Predictors of Smoking Cessation in Patients With Rheumatoid Arthritis in Two Cohorts: Healthcare Factors Most Predictive

Predictors of Smoking Cessation in Patients With Rheumatoid Arthritis in Two Cohorts: Healthcare Factors Most Predictive

Smoking doubles the risk of developing rheumatoid arthritis (RA) and additionally contributes to cardiovascular, pulmonary, and oncologic diseases, the main causes of death in patients with RA. While patients are more likely to quit smoking after diagnosis of a smoking-related chronic disease, research shows most will continue to smoke.

HIP Investigator, Dr. Christie Bartels et al. identified predictors of smoking cessation in patients with RA in two health systems to guide future intervention implementation efforts. Authors found that emphasizing smoking cessation with new or seropositive RA patients and leveraging health system interventions could improve smoking cessation and outcomes in RA.

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The Balanced Opioid Initiative

The Balanced Opioid Initiative

Rates of opioid prescribing tripled in the USA between 1999 and 2015 and were associated with significant increases in opioid misuse and overdose death. Roughly half of all opioids are prescribed in primary care. The challenge remains in implementing guidelines in a way that balances safety and effectiveness when following clinical guidelines recommending opioid prescribing practices.

HIP Investigator, Dr. Andy Quanbeck et al. designed a study to discover the most cost-effective sequence and combination of strategies for improving opioid prescribing practices in diverse primary care clinics. The results of the study promise to help understand how to cost effectively improve the implementation of evidence-based practices.

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Growing Evidence for Successful Care Management in Children With Medical Complexity

Growing Evidence for Successful Care Management in Children With Medical Complexity

In this article, Dr. Mary Ehlenbach and HIP Investigator Dr. Ryan Coller reviewed the success of programs designed to better coordinate children with medical complexity care. With respect to changes in acute care use, children likely respond to complex care models in different ways. Additionally, what complex care achieves and how it achieves it for any given child is likely not uniform in cross section or over time.

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Telemedicine for Glaucoma: Guidelines and Recommendations

Telemedicine for Glaucoma: Guidelines and Recommendations

Glaucoma is the leading cause of irreversible blindness worldwide, estimated to affect >60 million people. Access to glaucoma specialists is challenging and likely to become more difficult as the population ages. Glaucoma care guidelines are not as standardized as those for diabetic retinopathy, which allow for significant regional and provider variability in glaucoma diagnosis and management.

In these guidelines, co-authored by HIP Investigator Dr. Yao Liu, authors reviewed considerations and practice recommendations for teleglaucoma programs.

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Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

The third edition of the Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy includes fundamental requirements to be followed when providing medical and other health care services using telecommunication technologies, and any other electronic communications between patients, practitioners, and other health care providers, as well as “best practice” recommendations. These guidelines were co-authored by HIP Investigator, Dr. Yao Liu and aim to assist providers in pursuing a sound course of action in providing safe and effective medical care using telehealth tools based on current scientific knowledge, technological requirements, and patient needs.

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Health System Research Priorities for Children and Youth With Special Health Care Needs

Health System Research Priorities for Children and Youth With Special Health Care Needs

Children and youth with special health care needs (CYSHCN) have, or are at an increased risk for, chronic physical, developmental, behavioral, or emotional conditions and also require health and related services of a type or amount beyond that required by children generally.

HIP Investigator, Dr. Ryan Coller et al. synthesized the opinions of a national multidisciplinary group of CYSHCN experts, including family caregivers, to prioritize research topics facing CYSHCN. Authors sought to take a foundational step toward developing a national research agenda for CYSHCN systems of care.

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Factors associated with health psychology use in pediatric type 1 diabetes

Factors associated with health psychology use in pediatric type 1 diabetes

For children with type 1 diabetes (T1D), self-management is complex and requires coordination between a child and his or her family multiple times every day to test blood sugars, determine and administer insulin doses, and adjust as needed. The consequences of suboptimal self-management are a combination of short- and long-term complications, some of which are life-threatening.

In this publication, HIP Investigator Dr. Elizabeth Cox et al. evaluated the prevalence of health psychology use in children with T1D and the association of this use with individual and contextual characteristics.

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Better together: multidisciplinary approach improves adherence to pelvic floor physical therapy

Better together: multidisciplinary approach improves adherence to pelvic floor physical therapy

Pelvic floor muscle exercises are a mainstay in the treatment of pelvic floor disorders such as urinary incontinence, overactive bladder, pelvic organ prolapse, and fecal incontinence. Women are more likely to report improvement in incontinence symptoms when they participate in directly supervised pelvic floor physical therapy (PFPT) as opposed to performing recommended exercises without supervision. However, < 50% of women referred for PFPT complete their prescribed program. HIP Investigator, Dr. Heidi Brown et al. sought to determine whether consultation with PFPT at the time of initial urogynecologic evaluation increases adherence to PFPT and to identify factors associated with PFPT attendance and completion.

The authors were also interested in exploring the relationship between the rate of surgical management of patients seen in multidisciplinary clinic versus those seen in a traditional clinic and those who attended PFPT versus those who did not. They hypothesized that rates of PFPT adherence would be higher when the patient met with a physical therapist at her initial urogynecology consultation as opposed to meeting with the urogynecologist alone.

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A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers

A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers

Nearly 2 million Americans develop a diabetic foot ulcer each year; within 5 years of ulceration, 5% will undergo major amputation and 50% to 70% will die. Experts have recommended a multidisciplinary team approach to optimally address certain comorbidities in a coordinated manner and to reduce major amputations. Authors including HIP Investigators Dr. Meghan Brennan and Dr. Christie Bartels described multidisciplinary team composition and function using a systems engineering conceptual model and summarized the impact of multidisciplinary teams on major amputations. They hypothesized that multidisciplinary teams are associated with a reduced risk of major amputation.

The group found that multidisciplinary team composition was variable but reduced major amputations in 94% of studies.

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Impact of family‐centered tailoring of pediatric diabetes self‐management resources

Impact of family‐centered tailoring of pediatric diabetes self‐management resources

Behavioral interventions to improve self‐management, glycemic control, or quality of life (QOL) for children with type 1 diabetes have small to moderate positive effects, but a host of challenges diminishes their effectiveness in practice. A group of authors including HIP Investigator, Dr. Elizabeth Cox evaluated the hypothesis that delivering self‐management resources in a family‐centered manner, using PRISM to guide resource selection, will result in better glycemic control and quality of life for children and their parents.

Authors found that tailored self‐management resources may improve outcomes among specific populations, suggesting the need to consider families' self‐management barriers and patient characteristics before implementing self‐management resources.

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