In a recent study of over 250,000 Medicare patients with diabetes, Dr. Christie Bartels et al. found that patients with rheumatoid arthritis (RA) were 28% less likely to have diabetic retinopathy and 4% more likely to receive an eye exam than patients without RA. The authors suggest that RA physiology or treatments may protect against diabetic retinopathy and propose that future studies be conducted on this topic.
Rheumatoid arthritis and the prevalence of diabetic retinopathy
Development of a list of high-risk operations for patients 65 years and older
Dr. Gretchen Schwarze et al. recently developed a list of 227 high-risk operations that had at least 1% operative mortality for older adults. The list, published in JAMA Surgery, can serve as a tool in patient-doctor discussions of surgery risk, as well as in future studies and targeted clinical interventions. It was developed using a modified Delphi procedure and analysis of the Pennsylvania Health Care Cost Containment Council and Nationwide Inpatient Sample datasets.
Diagnosis and treatment of incident hypertension among patients with diabetes
In a recent study that evaluated hypertension diagnosis and treatment among patients with diabetes mellitus and incident hypertension, HIP investigators found that among the patients who met the clinical criteria for hypertension (130/80 mmHg), only 41% received a diagnosis and 37% received medication. Patients who had peripheral vascular disease or fewer visits were likely to have slower diagnosis rates and medication initiation.
Family-initiated dialogue about medications during family-centered rounds
In a video analysis of family-centered rounds published in Pediatrics, Jessica Benjamin and Elizabeth Cox et al. found that 65% of medication-related dialogue raised by families was about inpatient medications. Medication scheduling and adverse drug reactions were discussed most frequently, and changes to the child's medications occurred in response to 8% of the family-initiated dialogue. You can learn more about family-centered rounds in the Family-Centered Rounds Toolkit.
Neighborhood socioeconomic disadvantage and 30-day rehospitalization
In a recent study in the Annals of Internal Medicine, Dr. Amy Kind et al. found that patients residing in the most disadvantaged 15% of U.S. neighborhoods had a risk of being rehospitalized comparable to that of patients with chronic pulmonary disease, and that the more disadvantaged a patient's neighborhood is, the greater their risk of their return to the hospital. A calculator is available at www.HIPxChange.org that clinicians can use to check whether their patients are being discharged to high-risk neighborhoods, as well as a dataset that can be downloaded for research purposes.