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Category: Uncategorized

Hello World!

pjgrier Uncategorized

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PCOM Author Series – Joan Naidorf

jrpanacio Library News, Uncategorized

The PCOM Library is pleased to host Class of 1985 alum Joan Naidorf on February 8th for a special presentation on her new work “Changing How We Think about Difficult Patients: A Guide for Physicians and Healthcare Professionals.” This book explores the challenging task of working with challenging patients and provides the skills and attitudes needed to successfully overcome these difficulties and avoid burnout.

PCOM-PA Announced 2022 Student Researcher of the Year

jrpanacio Library News, Uncategorized

It is the Library’s pleasure to announce PCOM-PA’s 2022 Student Researcher of the Year: 

Bridgid Garrity, DO Candidate in the Class of 2023! 
Brigid shows her dedication, passion, and leadership in research with many first-authored and co-authored publications. She comes highly recommended by her Principal Investigators who not only vouch for her work ethic and professionalism, but also for her embodiment of the osteopathic philosophy. Her competitive resume should serve her well in her next steps to represent herself and PCOM for the National SROY against awardees from other osteopathic schools. We are very proud of her and wish her luck in her next endeavor!

Thank you to all who applied for this award.  A special thank you to the Student Researcher of the Year Committee, Dr. Chen, Dr. Reno, Dr. Roberts, Dr. George-Weinstein, and Dr. Lippman-Bell.

PCOM-PA’s 2022 Student Researcher of the Year Announced

jrpanacio Uncategorized

Bridgid Garrity, DO Candidate in the Class of 2023! 

Brigid shows her dedication, passion, and leadership in research with many first-authored and co-authored publications. She comes highly recommended by her Principal Investigators who not only vouch for her work ethic and professionalism, but also for her embodiment of the osteopathic philosophy. Her competitive resume should serve her well in her next steps to represent herself and PCOM for the National SROY against awardees from other osteopathic schools. We are very proud of her and wish her luck in her next endeavor!

Brigid Garrity Headshot.jpg

Thank you to all who applied for this award.  A special thank you to the Student Researcher of the Year Committee, Dr. Chen, Dr. Reno, Dr. Roberts, Dr. George-Weinstein, and Dr. Lippman-Bell.

Library Closure

katresaga Library News, Uncategorized

The physical library is currently closed until further notice. But don’t forget, virtual access is available 24/7. Feel free to contact the library and a librarian for any assistance. For library services, such as ILL, please email us.

Research Day

katresaga Library News, Uncategorized

Research Day has been postponed. If you have already submitted a proposal, you should receive an update. Please check back in the near future for the new date.

Sanford Guide (Web Edition) Trial

pjgrier Library News, Uncategorized

The Sanford Guide, a unique drug resource, provides searchable data on pathogens, syndromes and anti-infective agents, and includes specialized tabs on HIV/AIDS and Hepatitis. Users can research information on prevention measures, drug interactions, and pharmacological data.

The institutional trial starts today and ends on April 30th. Let us know what you think by sending comments to library@pcom.edu.

Hot Topics: Group Medical Visits Effective for Chronic Conditions

jackiewe Alternative and Complementary Medicine, Hot Topics in Research, Uncategorized

Characteristics and Components of Medical Group Visits for Chronic Health Conditions: A Systematic Scoping Review

Parikh M, Rajendran I, D’Amico S, Luo M, Gardiner P. Characteristics and components of medical group visits for chronic health conditions: A systematic scoping review. The Journal of Alternative and Complementary Medicine. 2019;25(7):683-698. https://doi.org/10.1089/acm.2018.0524.

Objectives: Chronic health conditions are a major challenge to the health care system. Medical Group Visits (MGVs) are a valuable health care delivery model used in a variety of medical settings and patient populations. We conducted a systematic scoping review of MGV research literature for chronic health conditions to summarize the characteristics and individual components of MGVs in the United States of America and Canada.

Design: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping review methodology and searched five databases using nine widely used MGV-related terms.

Subjects: We included studies conducted in the United States and Canada, whose participants were >18 years old and attended an MGV conducted in a medical setting by a billable health care provider. We excluded groups related to diabetes, pregnancy, and cancer.

Results: Of 3777 studies identified, we found 55 eligible studies of which 9 are randomized controlled trials and 46 are observational studies. The majority of studies were conducted in academic medical centers, were observational in design, and recruited patients using physician referrals. The three most frequently studied groups include a combination of several chronic conditions (n = 12), chronic pain conditions (n = 10), and cardiovascular disease (n = 9). Curriculum components included didactics (n = 55), experiential activities (n = 27), and socializing components (n = 12). Didactic areas include (1) medical topics such as symptoms management (n = 27) of which 14 included pain management, and (2) lifestyle/educational component (n = 33) that comprised of talks on nutrition (n = 29), exercise (n = 20), stress (n = 16), and sleep (n = 10). The top integrative medicine (IM) modalities (n = 13) included: mindfulness techniques (n = 8), meditation (n = 6), and yoga (n = 5). Substantial heterogeneity was observed in the recruitment, implementation, curriculum components, and outcomes reported.

Conclusion: The MGV is a model of patient-centered care that has captured the attention of researchers. IM modalities are well represented in the curriculum components of MGVs. Further investigation into the components identified by this study, may help in better targeting of group interventions to patients and contexts, where it is most likely to be effective.

Hot Topics: Spinal Surgery “Enhanced Recovery” Cuts Opioid Use

jackiewe Hot Topics in Research, Neurosurgery, Substance Use Disorders, Surgery, Uncategorized

Enhanced recovery after elective spinal and peripheral nerve surgery: pilot study from a single institution

Ali ZS, Flanders TM, Ozturk AK, et al. Enhanced recovery after elective spinal and peripheral nerve surgery: Pilot study from a single institution. Journal of Neurosurgery: Spine SPI. 2019:1-9. https://dx.doi.org/10.3171/2018.9.SPINE18681.

Enhanced recovery after surgery (ERAS) protocols address pre-, peri-, and postoperative factors of a patient’s surgical journey. The authors sought to assess the effects of a novel ERAS protocol on clinical outcomes for patients undergoing elective spine or peripheral nerve surgery.

METHODS

The authors conducted a prospective cohort analysis comparing clinical outcomes of patients undergoing elective spine or peripheral nerve surgery after implementation of the ERAS protocol compared to a historical control cohort in a tertiary care academic medical center. Patients in the historical cohort (September–December 2016) underwent traditional surgical care. Patients in the intervention group (April–June 2017) were enrolled in a unique ERAS protocol created by the Department of Neurosurgery at the University of Pennsylvania. Primary objectives were as follows: opioid and nonopioid pain medication consumption, need for opioid use at 1 month postoperatively, and patient-reported pain scores. Secondary objectives were as follows: mobilization and ambulation status, Foley catheter use, need for straight catheterization, length of stay, need for ICU admission, discharge status, and readmission within 30 days.

RESULTS

A total of 201 patients underwent surgical care via an ERAS protocol and were compared to a total of 74 patients undergoing traditional perioperative care (control group). The 2 groups were similar in baseline demographics. Intravenous opioid medications postoperatively via patient-controlled analgesia was nearly eliminated in the ERAS group (0.5% vs 54.1%, p < 0.001). This change was not associated with an increase in the average or daily pain scores in the ERAS group. At 1 month following surgery, a smaller proportion of patients in the ERAS group were using opioids (38.8% vs 52.7%, p = 0.041). The ERAS group demonstrated greater mobilization on postoperative day 0 (53.4% vs 17.1%, p < 0.001) and postoperative day 1 (84.1% vs 45.7%, p < 0.001) compared to the control group. Postoperative Foley use was decreased in the ERAS group (20.4% vs 47.3%, p < 0.001) without an increase in the rate of straight catheterization (8.1% vs 11.9%, p = 0.51).

CONCLUSIONS

Implementation of this novel ERAS pathway safely reduces patients’ postoperative opioid requirements during hospitalization and 1 month postoperatively. ERAS results in improved postoperative mobilization and ambulation.

Hot Topics: Current Patient Engagement Measures Fall Short

jackiewe Family Medicine, Hot Topics in Research, Uncategorized

Mishra MK, Saunders CH, Rodriguez HP, Shortell SM, Fisher E, Elwyn G. How do healthcare professionals working in accountable care organisations understand patient activation and engagement? Qualitative interviews across two time points. BMJ Open. 2018;8(10). http://dx.doi.org/10.1136/bmjopen-2018-023068

Objective If patient engagement is the new ‘blockbuster drug’ why are we not seeing spectacular effects? Studies have shown that activated patients have improved health outcomes, and patient engagement has become an integral component of value-based payment and delivery models, including accountable care organisations (ACO). Yet the extent to which clinicians and managers at ACOs understand and reliably execute patient engagement in clinical encounters remains unknown. We assessed the use and understanding of patient engagement approaches among frontline clinicians and managers at ACO-affiliated practices.

Design Qualitative study; 103 in-depth, semi-structured interviews.

Participants Sixty clinicians and eight managers were interviewed at two established ACOs.

Approach We interviewed healthcare professionals about their awareness, attitudes, understanding and experiences of implementing three key approaches to patient engagement and activation: 1) goal-setting, 2) motivational interviewing and 3) shared decision making. Of the 60 clinicians, 33 were interviewed twice leading to 93 clinician interviews. Of the 8 managers, 2 were interviewed twice leading to 10 manager interviews. We used a thematic analysis approach to the data.

Key results Interviewees recognised the term ‘patient activation and engagement’ and had favourable attitudes about the utility of the associated skills. However, in-depth probing revealed that although interviewees reported that they used these patient activation and engagement approaches, they have limited understanding of these approaches.

Conclusions Without understanding the concept of patient activation and the associated approaches of shared decision making and motivational interviewing, effective implementation in routine care seems like a distant goal. Clinical teams in the ACO model would benefit from specificity defining key terms pertaining to the principles of patient activation and engagement. Measuring the degree of understanding with reward that are better-aligned for behaviour change will minimise the notion that these techniques are already being used and help fulfil the potential of patient-centred care.