Davis, Carolyn Oates, Fay Wright

Patient Experience Journal

This case study reviews the virtual discharge nurse (VDN) process and its impact on patient experience and nursing workflow as an exemplar of an effective telehealth innovation at a community hospital 23-bed Short Stay Unit (SSU). At the SSU, the daily turnover rate of more than 50% of the unit census challenged the nurses’ ability to provide comprehensive individualized discharge education. SSU patient experience scores measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) reflected opportunities to improve the discharge process. Therefore, the direct care nurses on SSU suggested a trial innovation of a VDN to improve …

Triad: A Novel Team Structure Pilot And Its Impact On Patient Experience In The Pediatric Emergency Department, Walter Palmer Md, Joseph R. Mijares Iii, Md, Sephora Morrison Mbbs, Msci, Mba

Patient Experience Journal

Introduction: Patient experience is inextricably tied to effective communication between the care team and patient. Published trials designed to improve communication and therefore patient experience in the pediatric emergency department setting are lacking. Methods: This is a novel care team reorganization in a single tertiary care pediatric emergency department. A Triad team consisted of a nurse, emergency technician (Tech), and physician or advanced practice practitioner (APP). The team was designed and trained with an emphasis on closed loop communication with the team and patient to test whether improving effective communication can subsequently improve the patient experience. Using a real-time survey, …

Empowering Frontline Staff In Service Recovery, Sarah E. Duncan, Brianna Camera, Iva Ervin-Stanberry, Heather L. Pezzullo

Patient Experience Journal

Objective: This study aimed to develop and implement a standardized service recovery training program within the VA healthcare system to enhance patient experiences and address grievances effectively. The purpose of the training was to equip VA employees with the necessary skills and knowledge to resolve service issues promptly and empathetically, adhering to the principles of the VA’s SALUTE model for service recovery. Method: The training program was designed based on feedback from anonymous pre-surveys to identify knowledge gaps and incorporate industry best practices. The VA’s SALUTE model, which emphasizes six key actions—saying hello, apologizing, listening, understanding, taking action, …

A Case Report On Meeting The Spiritual Need Of Intubated Conscious Patient, Mahuya Karmakar, Santhna Letchmi Panduragan, Faridah Mohd Said

Patient Experience Journal

Nurses are showing more interest in including spiritual health to prevent and treat illnesses. For patients who can speak may ask for their spiritual need to the health care provider. But for intubated patients it.s difficult to express such needs. Most of the time caregivers focus on the physical parameters only for intubated patients. Apart from physical symptoms these patients also experience a variety of bio-psycho-socio-spiritual sensations. Research has shown that spiritual therapies can reduce distress, assist in preparing the patient for end-of life care, and enhance overall wellbeing along with improving their quality of life. The purpose of this …

A Systematic Review Of The Literature On The Validity, Reliability, And Utility Of The Nhs Friends And Family Test As A Method For Gathering Feedback On And Improving The Experiences Of Patients, Miss Jenny King, Catherine Davidson, Miss Hannah Wade, Chris Graham

Patient Experience Journal

The NHS Friends and Family Test (FFT) is widely used across the National Health Service to collect patient feedback on care experiences. Given its scale and cost, there is strong public and organisational interest in the validity, reliability, and utility of the FFT. This study aimed to systematically review the literature on the validity, reliability, and utility of the FFT as a method for gathering feedback on and improving patient experiences. PubMed and ProQuest databases were searched in September 2024. Studies were included if they met the inclusion criteria. Information extracted included study information (e.g., title, authors, publication year, research …

Reliability And Validity Of A Modified Version Of The Consumer Assessment Of Healthcare Providers And Systems (Cahps®) Clinician And Group Visit Survey 4.0 (Beta) For Ambulatory Behavioral Health Care, Jessica K. Jeffrey, Ron D. Hays, Randi Hissom, Mark Grossman, Samuel A. Skootsky

Patient Experience Journal

Patient experience is a fundamental indicator of healthcare quality. A patient experience survey that assesses telemedicine and in-person ambulatory behavioral health care is needed. This study aims to adapt the CAHPS Clinician and Group Visit Survey 4.0 (beta) to assess adult patient experience with ambulatory behavioral health services and its reliability and validity. Seven behavioral health subject matter experts (psychiatrists, therapists with master’s degrees, and primary care physicians) at an integrated delivery system aligned with an academic institution provided input to select a subset of items and make minor wording adjustments to the CAHPS survey. The adapted survey was administered …

Assessing Patient Satisfaction With The Services Provided Under The National Health Insurance Scheme At The Outpatient Department Of The Levy Mwanawasa University Teaching Hospital In Lusaka, Zambia, Wesley Kapaya Mwambazi, Mubanga Mpundu

Patient Experience Journal

The National Health Insurance Scheme (NHIS), introduced in Zambia in 2019 to enhance healthcare financing and service delivery, still faces challenges impacting patient satisfaction. This study assesses and investigates the factors influencing patient satisfaction with NHIS-provided services at a third-level tertiary public hospital. The study was conducted at the outpatient department (OPD) of Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia, deliberately chosen as one of the largest publicly financed tertiary referral hospitals and among the first NHIS-accredited facilities. A cross-sectional survey was conducted with 270 respondents using a modified SERVQUAL 5-point Likert scale questionnaire, whose reliability was assessed …

Using Patient Experience Data With Impact: A Framework For Healthcare Improvement, Corey Adams, Ramesh Walpola, Reema Harrison

Patient Experience Journal

Background: Despite major investment in patient experience measurement, healthcare organizations often struggle to translate patient feedback into lasting improvements. Existing knowledge translation frameworks provide useful concepts, but often lack the practical detail or contextual relevance needed to improve patient experiences. Objective: To develop and present the IMPACT Framework, an evidence-informed approach designed to bridge the gap between patient experience measurement and meaningful improvement in healthcare. Methods: This framework was informed by a systematic review of patient experience measurement and analysis of barriers to feedback use. Findings from contemporary patient experience research were combined with key principles of knowledge translation, change …

Enhancing System-Level Quality Improvement Through Patient-Inclusive Teamwork: A Review, Shaik Mohiuddin

Patient Experience Journal

Engaging patients in quality improvement (QI) initiatives offers significant advantages, including increased patient satisfaction, improved outcomes, and the integration of creative insights from patient perspectives. This review synthesizes findings from 14 peer-reviewed articles retrieved from PubMed and Google Scholar, focusing on patient-inclusive teamwork in healthcare settings. Despite the recognized benefits, patient involvement remains limited due to cultural and professional barriers, logistical challenges, and the need for structured training programs. The review contrasts conventional provider-centered approaches with patient-centered models, emphasizing the importance of policy reform, organizational culture change, and supportive training to enhance patient engagement. Traditional QI strategies often overlook patient …

Understanding Patient Experience Through Narrative Complaint Analysis: A Mixed Methods Study In A Rural Academic Health System, Htun Ja Mai, Jabeen Ahmad, Brant Oliver

Patient Experience Journal

Patient Experience (PX) is recognized as an independent dimension in assessing healthcare quality and is associated with the quality domain of patient-centeredness. A better understanding of PX can help clinical providers enhance care, guide further research, and inform quality improvement and policies. Our study aims to identify, classify, and prioritize patients’ complaints and grievances at a rural health care system to inform strategic improvement planning. We conducted standard inductive qualitative thematic analysis and quantitative Pareto analyses of narrative comments received from patients and families via phone calls, emails, or standard letters at the four settings under study (one major academic …

Patient Experience Second Opinion: Expanded Telemed Simulation Broadens Inquiry Of Health Care Provider Verbal And Nonverbal Communication Issues, Mike C. Porter, Xiaowen Guan, Paul G. Omodt

Patient Experience Journal

In the quest to improve patient experience and health outcomes, the impact of provider consultation generally earns serious consideration. This study recruited a richly diverse pool of participants to examine how patient demographics and psychographics during a telemedicine consultation simulation impact the perceptions of the provider that contribute to patient satisfaction. Further, this study relies on a between-subject experimental design to investigate how “provider” verbal and nonverbal communication and demographics in addition to patient demographics and psychographics impact patient perceptions and outcomes of the simulated telemedicine experience. Results inform how healthcare provider verbal and nonverbal communication might be improved through …

The Patient Experience Of The #Hellomynameis... Campaign And The Value Of Personalised Embroidered Student Uniforms, Julie Derbyshire, Gemma Bradley, Sasha Ban, Lianne Horscroft, Joanne Woodhead

Patient Experience Journal

Background: The #hellomynameis... campaign was an international initiative implemented to improve Person Centred Practice by increasing the number of health professionals who introduce themselves to every patient and place them at the centre of each interaction. To add to this campaign, the idea of personalised uniforms for undergraduate health care students was introduced at one University in the UK, embroidered with the #hellomynameis...logo and their name. This paper will present findings from a study that explored this initiative from the patient perspective. Methods: A case study research design was used, with semi-structured questionnaires consisting of open and closed questions to …

Communicating Effectively When Engaging People With Lived Experience In Mental Health And Substance Use Health Research: A Qualitative Descriptive Study, Lisa D. Hawke, Wuraola Dada-Phillips, Charlotte Munro, Shoshana Hauer, Claudia Sendanyoye, Yona Lunsky, Gillian Strudwick, Tanya Halsall, Natasha Y. Sheikhan

Patient Experience Journal

Background. People with lived experience of mental health and/or substance use challenges and families (PWLE/F) are increasingly engaged in research, providing positive impacts. However, effective engagement can be challenging, including ensuring effective communication. This qualitative study sought to understand the communication preferences of PWLE/F who are engaged in mental health and substance use health research. Method. A total of 18 participants (aged 19 to 79) took part in one of four focus group discussions. A semi-structured interview guide was used to facilitate the discussions. Focus group transcripts were analyzed using codebook thematic analysis. PWLE/F were engaged in all stages of …

“Better Than Any Medicine:” Understanding How Therapy Dogs Support Patients Presenting With Mental Health And Substance Use Concerns In An Emergency Department Setting, Alexandria R. Pavelich, Colleen A. Dell, James Stempien, Holly Mckenzie, Aimee Hozack, Jane Smith, Alexis Rowsell, Janet Gunderson, Elizabeth Pease

Patient Experience Journal

In Canada, emergency departments have a large number of patients with mental health and substance use concerns passing through their doors. Our research aim was to assess the impact that therapy dog visits may have for patients presenting with mental health and/or substance use concerns to an emergency department based in Saskatoon, Saskatchewan. Working alongside an active patient advisory group and community-based therapy dog program volunteers, our mixed method approach utilizing ethnography, surveys, and interviews showed that therapy dog visitation had a beneficial impact on both patients and staff, thus improving the overall patient experience. Our study displays how the …

Impact Of Non-Pharmacological Interventions On Patient Experience, Opioid Use, And Healthcare Utilization In Adult Cardiac Surgery: A Randomized Controlled Mixed Methods Trial, Julie R. Piazza, Alexander A. Brescia, Jessica N. Jenkins, Alexander J. Ivacko, Xiaoting Wu, Sara M. Jafri, Christopher J. Varlamos, James C. Piazza, Lindsay K. Heering, Stefanie L. Peters, Molly Dwyer-White, Bailey H. Brown, Faraz N. Longi, Katelyn P. Monaghan, Frederick W. Bauer, Varun G. Kathawate, Melissa C. Webster, Amanda M. Kasperek, Nickole L. Garvey, Claudia Schwenzer, Kiran H. Lagisetty, Michelle Riba, Donald S. Likosky, Jennifer F. Waljee, Nicholas H. Osborne, Mary E. Byrnes, G. Michael Deeb

Patient Experience Journal

Non-pharmacological techniques designed to reduce anxiety, pain, and healthcare utilization have shown effectiveness in pediatric and non-surgical adult populations; however, their application has not been widely evaluated among adult surgical patients. This study randomized opioid-naive adults undergoing first-time, elective cardiac surgery to receive either targeted interventions from a trained “comfort coach” or usual care. The primary outcome assessed was healthcare utilization, specifically measured as the number of days at home within the first 30 days post-surgery. Secondary outcomes included postoperative opioid use and patient-reported outcomes, collected via validated surveys. Additionally, 50 participants in the intervention group completed semi-structured qualitative interviews …

Perceived Social Support And Its Associated Factors In Patients Undergoing Hemodialysis: A Cross-Sectional Study, Hosna Karami, Parvin Abbasi

Patient Experience Journal

Introduction: Hemodialysis is a vital, lifelong therapy for patients with end-stage kidney disease. Due to various physiological and psychosocial challenges, it is often perceived as traumatic. Social support is recognized as an essential coping strategy for managing chronic illnesses, including advanced kidney failure. This study aimed to assess perceived social support and its related factors among patients undergoing hemodialysis. Methods: This analytical cross-sectional study was conducted from November 2024 to February 2025 at two major hemodialysis centers in Kermanshah, a city in western Iran. A total of 230 patients were selected through convenience sampling based on predefined criteria. Data were …

Correlation Between Resident Physician And Patient Perceptions Of Empathy In The Emergency Department, Austin Porter, James Christian, Meryll E. Bouldin, Erin Willard, Stefan Graw, Sarah House, Sofie Morgan, Kristin Parker, Carly Eastin

Patient Experience Journal

Background: Empathy is essential for emergency medicine physicians, impacting patient outcomes and experiences, especially in the fast-paced emergency department (ED). However, empathy often declines during medical training, negatively affecting care. Little is known about how emergency medicine trainees perceive their empathy compared to their patients. Objective: This study aimed to explore the correlation between patient perceptions of resident physician empathy and residents’ self-perceptions during ED visits. Methods: This was a prospective observational study was conducted at a Level 1 Trauma and Tertiary Care Center in the south-central U.S., using the Consultation and Relational Empathy (CARE) Measure. At patient disposition, ED …

Patients’ Experiences Of Triage And Waiting In Emergency Departments: A Cross-Sectional Survey, Carrie Janerka, Leslie D Gavin, Fenella J Gill, Pcc Ed Triage Group

Patient Experience Journal

Objective: Patient experience is a core aspect of care quality. Patient experiences of emergency departments (EDs) have been examined, but there has been less focus on ED triage and waiting areas, often patients’ initial point of contact with a health service. This study aimed to understand patients’ experiences of ED triage and waiting room. Methods: A cross-sectional survey was conducted across five Australian EDs to understand experiences of patients 14 years and over before, during and after triage. Quantitative data were analysed descriptively and explored for correlations. Qualitative responses for suggested improvements were analysed using a conventional content analysis approach. …

Narrative Medicine Skills For End-Of-Life, Elizabeth Summerfield

Patient Experience Journal

This paper looks at the potential of applying the skills of narrative medicine to end-of-life and palliative care as a means of enabling its spiritual and existential dimensions often overlooked in clinical practice. It tells the story of a family navigating the complex problem of managing the ending of a beloved mother’s life. It reflects on how the World Medical Association’s 2022 list of essential elements of care may be enacted. Amidst the dominant daily physical regime of medication and physical care, it captures the rare, unscripted moments of meaning and purpose of a lived life. It shows why these …

The Hand We Hold: Reflections On Empathetic Practice In Medicine, Aravind Sreeram

Patient Experience Journal

In this narrative, I reflect on an early clinical encounter that reshaped my understanding of what it means to provide patient-centered care. As a medical student, I entered the exam room with a preset algorithm of what to say and how to act. Yet, when faced with a patient whose suffering could not be measured or addressed by any checklist, I realized the limitations of my scripted approach. I began to understand that some of the most meaningful contributions we offer in healthcare come not from solutions, but from presence. This experience helped me see that patient partnership is not …

Changing Myths Into Truths: Dispelling Physician Misconceptions On Patient Experience, Amit Singh, Syed Ahmed, James Castellone, Michael H Kanter, Mikelle Key-Solle, Sherry Kroll, Paul A Lansdowne, Winnie Lee, Swati Mehta, Sofie Morgan, Sephora Morrison, Susan N Nathan, Sachin Patel, Alexie Puran, Donald Wickline, Liza Dileo Thomas

Patient Experience Journal

Patient experience work can be viewed by some physicians as outside their scope of practice and therefore the responsibility of non-medical providers. Assumptions may also be made by providers about what patient experience work is and is not. These myths can make it difficult to pursue meaningful patient experience related work that is in fact rooted in evidence showing improved outcomes. Moreover, these myths can downplay the importance of patient experience improvement work discouraging physicians who may be interested from pursuing it. In order to combat common myths that can be propagated about patient experience, the authors will cite research …

Beyond The Numbers: Elevating Meaning Through Metrics In Patient Experience, Geoffrey A. Silvera

Patient Experience Journal

This commentary submitted by Patient Experience Journal (PXJ) Associate Editor begins with a simple observation: sometimes, in our effort to measure everything, we miss what’s right in front of us. We look up at the data but fail to notice the larger shape taking form above it, something tall, quiet, and graceful that changes how we see the landscape. Patient experience work demands that we hold both the precision of metrics and the wonder of narrative to truly understand of patients’ experiences of care. Numbers tell us how we are performing and stories remind us why it matters. When we …

We Are Not There Yet! Why The Journey For Experience Excellence Must Persist, Jason A. Wolf

Patient Experience Journal

I am concerned, that many in healthcare think they have gotten to a “THERE” in experience excellence. That the survey scores they received are good enough, that the outcomes they are achieving reflect what they sought to accomplish. And with this in the face of today’s tumultuous healthcare landscape, decisions are being made to sustain efforts at best and in more cases now to reduce investment with the belief that things are ok. Now is NOT the time to cut short our efforts for experience excellence, or to believe there is a “there” to which we have arrived. It must …

Nm Snap-Ed 2025 Tribal Report, Elena E. Martinez, Theresa H Cruz

Reports & Documents

SNAP-Ed NM works to provide nutrition and physical activity education, environmental and systems changes, and social marketing among primarily SNAP-eligible populations to empower them to make healthy food choices and become more physically active. In May 2025, the SNAP-Ed evaluation team from the UNM Prevention Research Center (PRC) conducted a survey involving five implementing agencies and the state agency overseeing SNAP-Ed. The purpose of this survey was to evaluate engagement with Tribal communities and to assess any changes in engagement since the prior assessment in FY2023. The UNM PRC also surveyed the New Mexico Health Care Authority, the state agency …

Discovery Of A Novel Small Molecule Degrader Of Wild Type And Mutant Estrogen Receptors Using Dna Encoded Libraries, Anil Kumar Devakrishnan, Chandrashekhar Madasu, Yong Wang, Ramkumar Modukuri, Kurt M Bohren, Kevin R Mackenzie, Damian W Young, Suzanne A W Fuqua, Martin M Matzuk, Murugesan Palaniappan

Faculty, Staff and Students Publications

Estrogen receptor α (ERα) variants with mutations in the ligand binding domain (LBD) are less sensitive than wild type to standard-of-care drugs that bind ERα directly. To identify novel small-molecule drugs that target ERα mutants, we screened our multibillion-compound DNA-encoded libraries against ERα LBD variants. CDD-1274, which was highly enriched with all three variants, blocked spontaneous coactivator peptide recruitment to mutant ERα LBDs and inhibited estradiol-driven proliferative markers in several ER-positive breast cancer cell lines, but not in ER-negative breast cancer cells. We demonstrated that CDD-1274 induced proteasomal degradation of ERα variants in breast cancer cell lines and caused Y537S …