Literature Review
All posts tagged with “Research News | Journal Article.”
[Australia] Online plain language tool and health information quality-A randomized clinical trial
10/19/24 at 03:55 AMOnline plain language tool and health information quality-A randomized clinical trialJAMA Network Open; Julie Ayre, PhD; Carissa Bonner, PhD; Danielle M. Muscat, PhD; Erin Cvejic, PhD; Olivia Mac, MPH; Dana Mouwad, MHSc (Nsg); Heather L. Shepherd, PhD; Parisa Aslani, PhD; Adam G. Dunn, PhD; Kirsten J. McCaffery, PhD; 10/24National and international policies recognize that health literacy—a person’s capacity to access, understand, and act on health information—is a critical source of inequity in our health systems. Low health literacy contributes to higher mortality, morbidity, rates of hospitalization, emergency department visits, and medication errors independently of other social determinants of health, such as age, education, and socioeconomic disadvantage. In this randomized clinical trial, the Health Literacy Editor helped users simplify health information and apply health literacy guidelines to written text. The findings suggest the tool has high potential to improve development of health information for people who have low health literacy.
[Canada] Aerobic physical activity and depression among patients with cancer-A systematic review and meta-analysis
10/19/24 at 03:50 AM[Canada] Aerobic physical activity and depression among patients with cancer-A systematic review and meta-analysisJAMA Network Open; Matthew Kulchycki, MD; Henry Ratul Halder, MSc; Nicole Askin, MLIS; Rasheda Rabbani, PhD; Fiona Schulte, PhD; Maya M. Jeyaraman, MD; Lillian Sung, MD, PhD; Deepak Louis, MD; Lisa Lix, PhD; Allan Garland, MD, MA; Alyson L. Mahar, PhD; Ahmed Abou-Setta, PhD; Sapna Oberoi, MD, MSc; 10/24A cancer diagnosis increases the risk of anxiety, depression, and emotional distress among patients. Depression prevalence among patients with cancer ranges from 13% to 27%, which is 2 to 3 times higher than the general population. In this systematic review and meta-analysis, APA [aerobic physical activity]was associated with modest short-term and long-term reductions of depression among adults with cancer. Future studies should discern the effectiveness of APA in combination with other strategies for managing depression across various populations of patients with cancer.
Ethical considerations in the design and conduct of clinical trials of artificial intelligence
10/19/24 at 03:45 AMEthical considerations in the design and conduct of clinical trials of artificial intelligenceJAMA Network Open; Alaa Youssef, PhD; Ariadne A. Nichol, BA; Nicole Martinez-Martin, JD, PhD; David B. Larson, MD, MBA; Michael Abramoff, MD, PhD; Risa M. Wolf, MD; Danton Char, MD, MS; 9/24In this qualitative study, interviews with 11 investigators involved in clinical trials of AI [artificial intelligence] for diabetic retinopathy screening confirmed the applicability of current ethical principles but also identified unique challenges, including assessing social value, ensuring scientific validity, fair participant selection, evaluation of risk-to-benefit ratio in underrepresented groups, and navigating complex consent processes. These results suggest ethical challenges unique to clinical trials of AI, which may provide important guidance for empirical and normative ethical efforts to enhance the conduct of AI clinical trials. These considerations call for further guidance on where to focus empirical and normative ethical efforts to best support conduct clinical trials of AI and minimize unintended harm to trial participants.
Effectiveness of a mobile app (Meds@HOME) to improve medication safety for children with medical complexity: Protocol for a randomized controlled trial
10/19/24 at 03:40 AMEffectiveness of a mobile app (Meds@HOME) to improve medication safety for children with medical complexity: Protocol for a randomized controlled trialJMIR Research Protocols; Nicole E Werner, Makenzie Morgen, Sophie Kooiman, Anna Jolliff, Gemma Warner, James Feinstein, Michelle Chui, Barbara Katz, Brittany Storhoff, Kristan Sodergren, Ryan Coller; 9/24The Meds@HOME mobile app provides a promising strategy for improving PCG [primary caregiver] medication safety for CMC [children with medical complexity] who take high-risk medications. In addition, this protocol highlights novel procedures for recruiting SCGs [secondary caregivers] of CMC. In the future, this app could be used more broadly across diverse caregiving networks to navigate complex medication routines and promote medication safety.
Physician altruism and spending, hospital admissions, and emergency department visits
10/19/24 at 03:35 AMPhysician altruism and spending, hospital admissions, and emergency department visitsJAMA Health Forum; Lawrence P. Casalino, MD, PhD; Shachar Kariv, PhD; Daniel Markovits, JD, DPhil; Raymond Fisman, PhD; 10/24This cross-sectional study found that Medicare patients treated by altruistic physicians had fewer potentially preventable hospitalizations and emergency department visits and lower spending. Policymakers and leaders of hospitals, medical practices, and medical schools may want to consider creating incentives, organizational structures, and cultures that may increase, or at least do not decrease, physician altruism. Further research should seek to identify these and other modifiable factors, such as physician selection and training, that may shape physician altruism. Research could also analyze the relationship between altruism and quality and spending in additional medical practices, specialties, and countries, and use additional measures of quality and of patient experience.
Racial differences in pain assessment and false beliefs about race in AI models
10/19/24 at 03:30 AMRacial differences in pain assessment and false beliefs about race in AI modelsJAMA Network Open; Brototo Deb, MD, MIDS; Adam Rodman, MD, MPH; 10/24Physicians undertreat Black patients’ pain compared with White patients, irrespective of setting and type of pain, likely from underassessment of pain and undertreatment of pain on recognition. Large language models (LLMs) encode racial and ethnic biases and may perpetuate race and ethnicity–based medicine. Although LLMs rate pain similarly between races and ethnicities, they underestimate pain among Black individuals in the presence of false beliefs. Given LLMs’ significant abilities in assisting with clinical reasoning, as well as a human tendency toward automation bias, these biases could propagate race and ethnicity–based medicine and the undertreatment of pain in Black patients. Mitigating these biases involves many strategies during dataset preparation, training, and posttraining stages.
Applying a health equity lens to better understand end-of-life prognostication
10/19/24 at 03:25 AMApplying a health equity lens to better understand end-of-life prognosticationAMA Journal of Ethics; by Newsha Nikzad, Joelle Robertson-Preidler, Faith E. Fletcher; 10/24Racial and ethnic inequity exists throughout the lifespan, including at the end of life (EOL). Although prognostication is inherently fraught with uncertainty, many underrepresented minorities get prognoses that are overly optimistic, which can exacerbate inequity by depriving patients of details needed to make informed decisions and plan for EOL care. This article applies a health equity lens to facilitate better ethical and clinical understandings of how to care for patients of color more equitably at the EOL.
Annual wellness visits and early dementia diagnosis among Medicare beneficiaries
10/19/24 at 03:20 AMAnnual wellness visits and early dementia diagnosis among Medicare beneficiariesJAMA Network Open; Huey-Ming Tzeng, PhD; Mukaila A. Raji, MD, MS; Yong Shan, PhD; Peter Cram, MD, MBA; Yong-Fang Kuo, PhD' 10/24Optimal dementia care depends on early recognition of cognitive impairment and timely diagnosis of Alzheimer disease and related dementias (ADRD). Optimal dementia care should reflect what matters most to patients and adhere to evidence-informed ADRD stage-specific health care. These findings indicate that AWV [annual wellness visit] recipients had a timelier first MCI [mild cognitive impairment] diagnosis than those who did not receive an AWV, but first ADRD diagnosis differed little. This study suggests that the Medicare AWV health policy may increase MCI identification, prompting more specialized care.
Home health care and place of death in Medicare beneficiaries with and without dementia
10/19/24 at 03:15 AMHome health care and place of death in Medicare beneficiaries with and without dementiaGerontologist; Hyosin Dawn Kim , Paul R Duberstein, Anum Zafar, Bei Wu, Haiqun Lin , Olga F Jarrín; 11/24Home health care supports patient goals for aging in place. Use of home health care during the last 3 years of life was associated with reduced rates of inpatient death without hospice, and increased rates of home death with hospice. Increasing affordable access to home health care can positively affect end-of-life care outcomes for older Americans and their family caregivers, especially those with dementia.
Telehealth vs in-person early palliative care for patients with advanced lung cancer-A multisite randomized clinical trial
10/19/24 at 03:10 AMTelehealth vs in-person early palliative care for patients with advanced lung cancer-A multisite randomized clinical trialJAMA; Joseph A. Greer, PhD; Jennifer S. Temel, MD; Areej El-Jawahri, MD; Simone Rinaldi, ANP-BC; Mihir Kamdar, MD; Elyse R. Park, PhD, MPH; Nora K. Horick, MS; Kedie Pintro, MS; Dustin J. Rabideau, PhD; Lee Schwamm, MD; Josephine Feliciano, MD; Isaac Chua, MD, MPH; Konstantinos Leventakos, MD, PhD; Stacy M. Fischer, MD; Toby C. Campbell, MD; Michael W. Rabow, MD; Finly Zachariah, MD; Laura C. Hanson, MD; Sara F. Martin, MD; Maria Silveira, MD; Laura Shoemaker, DO; Marie Bakitas, DNSc; Jessica Bauman, MD; Lori Spoozak, MD; Carl Grey, MD; Leslie Blackhall, MD; Kimberly Curseen, MD; Sean O’Mahony, MB, BCh, BAO; Melanie M. Smith, MD; Ramona Rhodes, MD; Amelia Cullinan, MD; Vicki Jackson, MD; for the REACH PC; 9/24 The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC [non-small cell lung cancer], underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery. [These] findings underscore the potential to increase access to evidence-based early palliative care through telehealth delivery.
Socioeconomic trends in palliative care: A six-year study
10/19/24 at 03:05 AMSocioeconomic trends in palliative care: A six-year studyCureus; by Andrej Sodoma, Muhammad Wahdan Naseeb,Samuel Greenberg, Nicholas J. Knott, Jonathan Arias, Argirios Skulikidis, Mary Makaryus; 10/24Our study investigates trends in PC utilization, focusing on socioeconomic characteristics. The National Inpatient Sample (NIS) from 2015 to 2020 was used to identify adults hospitalized in the United States (US). International Classification of Diseases, Tenth Revision (ICD-10), was used for PC encounters, code Z51.5. An equal number of random records, stratified by year and without this code, were selected to serve as controls [5.2M visits]. Men were more likely to receive PC consults. Medicare/Medicaid holders’ PC access was limited compared to private insurance holders. Racial minorities, particularly Hispanics and Blacks, were less likely to engage in PC. Compared to urban teaching hospitals, rural hospitals had a decreased rate of PC utilization. Smaller hospitals had significantly fewer PC referrals than large hospitals. A lower socioeconomic status was associated with a reduced propensity to utilize PC services compared to an upper socioeconomic status.
Disbelief, distress, & distrust: trending institution related emotional distress during COVID-19
10/12/24 at 03:45 AMDisbelief, distress, & distrust: trending institution related emotional distress during COVID-19Journal of Social Work in End-of-Life & Palliative Care; Jillian Sherman, Shannon Petros; 10/24The COVID-19 pandemic had an unprecedented impact on the well-being of individuals working in the healthcare sector. Numerous themes were identified [in this study], including the importance of caseload, general support, team support, management, and professional flexibility. Additional end-of-life themes were identified, including the impact of death, lack of personal protective equipment, fear of transmitting the virus, COVID disbelief, and the inability of clinicians and/or family to be with patients in person. From the experience participants had during COVID-19, four areas of change were identified: professional resilience, management/ethics support, professional development, and physical and emotional safety.
A quality improvement initiative for inpatient advance care planning
10/12/24 at 03:40 AMA quality improvement initiative for inpatient advance care planningJAMA Health Forum; Olivia A Sacks, Megan Murphy, James O'Malley, Nancy Birkmeyer, Amber E Barnato; 10/24The Centers for Medicare & Medicaid Services (CMS) implemented advance care planning (ACP) billing codes in 2016 to encourage practitioners to conduct and document ACP conversations, and included ACP as a quality metric in the CMS Bundled Payments for Care Improvement Initiative in 2018. Increased ACP billing rates were significantly associated with decreased rates of inpatient death in the intervention group ... compared to the nonintervention ... and control groups ... Conclusions and relevance: This nationwide cohort study suggests that while the ACP quality initiative increased ACP billing, changes in clinical outcomes were inconsistent with the hypotheses.
Fear of cancer recurrence in adult survivors of childhood cancer
10/12/24 at 03:35 AMFear of cancer recurrence in adult survivors of childhood cancerJAMA Network Open; Alex Pizzo, MSc; Wendy M. Leisenring, ScD; Kayla L. Stratton, MSc; Élisabeth Lamoureux, BA; Jessica S. Flynn, MSc; Kevin Alschuler, PhD; Kevin R. Krull, PhD; Lindsay A. Jibb, PhD, RN; Paul C. Nathan, MD, MSc; Jeffrey E. Olgin, MD; Jennifer N. Stinson, PhD, RN; Gregory T. Armstrong, MD, MSc; Nicole M. Alberts, PhD; 10/24In this cross-sectional study of 229 North American adults who survived childhood cancer, one-third of survivors reported experiencing elevated fear that their primary cancer will recur or a subsequent malignant neoplasm will develop. Fear of cancer recurrence was associated with chronic health conditions, treatment-related factors, anxiety, depression, and perceived health status.
Socioeconomic status and major adverse transplant events in pediatric heart transplant recipients
10/12/24 at 03:20 AMSocioeconomic status and major adverse transplant events in pediatric heart transplant recipientsJAMA Network Open; Christina Hartje-Dunn, MD; Kimberlee Gauvreau, ScD; Heather Bastardi, PNP; Kevin P. Daly, MD; Elizabeth D. Blume, MD; Tajinder P. Singh, MD, MSc; 10/24In this cohort study of pediatric HT recipients, there was no difference in posttransplant outcomes among recipients stratified by SES, a notable improvement from prior studies. These findings may be explained by state-level health reform, standardized posttransplant care, and early awareness of outcome disparities.
The influence of patient-provider communication on self-management among patients with chronic illness: A systematic mixed studies review
10/12/24 at 03:10 AMThe influence of patient-provider communication on self-management among patients with chronic illness: A systematic mixed studies reviewJournal of Advanced Nursing; Christin Iroegbu, Delphine S Tuot, Lisa Lewis, Lea Ann Matura; 9/24Chronic illnesses studied: diabetes, heart failure, hypertension, chronic obstructive pulmonary disease and asthma. Available evidence suggests that patient-provider communication influences chronic illness self-management. A provider's ability to adjust and tailor their communication style is an important factor in helping patients to achieve optimal self-management. Future research should explore this phenomenon in other common chronic illnesses not included in this review. Additionally, research on the patient's role in this process could help improve patient-provider communication.
Implementation and outcomes of a dementia-friendly training program in five hospitals
10/12/24 at 03:05 AMImplementation and outcomes of a dementia-friendly training program in five hospitalsGeriatric Nursing; Ellen Roberts, Ellen C Schneider, Maureen Dale, Cristine B Henage, Casey J Kelley, Jan Busby-Whitehead; 10/24Hospitalized patients living with dementia (PLWD) age 65+ generally experience poor outcomes. This study's purpose was to implement dementia-friendly training with staff, track patient outcomes, and implement sustainable system changes. Positive changes in staff ratings from pre- to post- intervention were observed. Number of falls and readmissions did not change. The average number of stays per patient decreased ... Conclusions: Dementia-friendly hospital training is effective in improving staff recognition of the symptoms and needs of PLWD, and responding appropriately.
Risk of dementia diagnosis after injurious falls in older adults
10/12/24 at 03:05 AMRisk of dementia diagnosis after injurious falls in older adultsJAMA Network Open; Alexander J. Ordoobadi, MD; Hiba Dhanani, MD, ScM; Samir R. Tulebaev, MD; Ali Salim, MD; Zara Cooper, MD, MSc; Molly P. Jarman, PhD, MPH; 9/24In this cohort study, new ADRD [Alzheimer disease and related dementias] diagnoses were more common after falls compared with other mechanisms of injury, with 10.6% of older adults being diagnosed with ADRD in the first year after a fall. To improve the early identification of ADRD, this study’s findings suggest support for the implementation of cognitive screening in older adults who experience an injurious fall that results in an ED visit or hospital admission.
The prevalence of lifetime trauma and association with physical and psychosocial health among adults at the end of life
10/12/24 at 03:00 AMThe prevalence of lifetime trauma and association with physical and psychosocial health among adults at the end of lifeJournal of the American Geriatics Society; by Kate A. Duchowny, Alexander K. Smith, Irena Cenzer, Chelsea Brown, Grace Noppert, Kristine Yaffe, Amy L. Byers, Carla Perissinotto, Ashwin A. Kotwal; 10/24National guidelines recognize lifetime trauma as relevant to clinical care for adults nearing the end of life. We determined the prevalence of early life and cumulative trauma among persons at the end of life by gender and birth cohort, and the association of lifetime trauma with end-of-life physical, mental, and social well-being. Older adults in the last years of life report a high prevalence of lifetime traumatic events which are associated with worse end-of-life physical and psychosocial health. A trauma-informed approach to end-of-life care and management of physical and psychosocial needs may improve a patient's quality of life.
Feasibility of a digital palliative care intervention (Convoy-Pal) for older adults with heart failure and multiple chronic conditions and their caregivers: a waitlist randomized control trial
10/12/24 at 03:00 AMFeasibility of a digital palliative care intervention (Convoy-Pal) for older adults with heart failure and multiple chronic conditions and their caregivers: a waitlist randomized control trialBMC Palliative Care; by Lyndsay DeGroot, Riley Gillette, Jennifer Paola Villalobos, Geoffrey Harger, Dylan Thomas Doyle, Sheana Bull, David B Bekelman, Rebecca Boxer, Jean S Kutner, Jennifer D Portz; 10/24Although older adults with heart failure (HF) and multiple chronic conditions (MCC) frequently rely on caregivers for health management, digital health systems, such as patient portals and mobile apps, are designed for individual patients and often exclude caregivers. There is a need to develop approaches that integrate caregivers into care. This study tested the feasibility of the Social Convoy Palliative Care intervention (Convoy-Pal), a 12-week digital self-management program that includes assessment tools and resources for clinical palliative care, designed for both patients and their caregivers. Recruiting informal caregivers proved challenging. Nonetheless, Convoy-Pal retained patients and collected meaningful self-reported outcomes, showing potential benefits for both patients and caregivers. Given the importance of a patient and caregiver approach in palliative care, further research is needed to design digital tools that cater to multiple simultaneous users.
Patient considerations of social media account management after death
10/12/24 at 03:00 AMPatient considerations of social media account management after deathSupportive Care in Cancer; Rida Khan, Jacqueline Tschanz, Maxine De La Cruz, David Hui, Diana Urbauer, Astrid Grouls, Eduardo Bruera; 10/24Social media is widely used but few studies have examined how patients with advanced cancer want their accounts managed after death. The objective of this study was to determine the proportion of our patients with advanced cancer who have discussed the post-mortem management of their social media accounts with their family or friends. Conclusion: Few patients have had conversations on the management of their accounts after death, although more were interested in exploring their options further. More research is needed to examine the role of social media as a digital legacy and a coping tool for patients with advanced cancer.
Top ten tips palliative care clinicians should know about hospice live discharge
10/05/24 at 03:00 AMTop ten tips palliative care clinicians should know about hospice live dischargeJournal of Palliative Medicine; Stephanie P Wladkowski, Lauren J Hunt, Elizabeth A Luth, Joan Teno, Krista L Harrison, Cara L Wallace; 9/24Hospice care is designed to support the medical and psychosocial needs of individuals with serious illness and their caregivers through the dying process. Some individuals, though, leave hospice prior to death, generally referred to as disenrollment or a "live discharge." Live discharge from hospice is a common and often distressing issue for hospice patients, their caregivers, and also for hospice professionals and agencies. This paper discusses common issues surrounding live discharge that clinicians and other healthcare professionals should consider when dealing with live discharge in their own clinical practices. Where applicable, we provide practical steps for hospice and palliative care clinicians to better support patients and families through this critical care transition. Further, we offer strategic directions interprofessional clinicians can take to affect systemic change to improve live discharge experiences.
Data points to need for trauma-centered care at end of life
10/04/24 at 03:00 AMData points to need for trauma-centered care at end of lifeMcKnight's Long-Term Care News; by Kristen Fischer; 10/2/24A new study has found that early life and cumulative trauma are linked to poorer physical and psychosocial health at the end of life. The report was published Tuesday in the Journal of the American Geriatrics Society. Among participants, 19% reported no trauma, while 47% experienced one to two traumatic events and 25% had three to four traumatic events. A total of 9% of people reported more than five traumatic events in their lives. “Findings highlight the need for clinicians caring for seriously ill older adults to ensure interdisciplinary care for trauma symptoms and potentially adopting a trauma-informed approach to end-of-life care,” the authors wrote.
[Ghana] A qualitative study on the experiences of family caregivers of children with End Stage Kidney Disease (ESKD)
09/28/24 at 03:50 AM[Ghana] A qualitative study on the experiences of family caregivers of children with End Stage Kidney Disease (ESKD)BioPsychoSocial Medicine; Edward Appiah Boateng, Mabel Baaba Bisiw, Rosemary Agyapomah, Isaac Enyemadze, Joana Kyei-Dompim, Samuel Peprah Kumi, Dorothy Serwaa Boakye; 8/24Family caregivers, mostly parents, are greatly involved in the care of their children with end stage kidney disease (ESKD) globally. Yet, the experiences of these caregivers and the demands placed on them by the caregiving role have not been explored or documented in Ghana. The majority of the family caregivers experienced anxiety, fear, uncertainty, and hopelessness in response to the children's diagnosis and care ... [and] ... the thought of the possibility of the children dying was deeply traumatizing for our participants. Most participants reported bodily pains and physical ailments because of lifting and caring for the children. Financial constraint was also a key issue for all the family caregivers. All the family caregivers had their psychological well-being compromised as a result of the challenges they encountered physically, socially, and spiritually.
[Germany] Impacts of clinical decision support systems on the relationship, communication, and shared decision-making between health care professionals and patients: Multistakeholder interview study
09/28/24 at 03:50 AM[Germany] Impacts of clinical decision support systems on the relationship, communication, and shared decision-making between health care professionals and patients: Multistakeholder interview studyJournal of Medical Internet Research; Florian Funer, Diana Schneider, Nils B Heyen, Heike Aichinger, Andrea Diana Klausen, Sara Tinnemeyer, Wenke Liedtke, Sabine Salloch, Tanja Bratan; 8/24Clinical decision support systems (CDSSs) are increasingly being introduced into various domains of health care. The results indicate that using CDSSs could restructure established power and decision-making relationships between (future) health care professionals and patients. In addition, respondents expected that the use of CDSSs would involve more communication, so they anticipated an increased time commitment. The results shed new light on the existing discourse by demonstrating that the anticipated impact of CDSSs on the health care professional-patient relationship appears to stem less from the function of a CDSS and more from its integration in the relationship.