Sick senior woman fallen

Comparing Strategies for Identifying Falls in Older Adult Emergency Department Visits Using EHR Data

Comparing Strategies for Identifying Falls in Older Adult Emergency Department Visits Using EHR Data

Emergency department (ED) visits for falls among older adults are often sentinel events for poor health trajectories; however, challenges exist in defining fall‐related visits in the ED. Authors including HIP Investigators Dr. Brian Patterson and Dr. Maureen Smith developed and validated a simple rules‐based Natural language processing system that accurately identified falls from the text of ED physician notes.

The goal of the study was to compare performance characteristics of several fall identification strategies using EHR data from ED visits using manual chart abstraction as a gold standard.

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After the Randomized Trial: Implementation of Community-Based Continence Promotion in the Real World

After the Randomized Trial: Implementation of Community-Based Continence Promotion in the Real World

Most women aged 65 and older have incontinence, associated with high healthcare costs, institutionalization, and negative quality of life, but few seek care. Mind over Matter: Healthy Bowels, Healthy Bladder (MOM) is a small-group self-management workshop, led by a trained facilitator in a community setting, proven to improve incontinence in older women.

The main objective of the study by HIP Investigator, Dr. Heidi Brown et al. was to quantify and understand barriers to and facilitators of implementation, adoption, and maintenance of the MOM intervention. The secondary objective was to engage study communities and WIHA staff in the development of a partner‐focused implementation package for MOM.

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Daily medications

Workflow Barriers and Strategies to Reduce Antibiotic Overuse in Nursing Homes

Workflow Barriers and Strategies to Reduce Antibiotic Overuse in Nursing Homes

Antibiotics are among the most commonly prescribed medications in nursing homes (NHs), being prescribed to two‐thirds of residents annually. Although often beneficial, their overuse is associated with avoidable adverse effects.

This article by HIP Investigator, Dr. Edmond Ramly et al. seeks to characterize the workflows performed in NHs before a prescriberʼs decision to prescribe antibiotics. By analyzing the preprescribing workflow across NHs, authors sought to identify barriers to reducing antibiotic overuse and strategies to address them to improve antibiotic prescribing.

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Bandaging amputee

Expect Delays: Poor Connections Between Rural and Urban Health Systems Challenge Multidisciplinary Care for Rural Americans With Diabetic Foot Ulcers

Expect Delays: Poor Connections Between Rural and Urban Health Systems Challenge Multidisciplinary Care for Rural Americans With Diabetic Foot Ulcers

Over 30 million people in the United States have diabetes, and up to 25% of them will develop a diabetic foot ulcer (DFU). Specific to DFUs, rural patients face 50% higher odds of major (above-ankle) amputation and 40% higher odds of death compared to their urban counterparts. A group of authors including HIP Investigators, Dr. Meghan Brennan and Dr. Christie Bartels sought to understand what health system factors contribute to the rural disparity in diabetic foot ulcer outcomes.

The authors concluded that future interventions focusing on mitigating the poor connections across rural and urban healthcare systems could reduce the rural disparity in major amputations.

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Senior women in classroom

Reasons Behind Preferences for Community-Based Continence Promotion

Reasons Behind Preferences for Community-Based Continence Promotion

More than 60% of women older than 65 years in the United States have urinary or bowel incontinence. Despite the existence of effective, minimally invasive therapies, more than half of women with urinary incontinence and two-thirds of women with bowel incontinence do not seek medical care.

In this study, HIP Investigator Dr. Heidi Brown et al. sought to understand sought to understand the potential reach of 3 continence promotion formats: a single lecture, an interactive 3-session workshop, and an online program. Authors found that most incontinent women are willing to participate in continence promotion, especially online.

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Eye exam

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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Chemoprevention of Colorectal Cancer

Chemoprevention of Colorectal Cancer

Although colorectal cancer (CRC) screening has reduced the incidence of and mortality from CRC, chemoprevention strategies have the potential to further reduce CRC incidence and mortality. Chemoprevention agents might be used for average-risk as well as high-risk groups, and to prevent CRC recurrence after therapy. CRC chemoprevention agents that have been studied include aspirin, nonaspirin nonsteroidal anti-inflammatory drugs, statins, agents that target metabolic pathways, and vitamins and minerals.

In this article, HIP Investigator Dr. Jennifer Weiss along with Dr. Bryson Katona reviewed the prospect of chemoprevention of colorectal cancer, results from preclinical and human studies, challenges, and future directions.

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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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Association of Cardiovascular and Alzheimer’s Disease Risk Factors with Intracranial Arterial Blood Flow in Whites and African Americans

Association of Cardiovascular and Alzheimer’s Disease Risk Factors with Intracranial Arterial Blood Flow in Whites and African Americans

Alzheimer’s disease (AD) is the most common cause of dementia among older adults (≥60 years old), affecting more than 5.3 million people in the United States. AD has a higher prevalence among African Americans. Targeting cardiovascular and metabolic risk factors may be potential mechanisms to modify AD risk and address racial/ethnic disparities in AD dementia. HIP Investigator, Dr. Heather Johnson et al. investigated relationships among cardiovascular and metabolic risk factors, APOE genotype, AD biomarkers, and intracranial arterial blood flow in Whites and African Americans enriched for AD risk.

Authors found that elevated fasting glucose and triglycerides were associated with lower intracranial arterial flow; these relationships were more prominent in African Americans. Targeting metabolic risk factors may impact intracranial arterial health. Additional research is needed to determine if this will impact disparities in dementia prevalence.

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