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.

Read the article

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.

Read the article

Female doctor consulting young patient

Investigating lupus retention in care to inform interventions for disparities reduction: an observational cohort study

Investigating lupus retention in care to inform interventions for disparities reduction: an observational cohort study

Systemic lupus erythematosus (SLE) is an autoimmune disease that disproportionately impacts young women, patients of color, and the socioeconomically disadvantaged, making SLE an important target for health disparity measurement and research. HIP Investigator, Dr. Christie Bartels et al. applied WHO-endorsed metrics that helped reduce similar disparities in HIV to investigate relationships between race, disadvantage, and retention in care in an urban lupus cohort. The authors examined predictors of lupus retention in care, developed an SLE Care Continuum, and informed interventions to reduce disparities. Key findings include 40% of patients not being retained at one year, and neighborhood disadvantage was the leading predictor of retention gaps.

Read the article

Older women talking

Small-Group, Community-Member Intervention for Urinary and Bowel Incontinence: A Randomized Controlled Trial

Small-Group, Community-Member Intervention for Urinary and Bowel Incontinence: A Randomized Controlled Trial

More than 60% of older U.S. women suffer from urinary incontinence, bowel incontinence, or both, the annual cost of which exceeds $30 billion. In addition to significant negative effect on quality of life and depression,2 incontinence increases risk for institutionalization. HIP Investigator, Dr. Heidi Brown et al. evaluated the effects of Mind Over Matter: Healthy Bowels, Healthy Bladder, a small-group intervention, on urinary and bowel incontinence symptoms among older women with incontinence.

The authors found that participation in a small-group intervention improves symptoms of both urinary and bowel incontinence in older women. Mind Over Matter is a feasible model with potential to bring effective behavioral solutions to the community.

Read the article

Learn more about Mind Over Matter

Doctor using tablet

Anxiety and Hypertension: Is There a Link? A Literature Review of the Comorbidity Relationship Between Anxiety and Hypertension

Anxiety and Hypertension: Is There a Link? A Literature Review of the Comorbidity Relationship Between Anxiety and Hypertension

There is increasing evidence of a positive association between comorbid anxiety and hypertension. This contemporaneous review by HIP Investigator, Dr. Heather Johnson supports similar findings in historical studies and provides mechanistic hypotheses for larger, longitudinal studies. The objective of this review is to summarize contemporaneous studies evaluating the relationship between prevalent anxiety and comorbid prevalent hypertension, or the development of incident (future) hypertension.

Read the article

Big Data Word Scramble

The Importance of Health Insurance Claims Data in Creating Learning Health Systems: Evaluating Care for High-Need High-Cost Patients Using the National Patient-Centered Clinical Research Network (PCORNet)

The Importance of Health Insurance Claims Data in Creating Learning Health Systems: Evaluating Care for High-Need High-Cost Patients Using the National Patient-Centered Clinical Research Network (PCORNet)

Case management programs for high-need high-cost patients are spreading rapidly among health systems. PCORNet has substantial potential to support learning health systems in rapidly evaluating these programs, but access to complete patient data on health care utilization is limited as PCORNet is based on electronic health records not health insurance claims data. Because matching cases to comparison patients on baseline utilization is often a critical component of high-quality observational comparative effectiveness research for high-need high-cost patients, limited access to claims may negatively affect the quality of the matching process. A team of authors including HIP Investigators Dr. Maureen Smith and Dr. Menggang Yu sought to determine whether the evaluation of programs for high-need high-cost patients required claims data to match cases to comparison patients.

Read the article

View the toolkit

MyHEART logo

Rationale and study design of the MyHEART study: A young adult hypertension self-management randomized controlled trial

Rationale and study design of the MyHEART study: A young adult hypertension self-management randomized controlled trial

To address the unmet need in hypertensive care for young adults, we developed MyHEART (My Hypertension Education And Reaching Target), a multi-component, theoretically-based intervention designed to achieve self-management among young adults with uncontrolled hypertension. MyHEART is a patient-centered program, based upon the Self-Determination Theory, that uses evidence-based health behavior approaches to lower blood pressure. Therefore, HIP Investigator, Dr. Heather Johnson and a team of investigators including Dr. Maureen Smith, evaluated MyHEART's impact on changes in systolic and diastolic blood pressure compared to usual care after 6 and 12 months in 310 geographically and racially/ethnically diverse young adults with uncontrolled hypertension.

Read the article

Doctor talking to patient and writing down notes

Sociodemographics and hypertension control among young adults

Sociodemographics and hypertension control among young adults

Young adults ages 18-39 have low hypertension control rates compared to young adults. Using electronic health record data, Dr. Heather Johnson et al. evaluated the role of sociodemographic factors in hypertension control among young adults with primary care access and incident hypertension. They found that young men had a 39% lower rate of hypertension control compared to young women, and that people for whom English was not their primary language and unmarried people also had lower control rates.

Read the article

Nurse checking senior woman's blood pressure

Frequency and predictors of communication about high blood pressure in RA visits

Frequency and predictors of communication about high blood pressure in RA visits

Patients with rheumatoid arthritis (RA) have a heightened risk of cardiovascular disease. Dr. Christie Bartels et al. conducted a retrospective cohort study to determine whether having high blood pressure increased the likelihood of communication about blood pressure in rheumatology visits. The investigators identified patients in the electronic health record who had both RA and uncontrolled hypertension and who received both primary and rheumatology care, and then trained abstractors reviewed the RA visit notes to determine whether blood pressure communication occurred. They found that only 22% of RA clinic visits contained documented communication about blood pressure, and that patients with stage II elevation of blood pressure were not singificantly more likely to have documented communication. Action steps recommending follow-up for high blood pressure were documented in less than 10% of eligible visits. 

Press about the article was featured in Rheumatology News and Healio.

Read the article

Doctor with arms crossed and blue ribbon on medical coat

Primary care colorectal cancer screening correlates with breast cancer screening

Primary care colorectal cancer screening correlates with breast cancer screening

In a retrospective cohort study, Dr. Jennifer Weiss et al. examined 90 primary care providers (PCPs) and over 33,000 patients eligible for colorectal cancer (CRC) screening to determine whether PCP colorectal cancer screening practices correlate with other preventive and chronic care needs. The investigators looked at CRC screening rates in comparison to five other PCP quality metrics—breast cancer screening, cervical cancer screening, HgbA1c and LDL testing, and blood pressure control—and found that PCP CRC screening rates have a strong correlation with breast cancer screening rates and a weak correlation with the other metrics. These results indicate that efforts to increase PCPs' CRC screening rates could be bundled with breast cancer screening improvement interventions to increase their impact.

Read the article

Pages