Journal of Patient-Centered Research and Reviews最新文献

{"title":"In Pursuit: A Mother's Account of Her Son's Rare Disease Diagnosis Journey.","authors":"Anne M Jones","doi":"10.17294/2330-0698.1845","DOIUrl":"https://doi.org/10.17294/2330-0698.1845","url":null,"abstract":"","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 4","pages":"360-362"},"PeriodicalIF":1.7,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8530234/pdf/jpcrr-8.4.360.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39580488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Cancer Screening Rates in Primary Care via Practice Facilitation and Academic Detailing: A Multi-PBRN Quality Improvement Project.","authors":"Christopher P Morley, Laura A Schad, Laurene M Tumiel-Berhalter, Laura A Brady, Alexandrea Bentham, Karen Vitale, Amanda Norton, Gary Noronha, Carlos Swanger","doi":"10.17294/2330-0698.1855","DOIUrl":"10.17294/2330-0698.1855","url":null,"abstract":"<p><strong>Purpose: </strong>In the United States, cancer screening rates are often below national targets. This project implemented practice facilitation and academic detailing aimed at increasing breast, cervical, and colorectal cancer screening rates in safety-net primary care practices.</p><p><strong>Methods: </strong>Three practice-based research networks across western and central New York State partnered to provide quality improvement strategies on breast, cervical, and colorectal cancer screening. Pre/postintervention screening rates for all participating practices were collected annually, as were means across all practices over 7 years. Simple ordinary least squares linear regression was used to calculate the trend for each cancer type and test for statistical significance (ie, P≤0.05), using the ordinal time point as a fixed effect.</p><p><strong>Results: </strong>An overall increase in mean screening rates was seen over the duration of this project for colorectal (24.6% preintervention to 48.0% in year 7 of intervention; P<0.001) and breast cancer (37.0% preintervention to 48.6% in year 7; P=0.460). Mean cervical cancer screening rates decreased (35.5% preintervention to 31.4% in year 7; P=0.209). Success in increasing screening rates varied across regions of New York State.</p><p><strong>Conclusions: </strong>Practice facilitation and academic detailing were successful in significantly increasing, on average, colorectal cancer screening rate. Cervical cancer screening showed an overall decrease, likely due to difficulties for primary care practices in tracking and implementation, as many patients seek this service at outside gynecology facilities. Regional differences, guideline changes, and practice reorganization each may have played a part in observed trends. A standardization of queries being used to pull screening rates is an important step in increasing the reliability of these data.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 4","pages":"315-322"},"PeriodicalIF":1.7,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8530242/pdf/jpcrr-8.4.315.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39580553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Objective Structured Clinical Examination Case for Opioid Management: Standardized Patient Ratings of Communication Skills as a Predictor of Systems-Based Practice Scores.","authors":"Heidi Kenaga,&nbsp;Tsveti Markova,&nbsp;R Brent Stansfield,&nbsp;Sarwan Kumar,&nbsp;Pierre Morris","doi":"10.17294/2330-0698.1800","DOIUrl":"https://doi.org/10.17294/2330-0698.1800","url":null,"abstract":"<p><p>The Wayne State University Office of Graduate Medical Education (WSUGME) uses an objective structured clinical examination (OSCE) to assess its programs' contribution to enhancing residents' communication skills. In response to revisions in Michigan's opioid-prescribing mandates in 2017, WSUGME developed a pain management case in collaboration with faculty and the Wayne State University School of Medicine to educate residents about these mandates while gauging their skills in Systems-Based Practice (SBP), an Accreditation Council for Graduate Medical Education Core Competency. This study examined whether resident OSCE performance predicted year-end milestones scores in SBP1 (coordinates patient care within various health care delivery settings), SBP2 (works in interdisciplinary teams to enhance patient safety and improve patient care quality), and SBP3 (practices and advocates for cost-effective, responsible care). Participants included two cohorts of first- (PRG-1) and second-year (PRG-2) residents in 6 programs: one cohort from academic year 2018-2019 (n=33), the other from 2019-2020 (n=37). Before the OSCE, WSUGME emailed residents the new state prescription requirements. During the simulated encounter, standardized patients rated residents on a validated communication instrument, and WSUGME conducted a linear regression of patient ratings on resident SBP milestone scores. The ratings of communication skills of PRG-1 residents did not predict any of the year-end SBP milestones. However, ratings of communication skills of PRG-2 residents predicted SBP1 and SBP2, though not SBP3, milestones. The OSCE opioid case proved to be a valid measure of PRG-2 residents' competence gained across the first year but was less meaningful when applied to PRG-1 residents.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 3","pages":"261-266"},"PeriodicalIF":1.7,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297494/pdf/jpcrr-8.3.261.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Experience of OFF Periods in Parkinson's Disease: Descriptions, Triggers, and Alleviating Factors.","authors":"Sneha Mantri,&nbsp;Madeline Lepore,&nbsp;Briana Edison,&nbsp;Margaret Daeschler,&nbsp;Catherine M Kopil,&nbsp;Connie Marras,&nbsp;Lana M Chahine","doi":"10.17294/2330-0698.1836","DOIUrl":"https://doi.org/10.17294/2330-0698.1836","url":null,"abstract":"<p><strong>Purpose: </strong>Wearing off of Parkinson's disease medication is common, but triggers and coping strategies for this transient phenomenon are poorly understood. We aimed to assess the lived experience of OFF periods for people with Parkinson's disease.</p><p><strong>Methods: </strong>Participants in the longitudinal Fox Insight study who endorsed OFF periods were invited to complete a survey consisting of both multiple-choice and free-text responses. Descriptive statistics were used to summarize multiple-choice responses, and free-text responses were classified into themes through iterative discussion by 3 movement disorders specialists.</p><p><strong>Results: </strong>A total of 2110 participants (52.4% male) completed the survey. Tremor was the most common description of OFF periods (n=1038, 49.2%), followed by gait changes (n=535, 25.4%) and rigidity (n=430, 20.4%). Of 1498 specific triggers for OFF symptoms, the most common was stress (n=920, 61.4%), followed by anxiety/depression (n=476, 31.8%) and tiredness/fatigue (n=351, 23.4%). Common coping strategies (n=1416 responses) included exercise (n=678, 47.9%), taking a break (n=504, 35.6%), and meditation (n=276, 19.5%).</p><p><strong>Conclusions: </strong>Although OFF periods are common, the individual experiences of OFF vary. This knowledge could be used to develop new counseling strategies for OFF periods in people with Parkinson's disease.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 3","pages":"232-238"},"PeriodicalIF":1.7,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297496/pdf/jpcrr-8.3.232.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39255229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Review and Update of Burning Eye Syndrome.","authors":"Stephen Giacomazzi,&nbsp;Ivan Urits,&nbsp;Briggs Hoyt,&nbsp;Ashley Hubble,&nbsp;Elyse M Cornett,&nbsp;Kyle Gress,&nbsp;Karina Charipova,&nbsp;Amnon A Berger,&nbsp;Hisham Kassem,&nbsp;Alan D Kaye,&nbsp;Omar Viswanath","doi":"10.17294/2330-0698.1813","DOIUrl":"https://doi.org/10.17294/2330-0698.1813","url":null,"abstract":"<p><p>Keratoconjunctivitis sicca (\"dry eye\") is a common (14%-30% of adults over age 48) though difficult to treat condition that causes both discomfort and disability with associated dryness, pain, and visual disturbances. Etiology is not clearly understood but is likely varied, with a subset of patients suffering from chronic neuropathic pain referred to as \"burning eye syndrome.\" This review of existing literature summarizes the clinical presentation, natural history, pathophysiology, and treatment modalities of burning eye syndrome. Chronicity of burning eye syndrome is likely secondary to increased nociception from the cornea, decrease in inhibitory signals, and nerve growth factor expression alterations. Treatment centers around symptomatic alleviation and reduction of inflammation. Conservative treatments focus on well-being and perception and include exercise, acupuncture, and cognitive behavioral therapy. Topical treatment consists of the anti-adhesion T-cell antagonist lifitegrast, corticosteroids, and cyclosporine; all have moderate efficacy and good safety. Autologous serum eye drops are a second-line topical that may promote corneal and neural healing on top of symptomatic relief. When these treatments fail, patients may trial neuromodulation with transcranial magnetic stimulation. Despite general treatment safety, more research is needed to develop novel approaches to this condition, possibly focusing more directly on the neurological component.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 3","pages":"255-260"},"PeriodicalIF":1.7,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297487/pdf/jpcrr-8.3.255.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39255232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Business Cards as a Mechanism to Encourage Patient Feedback About Trainees.","authors":"Marc Atzenhoefer,&nbsp;Jodie Ruffin,&nbsp;David Parewski,&nbsp;Nicole Deklotz,&nbsp;M Fuad Jan,&nbsp;Ana Cristina Perez Moreno,&nbsp;Suhail Q Allaqaband","doi":"10.17294/2330-0698.1802","DOIUrl":"https://doi.org/10.17294/2330-0698.1802","url":null,"abstract":"<p><p>This project sought to evaluate if business card distribution improved the utility of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys by serving as a feedback mechanism for trainees. Between fall 2018 and spring 2019, patient encounters for 6 cardiovascular disease fellows were tracked over two 60-day periods. Six weeks were allowed for HCAHPS surveys to be returned. Business cards were subsequently deployed and encounters similarly tracked. During the control-group monitoring period, 721 patient encounters were logged and 80 (11.1%) surveys were returned. Qualitative feedback, in the form of free-response comments, was provided in 41 (51.3%) surveys. Business cards were then deployed and encounters similarly tracked. During the business card period, 508 patient encounters occurred and 97 (19.1%) surveys were returned. Qualitative feedback was provided in 52 (53.6%) surveys. No fellow-specific feedback was returned in either group. Business card use by trainees was associated with an improved rate of survey return, from 11.1% to 19.1%, but no effect on feedback to fellows or patient satisfaction scores was found. HCAHPS surveys were not useful in providing trainees with feedback. Immediate verbal feedback from patients via ancillary staff was observed. A method of relaying communication from patients to ancillary staff and medical education programs is needed.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 3","pages":"267-271"},"PeriodicalIF":1.7,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297493/pdf/jpcrr-8.3.267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental Finding of Anomalous Pulmonary Venous Return of the Left Upper Lobe, a Rare Anatomical Variation.","authors":"Anika Dutta,&nbsp;Loren Zuiderveld","doi":"10.17294/2330-0698.1809","DOIUrl":"https://doi.org/10.17294/2330-0698.1809","url":null,"abstract":"<p><p>Partial anomalous pulmonary venous return (PAPVR) is a rare congenital abnormality in which 1 to 3 of the pulmonary veins connect to the right atrium rather than the left atrium. In this synthesis of the literature on PAPVR of the left upper lobe, we attempt to illustrate this clinical entity using a case detected incidentally on chest computed tomography, explain the anatomical aspects of this anomaly, and summarize the reported incidence and etiology of left-sided PAPVR. Lastly, differential diagnoses, clinical relevance, and management of left-sided PAPVR are presented. The identification of this variant is important, as it may have serious consequences.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 3","pages":"277-280"},"PeriodicalIF":1.7,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297490/pdf/jpcrr-8.3.277.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Exercise Prevent Gestational Diabetes Mellitus in Pregnant Women? A Clin-IQ.","authors":"Olivia Lust,&nbsp;Tana Chongsuwat,&nbsp;Elizabeth Lanham,&nbsp;Ann F Chou,&nbsp;Elizabeth Wickersham","doi":"10.17294/2330-0698.1811","DOIUrl":"https://doi.org/10.17294/2330-0698.1811","url":null,"abstract":"<p><p>Excessive weight gain during pregnancy has been on the rise globally, leading to increased prevalence of gestational diabetes mellitus (GDM). A diagnosis of GDM often leads to pregnancy and infant-related complications. Regular exercise may have the potential to prevent GDM. However, evidence surrounding the utility of exercise during pregnancy as an effective risk reduction intervention has been mixed. This clinical inquiry examined the role of regular exercise during pregnancy in preventing GDM in both obese and normal-weight women and analyzed specific aspects of exercise that make it an effective preventive measure. The review of evidence included 3 meta-analyses, 3 systematic reviews, and 1 umbrella review. Findings identified several components of an exercise program that can reduce GDM risk. Specifically, an exercise intervention of 40- to 60-minute sessions 3 times per week beginning as early as possible during pregnancy and continuing with good adherence over the course of pregnancy yielded clinically significant results. Adhering to a similar exercise routine before pregnancy also was shown to be protective against GDM for all women, but especially so for women who are overweight or obese.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 3","pages":"281-285"},"PeriodicalIF":1.7,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297497/pdf/jpcrr-8.3.281.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Deliveries: Maternal Features and Neonatal Outcomes.","authors":"Viviana Zlochiver,&nbsp;Blair Tilkens,&nbsp;Ana Cristina Perez Moreno,&nbsp;Fatima Aziz,&nbsp;M Fuad Jan","doi":"10.17294/2330-0698.1848","DOIUrl":"https://doi.org/10.17294/2330-0698.1848","url":null,"abstract":"<p><p>Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23-31) and 39 weeks (IQR: 37.3-40.0), respectively. Of the 85 SARS-CoV-2-positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented severe COVID-19 symptoms that required hospitalization. Patients in the severe COVID-19 group had significantly longer hospitalizations than those with nonsevere COVID-19 (7 [IQR: 4.5-9.5] vs 2 [IQR: 2-3] days; P<0.01). Neonatal outcomes included 100% live births with a median 1-minute Apgar score of 8 and 15% preterm births. No neonatal deaths or vertical transmissions were reported, and all neonatal intensive care unit admissions were related to prematurity. Overall, maternal symptom prevalence and peripartum complication rates were low, suggesting a generally good prognosis for pregnant women with SARS-CoV-2 infections at the time of delivery.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 3","pages":"286-289"},"PeriodicalIF":1.7,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297489/pdf/jpcrr-8.3.286.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the Perception and Willingness of Primary Care Providers to Prescribe Advanced Diabetes Technologies.","authors":"Alexander O'Donovan,&nbsp;Sean M Oser,&nbsp;Jessica Parascando,&nbsp;Arthur Berg,&nbsp;Donald E Nease,&nbsp;Tamara K Oser","doi":"10.17294/2330-0698.1819","DOIUrl":"https://doi.org/10.17294/2330-0698.1819","url":null,"abstract":"<p><p>Advanced diabetes technologies have produced increasingly favorable outcomes compared to older treatments. Disparities in practice resources have led to a treatment disparity by clinical setting, where endocrinologists typically prescribe far more such technologies than primary care providers (PCPs). Fully automated artificial pancreas systems (APS), which combine technologies to deliver and adjust insulin dosing continuously in response to automatic and continuous glucose monitoring, may be more straightforward for PCPs to prescribe and manage, therefore extending their benefit to more patients. We aimed to assess willingness of PCPs to prescribe advanced diabetes technologies through a cross-sectional survey of PCPs from 4 geographically diverse centers. While respondents were uncomfortable initiating (63 of 72, 88%) or adjusting (64 of 72, 89%) traditional insulin pumps, their views on APS were quite different: 71 of 76 (93%) saw advantages to prescribing APS by PCPs rather than only endocrinologists. Most would consider prescribing APS for type 1 diabetes (58 of 76, 76%) and type 2 diabetes (52 of 76, 68%). No differences were seen among attendings, residents, or nurse practitioners. APS were much more acceptable than traditional insulin pumps among this primary care sample. If successful, primary care management of closed-loop APS would greatly increase access to such therapies and reduce disparities among those patients who face more difficulty accessing subspecialty care than they do primary care.</p>","PeriodicalId":16724,"journal":{"name":"Journal of Patient-Centered Research and Reviews","volume":"8 3","pages":"272-276"},"PeriodicalIF":1.7,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297491/pdf/jpcrr-8.3.272.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}