Publications

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Annals of internal medicine

Web Exclusive. Annals On Call - Hypertension in the Hospital.

2020

Authors: Centor RM, Anderson TS, Wray CM

Gastroenterology

Simulation-Based Mastery Learning (SBML) With Virtual Coaching - Experience in Training Standardized Upper Endoscopy to Novice Endoscopists.

2020

Authors: Soetikno R, Cabral-Prodigalidad PA, Kaltenbach T

JAMA internal medicine

Assessing Telemedicine Unreadiness Among Older Adults in the United States During the COVID-19 Pandemic.

2020

Authors: Lam K, Lu AD, Shi Y, Covinsky KE

Federal practitioner : for the health care professionals of the VA, DoD, and PHS

Integrating Germline Genetics Into Precision Oncology Practice in the Veterans Health Administration: Challenges and Opportunities.

2020

Authors: Scheuner MT, Myrie K, Peredo J, Hoffman-Hogg L, Lundquist M, Guerra SL, Ball D

European journal of clinical nutrition

Association of dietary acid load with serum bicarbonate in chronic kidney disease (CKD) patients.

2020

Authors: Angeloco LRN, Arces de Souza GC, Romão EA, Frassetto L, Chiarello PG

European journal of clinical nutrition

How metabolic acidosis and kidney disease may accelerate the aging process.

2020

Authors: Frassetto LA, Sebastian A, DuBose TD

Federal practitioner : for the health care professionals of the VA, DoD, and PHS

Effects of Computer-Based Documentation Procedures on Health Care Workload Assessment and Resource Allocation: An Example From VA Sleep Medicine Programs.

2020

Authors: Sarmiento KF, Boudreau EA, Smith CJ, Kaul B, Johnson N, Folmer RL

The Journal of invasive cardiology

Patient Risk Assessment for Transcatheter Aortic Valve Replacement at Veterans Health Administration Hospitals.

2020

Authors: Burke L, Gozdecki L, Doukas D, Joyce C, Weaver F, Bavry AA, Garcia S, Cohen DJ, Shunk KA, Mathew V

Gastrointestinal endoscopy

Endoscopic transmission of carbapenem-resistant Enterobacteriaceae: implications for Food and Drug Administration approval and postmarket surveillance of endoscopic devices.

2020

Authors: Saleem N, Ismail MK, Tombazzi CR, Soin S, Dhruva SS

The American journal of managed care | Volume 26 of Issue 8

Impact of primary care intensive management on medication adherence and adjustments.

2020

Authors: Yoon J, Wu F, Chang E

OBJECTIVES

The Veterans Health Administration implemented a pilot program for primary care intensive management (PIM) for patients at high risk for hospitalization. We examined the impact of the program on medication adherence and adjustments for patients with chronic conditions.

STUDY DESIGN

A randomized quality improvement trial was conducted in 5 sites in which high-risk patients were randomized into PIM or usual primary care; outcomes were measured in the 12 months before and after randomization. Interdisciplinary PIM teams assessed patients for unmet needs and offered services including pharmaceutical care and care coordination.

METHODS

Outcomes included adherence, measured by proportion of days covered, and several measures of medication adjustments for diabetes, depression, hyperlipidemia, and hypertension medications. Differences-in-differences methods were used to estimate changes in outcomes between PIM and usual care groups.

RESULTS

There were 1527 patients in the medication adherence cohort and 1719 in the medication adjustments cohort. Mean adherence was mostly similar between groups but 16% higher among PIM patients for dipeptidyl-peptidase-4 (DPP-4) inhibitors (for diabetes) after randomization (0.12 vs -0.04; P = .02). The mean number of hyperlipidemia drugs filled was higher among PIM patients (1.1 vs 1.0; P = .006). The mean number of discontinued depression medications was higher and the mean number of dose changes for hypertension medications was lower for PIM patients, although these comparisons did not reach statistical significance.

CONCLUSIONS

Medication adherence improved for DPP-4 inhibitors, and more hyperlipidemia drugs were prescribed for PIM patients. Overall impacts of PIM were modest.