Improve Patient Health Outcomes Research Articles

Perceptions of Telehealth in the United States: Are There Racial/Ethnic Differences?

Introduction: Telehealth, a beneficial and safe option for in-person medical patient visits, has the potential to significantly improve patient health outcomes. While its use increased during the COVID-19 pandemic, there is limited research on the perception of telehealth compared with in-person care among different racial and ethnic groups in the United States. We aimed to investigate the relationship between race/ethnicity and the perception that telehealth is similar to in-person care. Methods: The study used the Health Information Nation Trends Survey Cycle 6, a nationally representative survey conducted between March and November 2022, as its primary data source. The analytic sample included 2,384 participants of age 18 years and older. The primary outcome, perceived telehealth equivalency, was measured as the self-reported perception that telehealthis equivalent to in-person care. Logistic regression examined the association between race/ethnicity and perceived telehealth equivalency, adjusting for several potential confounding factors. Results: The findings indicated that being non-Hispanic Black or African American, relative to non-Hispanic White, was significantly associated with the perception that telehealth is similar to in-person care (odds ratio [OR] = 2.02, 95% confidence interval [CI] = 1.14-3.57, p = 0.016). High school graduates (OR = 1.82, 95% CI = 1.02-3.25, p = 0.04) and those insured (OR = 2.98, 95% CI = 1.29-6.91, p = 0.01) were significantly more likely to report a perception that telehealth is similar to in-person care. The different modalities, such as video or audio, were not significantly associated with perceived telehealth equivalency. Conclusions: These findings suggest that understanding demographic and contextual factors may help enhance telehealth acceptance and utilization and inform efforts to increase equitable access to health care.

Gender, race, and economic factors influencing screening practices in hidradenitis suppurativa: a cross-sectional analysis.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that significantly impacts patients' quality of life. Despite its substantial burden, HS remains underdiagnosed and undertreated, particularly among marginalized populations. This study aimed to elucidate the primary social determinants of health (SDOH) and structural determinants of health (StDOH) influencing rates and patterns of screening for patients diagnosed with HS. Using data from the All of Us Research Program database, participants with HS were identified using ICD-10 codes and stratified based on various sociodemographic factors, including race, gender, and income. The primary outcome variables were participation in viral screening and disease screening among HS patients. Statistical analyses were performed to assess the relationship between sociodemographic factors and screening practices. Income and gender had significant impacts on screening practices. Higher-income patients were more likely to receive necessary disease screening and less likely to receive unnecessary disease screening compared to lower-income patients. Non-male patients had significantly higher rates of unnecessary disease and viral screening than male patients. While differences in screening practices within each income level were significant, there were no significant differences across different income brackets or racial groups. These findings suggest that subjectivity associated with individual physicians' recommendations may contribute to disparities in screening outcomes, especially in lower-income and non-male HS patients. The study highlights the need for more clearly delineated screening guidelines and continued research on the role of SDOH in improving patient health outcomes.

Assessing Disease Self-Management in Multi-Ethnic Patients with Chronic Conditions and Evaluating Psychometric Properties of the Partners in Health Scale

The increasing prevalence of chronic diseases globally has resulted in increased healthcare utilization. Patients’ self-management of chronic diseases is important for efficient healthcare and improving patient health outcomes. This study aims to evaluate the psychometric properties of the Partners in Health (PIH) scale in a representative, multi-ethnic sample of patients with chronic diseases in Singapore and examine factors that can contribute to chronic disease self-management. A cross-sectional household survey included the PIH scale administered to 502 patients aged 40 and above who reported having at least one chronic condition. Bayesian Confirmatory Factor Analysis was applied to evaluate the factor structure and gender measurement invariance of PIH. The results suggested that a four-factor structure fit the Singaporean sample and had approximate measurement equivalence between males and females for most of the PIH items. The PIH scale and subscales also demonstrated criterion validity by having expected correlations with conceptually relevant constructs. Finally, sociodemographic characteristics and satisfaction with healthcare are significantly related to self-management based on the PIH scale. Satisfaction with healthcare also attenuated the reduction of self-management in patients from minority ethnic groups or those with lower education. This suggested that those groups can benefit from high satisfaction towards care providers in enhancing their disease management. In conclusion, this study demonstrated that PIH can be a promising tool for assessing patient self-management in the Singaporean population.

Training physicians in motivational communication: An integrated knowledge transfer study protocol.

While behavior change counseling (BCC) targeting health risk behaviors has shown efficacy for improving patient health outcomes, barriers to knowledge translation have resulted in poor uptake among health care providers (HCPs). This article outlines the development of a new BCC training framework for HCPs, from inception to readiness for efficacy testing. It provides an example of integrated knowledge translation (iKT) used in alignment with the obesity-related behavioral intervention trials model. (a) A modified Delphi process identified essential BCC skills for HCPs; (b) a survey assessed HCP attitudes and training needs; (c) an online competency assessment tool was developed using iKT mixed methods; (d) a training program was developed and refined using a logic model; and (e) the program was optimized using iterative rounds of participant feedback. A future proof-of-concept trial (f) will determine the program's readiness for full efficacy testing. A Delphi panel (n = 46) identified 11 core BCC competencies for HCPs, defining "motivational communication." The HCP survey (n = 80) showed willingness to devote 4 hr to introductory training in BCC. The Motivational Communication Competency Assessment Test (MC-CAT: an online, interactive evaluation tool) and a motivational communication training program (MOTIVATOR: accredited for continuing education by the Royal College of Physicians and Surgeons of Canada) were collaboratively developed with knowledge users. The optimization process (n = 11) provided key feedback, with minor changes being made to the program. In developing a new BCC framework, obstacles to BCC implementation were addressed through an iterative iKT process. This should improve eventual intervention uptake. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effect of Self-Management on Patients with Chronic Diseases: A Systematic Review and Meta-Analysis.

Chronic diseases significantly impact global morbidity and mortality, affecting millions. Self-management interventions are crucial for improving patient health outcomes. This study explores the effects of self-management interventions on the quality of life (QOL), self-efficacy, depression, and anxiety of patients with chronic diseases. Relevant studies were searched from PubMed, EMBASE, and Web of Science. Two reviewers independently screened the literature, evaluated the risk of bias assessment, and extracted characteristics and outcomes among patients with chronic diseases. For each included study, we calculated the standardized mean difference (SMD) and 95% confidence interval (CI) of the main outcomes. When deemed feasible, the heterogeneity of the study was explored by meta-analysis and subgroup analysis. Thirty-four studies involving a total of 7603 patients with chronic diseases were included. Self-management interventions significantly improved quality of life (Higher-better QOL and Lower-better QOL), self-efficacy, and reduced depression symptoms compared to usual care (95%CI 0.01 to 0.15, p = 0.03; 95%CI -0.49 to -0.08, p = 0.006; 95%CI 0.19 to 0.62, p < 0.001; 95%CI -0.23 to -0.07, p < 0.001). However, no significant effect was found for anxiety (95%CI -0.18 to 0.03, p = 0.18). In the heterogeneity analysis, Lower-better QOL and self-efficacy were all higher than 50% (I2 = 80%, 87%). After the subgroup analysis, the heterogeneity of Lower-better QOL and self-efficacy was less than 50% (I2 = 0%, 16.1%). Subgroup analyses revealed that studies with mean age greater than 60 years old and follow-up times greater than 6 months were more effective in improving patients' Lower-better QOL (p = 0.03, p = 0.004), whereas follow-up times less than 6 months were better at reducing patients' anxiety symptoms (p = 0.03). Self-management interventions are more effective than routine care in managing chronic diseases, significantly improving patients' quality of life, self-efficacy, and reducing depressive symptoms, but they did not show significant improvements in anxiety symptoms. Overall, self-management interventions for chronic diseases can help patients adapt to the changes brought about by the disease and self-manage diseases to prevent disease progression.

Assessing Patient Feedback on the Feasibility of the YourRx Telepharmacy Mobile Application.

Background: Telepharmacy is a method utilized in pharmacy practice that delivers pharmaceutical care services via telecommunication technology. In the Philippines, the current process for patients to avail of telepharmacy services utilizes a variety of existing applications or websites instead of a single application. Objectives: This study aimed to assess patient feedback on the feasibility of the newly developed telepharmacy mobile application, YourRx. Specifically, it evaluated the application's functionality, usability, security, and performance. Methods: The study had 3 phases: (1) the design and development phase, (2) the implementation phase, wherein the pharmacists and patients were oriented beforehand with the use of YourRx mobile application, and (3) the evaluation phase, where the mobile application was evaluated for its functionality, usability, security, and performance by the patients through the use of a survey questionnaire and an interview. Results: YourRx application was developed and evaluated successfully. It is available for Android users and has primary features, including video calls, sharing, and setting an appointment. A total of 46 patients used the YourRx. Most of the patients were very satisfied with the navigation, service acquisition, and overall design of the YourRx. They expressed convenience in acquiring telepharmacy services because the application was easy to understand, use, and navigate. Conclusion: YourRx is a pioneering telepharmacy mobile application in the Philippines. The results of this study substantiate that YourRx is a user-friendly platform that provides patients convenient access to telepharmacy services with less time and effort thus improving patient health outcomes.

Safety Culture in Focus: Review of Patient Safety Culture Survey Results in Primary Health Care Corporation Qatar

Abstract Background Patient Safety is a crucial aspect of every healthcare organization and understanding the safety culture is essential for improving patient health outcomes. Evaluating the patient safety culture enables the health care organizations to gain insights into how their internal system’s structure and processes impact the patient’s overall well-being. In this paper, the hospital survey on patient safety culture that is adopted from AHRQ was used to examine the patient safety culture in the primary health centers in Qatar (PHCC), allowing for a better understanding of areas of strength and areas that require improvements Method The study aimed at comparing the organization’s safety culture in 2021 and its improvement in 2023. The survey was disseminated into 28 primary health centers with different sizes and patient volumes. The survey was sent electronically to all PHCC staff, allowing for better convenience and higher response rate Findings The results of this survey revealed numerous areas of strength, including teamwork across departments, error reporting, management support, communication error, non-punitive response to errors and staffing. On the other side, survey composites such as continuous learning and teamwork within department were identified as areas for improvement Conclusion By allowing for better insights into the culture of safety and identifying areas of strength and weaknesses, PHCC can make informed decisions and implement effective interventions. This will support in enhancing the health and wellbeing of Qatar’s population that aligns with the national health strategies which improves the overall healthcare in the region.

Hemodialysis Intervention to Improve Patient Quality of Life in Mr. A with Chronic Renal Failure

Patients with chronic renal failure require treatment that can replace kidney function in the human body. One such treatment is hemodialysis, which aims to filter fluids, electrolytes, and metabolic waste in order to improve the patient's quality of life. This study aims to describe the nursing care provided to patients with chronic renal failure undergoing hemodialysis, with a focus on improving their quality of life. This research used a qualitative case study approach, with instruments such as observation sheets, interviews, and document analysis. The research subject was a patient, Mr. A, who was diagnosed with chronic renal failure at Gunung Jati General Hospital, Cirebon City. The results showed that the management of nursing problems such as ineffective renal perfusion and hypervolemia was successfully carried out, as indicated by the absence of edema, a more stable increase in body weight, and a decrease in serum creatinine levels. Despite the improvement, the patient still requires hemodialysis to maintain kidney function. This study confirms the importance of continuous care through hemodialysis in improving the quality of life of patients with chronic renal failure. The findings also highlight the important role of nursing interventions in managing complications and improving patient health outcomes.

Attention based UNet model for breast cancer segmentation using BUSI dataset.

Breast cancer, a prevalent and life-threatening disease, necessitates early detection for the effective intervention and the improved patient health outcomes. This paper focuses on the critical problem of identifying breast cancer using a model called Attention U-Net. The model is utilized on the Breast Ultrasound Image Dataset (BUSI), comprising 780 breast images. The images are categorized into three distinct groups: 437 cases classified as benign, 210 cases classified as malignant, and 133 cases classified as normal. The proposed model leverages the attention-driven U-Net's encoder blocks to capture hierarchical features effectively. The model comprises four decoder blocks which is a pivotal component in the U-Net architecture, responsible for expanding the encoded feature representation obtained from the encoder block and for reconstructing spatial information. Four attention gates are incorporated strategically to enhance feature localization during decoding, showcasing a sophisticated design that facilitates accurate segmentation of breast tumors in ultrasound images. It displays its efficacy in accurately delineating and segregating tumor borders. The experimental findings demonstrate outstanding performance, achieving an overall accuracy of 0.98, precision of 0.97, recall of 0.90, and a dice score of 0.92. It demonstrates its effectiveness in precisely defining and separating tumor boundaries. This research aims to make automated breast cancer segmentation algorithms by emphasizing the importance of early detection in boosting diagnostic capabilities and enabling prompt and targeted medical interventions.

Social determinants of health and diabetes in pregnancy.

Social determinants of health (SDOH) are the conditions in which people are born, grow, work, live, and age. SDOH are systemic factors that may explain, perpetuate, and exacerbate disparities in health outcomes for different populations, and can be measured at both an individual- and neighborhood- or community-level (iSDOH, nSDOH). In pregnancy, increasing evidence shows that adverse iSDOH and/or nSDOH are associated with a greater likelihood that diabetes develops, and that when it develops, there is worse glycemic control and a greater frequency of adverse pregnancy outcomes. Future research should not only continue to examine the relationships between SDOH and adverse pregnancy outcomes with diabetes, but should determine whether multi-level interventions that seek to mitigate adverse SDOH result in equitable maternal care and improved patient health outcomes for pregnant individuals living with diabetes.

Increasing Effective Primary Care Screenings in the U.S. Virgin Islands Department of Health Community Clinic.

Background: In 2019, 1.8 million new cancer cases occurred, and 500,000 cancer deaths were expected in the United States, costing $21 billion. Regular primary care screenings have correlated with early cancer detection, treatment, health promotion, and reduced costs. Objectives: The aim was to increase effective primary care screenings in adults in St. Thomas U.S. Virgin Islands Department of Health Community Clinic to 75% within 8 weeks. Methods: This quality improvement initiative used four Plan-Do-Study-Act cycles over 8 weeks. Two core interventions, each with four tests of change, were implemented. Interventions: Core interventions included screening utilizing a checklist for body mass index, depression, and colorectal, lung, breast, cervical, uterine, and prostate cancer and engagement utilizing a checklist for correlated screening-related education, interventions, shared decision-making, and referral. Results: Primary care screenings increased from 55% to 96%, and patient engagement increased from 6% to 82%. Effective primary care screenings increased to 89%, exceeding the aim. Conclusions: This project improved primary care screening and engagement and effectively applied patient-centered care. Achievements were made through standardized screening and engagement. Implications for Nursing: This quality improvement project may be spread to other clinics to improve patient health outcomes.

THE RELEVANCE OF MEDICAL RESEARCH IN THE TRAINING PROCESS OF FUTURE PHYSICIANS IN INSTITUTIONS OF HIGHER MEDICAL EDUCATION IN UKRAINE

This article delves into the critical role that medical research plays in the education and training of future physicians. Medical research is indispensable for the accurate diagnosis, effective treatment, and prevention of diseases, making it a cornerstone of modern medical practice. The involvement of medical students in research activities not only equips them with vital skills but also shapes their professional identity and ethical framework. Participating in medical research enhances students' critical thinking and analytical skills. It immerses them in the latest scientific advancements, ensuring they stay abreast of new developments in the medical field. This exposure fosters a scientific mindset, encouraging students to approach clinical problems with a research-oriented perspective. Moreover, engaging in research cultivates a sense of ethics and professionalism, which are essential qualities for any medical practitioner. The author advocates for the integration of medical research into the medical education curriculum. This integration can be achieved through various means, such as practical sessions, involvement in scientific projects, participation in conferences, and opportunities for publication. Practical sessions provide hands-on experience, allowing students to apply theoretical knowledge in real-world scenarios. Scientific projects, whether individual or collaborative, encourage in-depth exploration of specific medical issues, fostering a deeper understanding of the subject matter. Conferences serve as platforms for students to present their research findings, engage with peers and experts, and receive constructive feedback. This interaction not only broadens their knowledge but also enhances their communication and presentation skills. Publications, on the other hand, offer students the opportunity to contribute to the body of medical knowledge, gaining recognition for their work and encouraging a culture of continuous learning and inquiry. The integration of research into the educational process is not just about acquiring knowledge; it is about shaping a new generation of physicians who are well-equipped to utilize scientific advancements in their practice. By embedding research into the curriculum, medical schools can prepare students to become highly qualified doctors who are adept at applying research findings to improve patient health outcomes.

Components of pharmacist-led medication reviews and their relationship to outcomes: a systematic review and narrative synthesis

IntroductionPharmacist-led medication reviews are an established intervention to support patients prescribed multiple medicines or with complex medication regimes. For this systematic review, a medication review was defined as ‘a consultation...

Diagnostic Accuracy of Artificial Intelligence in Endoscopy: Umbrella Review.

Some research has already reported the diagnostic value of artificial intelligence (AI) in different endoscopy outcomes. However, the evidence is confusing and of varying quality. This review aimed to comprehensively evaluate the credibility of the evidence of AI's diagnostic accuracy in endoscopy. Before the study began, the protocol was registered on PROSPERO (CRD42023483073). First, 2 researchers searched PubMed, Web of Science, Embase, and Cochrane Library using comprehensive search terms. Then, researchers screened the articles and extracted information. We used A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) to evaluate the quality of the articles. When there were multiple studies aiming at the same result, we chose the study with higher-quality evaluations for further analysis. To ensure the reliability of the conclusions, we recalculated each outcome. Finally, the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to evaluate the credibility of the outcomes. A total of 21 studies were included for analysis. Through AMSTAR2, it was found that 8 research methodologies were of moderate quality, while other studies were regarded as having low or critically low quality. The sensitivity and specificity of 17 different outcomes were analyzed. There were 4 studies on esophagus, 4 studies on stomach, and 4 studies on colorectal regions. Two studies were associated with capsule endoscopy, two were related to laryngoscopy, and one was related to ultrasonic endoscopy. In terms of sensitivity, gastroesophageal reflux disease had the highest accuracy rate, reaching 97%, while the invasion depth of colon neoplasia, with 71%, had the lowest accuracy rate. On the other hand, the specificity of colorectal cancer was the highest, reaching 98%, while the gastrointestinal stromal tumor, with only 80%, had the lowest specificity. The GRADE evaluation suggested that the reliability of most outcomes was low or very low. AI proved valuabe in endoscopic diagnoses, especially in esophageal and colorectal diseases. These findings provide a theoretical basis for developing and evaluating AI-assisted systems, which are aimed at assisting endoscopists in carrying out examinations, leading to improved patient health outcomes. However, further high-quality research is needed in the future to fully validate AI's effectiveness.

Impact of mobile application and outpatient follow-up on renal endpoints and physiological indices in patients with chronic kidney disease: a retrospective cohort study in Southwest China

BackgroundChronic kidney disease (CKD) is a significant public health concern, and patient self-management is an effective approach to manage the condition. Mobile applications have been used as tools to assist in improving patient self-management, but their effectiveness in long-term outpatient follow-up management of patients with CKD remains to be validated. This study aimed to investigate whether using a mobile application combined with traditional outpatient follow-up can improve health outcomes of patients with CKD .MethodsThis retrospective cohort study recruited CKD patients with stage 1–5 who were not receiving renal replacement therapy from a CKD management center. Two groups were established: the APP + outpatient follow-up group and the traditional outpatient follow-up group. Baseline data was collected from January 2015 to December 2019, followed by a three-year long-term follow-up until December 2022. Laboratory data, all-cause mortality, and renal replacement treatment were then collected and compared between the two groups.Results5326 patients were included in the study, including 2492 in the APP + outpatient group and 2834 in the traditional outpatient group. After IPTW virtualization matching, the final matched the APP + outpatient group consisted of 2489 cases (IQR, 33–55) and 2850 (IQR, 33–55) in the traditional outpatient group. By the end of the study, it was observed that the laboratory data of Phosphorus, Sodium, Triglyceride, Hemoglobin showed significant improvements, Furthermore the APP + outpatient group demonstrated superior results compared to the traditional outpatient group (P < .05). And it was observed that there were 34 deaths (1.4%) in the APP + outpatient group and 46 deaths (1.6%) in the traditional outpatient group(P = .49). After matching for renal replacement therapy outcomes, the two groups were found to be comparable (95% CI [0.72–1.08], P = .23), with no significant difference. However, it was noted that the traditional outpatient group had a lower incidence of using temporary catheters during initial hemodialysis (95% CI [8.4-29.8%], P < .001).ConclusionThe development and application of an app combined with outpatient follow-up management can improve patient health outcomes. However, to ensure optimal preparation for kidney replacement therapy, patients in CKD stages 4–5 may require more frequent traditional outpatient follow-ups, and further develop an information-based decision-making support tool for renal replacement therapy.

Impact of the AI Dependency Revolution on Both Physical and Mental Health

Artificial intelligence (AI) offers capabilities beyond human performance, which has led to the global transformation of various industries, sectors, and other elements of our daily lives. Whether we use an application like Siri to send a text message or facial recognition to access a device, AI is an integral part of everyday technology. Artificial Intelligence has especially been integrated into various healthcare sectors, improving patient health outcomes and overall healthcare delivery. Diagnostic AI systems enhance clinical decision-making, personalizing treatment, and reducing stigma. However, its extensive use raises concerns about dependency, credibility, and its effects on physical and mental health. This research explores the advantages and drawbacks of AI dependency, emphasizing the need to use AI judiciously to safeguard decision-making capabilities. Additionally, trust and confidence in AI is vital for its successful implementation in healthcare. In mental health, AI offers promise for early detection and personalized treatment, addressing accuracy and accessibility limitations. To fully harness AI’s potential, ethical concerns, data privacy, and algorithmic bias must be addressed to harness AI’s potential in mental health care.

National Comprehensive Cancer Network guideline compliance in an oncology value-based care program serving Medicare members.

e23095 Background: Value-based care (VBC) focuses on improving patient health outcomes while reducing the overall cost of healthcare. National Comprehensive Cancer Network (NCCN) cancer treatment guidelines standardize and improve quality of care. While studies have shown that compliance to NCCN guidelines improves survival, little information exists regarding the impact of compliance in VBC arrangements. This study aimed to evaluate compliance to NCCN regimen guidelines in Medicare members being treated for cancer under a VBC arrangement. Methods: This is a cohort study of individuals receiving care, in a single state, enrolled in a VBC contract within a large national insurer from February 2023 to October 2023. Medicare members with bladder, colon, lung, melanoma, breast, hepatocellular, rectal, pancreatic, multiple myeloma, gastric, ovarian, esophageal, lymphoma, kidney, leukemia, head and neck, biliary tract and uterine cancer with at least one oncology claim within the contract year were included. NCCN compliance was a quality measure of the VBC. NCCN regimen compliance was identified from pharmacy and medical claims and defined as concordant if the entire prescribed treatment regimen matched an NCCN regimen (Level 1 and 2a); members not receiving an NCCN recommended regimen were deemed to be non-concordant. Results: This study included 561 patients, the mean [SD] age was 75.7 [8.2] years and 286 [51.0%] members identified as male. The total population captured through the automated prior authorization platform yielded 100% NCCN compliance. Conclusions: In this study, individuals receiving chemotherapy participating in a shared savings VBC demonstrated 100% compliance to NCCN guidelines.

Geriatric assessment and management with question prompt list using a web-based application for elderly patients with cancer to communicate aging-related concerns: A randomized clinical trial (J-SUPPORT 2101 study).

1511 Background: Older adults with cancer have aging-related physical and psychosocial problems that should be fully shared with their oncologists. Geriatric assessment (GA) can assess these aging-related problems and guide management. Communication support might also facilitate implementation of GA-guided management (GAM). We conducted this single-blind, parallel-group, multicenter, randomized controlled trial to evaluate the efficacy of a program providing GAM recommendation and communication support between older Japanese patients with cancer and their oncologists. Methods: Eligibility criteria were age≥70 years, advanced or recurrent cancers of gastrointestinal origin, referral to one of the two institutions for first- or second-line systemic therapy, and impairment in at least one GA domain as assessed using a web-based application at baseline. In the intervention group, GAM recommendations and question prompt list (QPL) were provided to patients by trained intervention providers to be shared with their oncologists at the first outpatient visit after randomization. Over 5 months after the initial intervention, implementation of GAM recommendations was reviewed monthly by the intervention providers with the patients and their oncologists. Patients in the control group received usual care. The primary endpoint was the number of conversations about aging-related concerns at the first visit. The quality of conversations was assessed in terms of the number of conversations in which stated concerns were acknowledged and considered further by the oncologist and the number of conversations in which acknowledged concerns motivated implementation of GAM recommendations. Results: A total of 215 patients (99 women, 116 men; median age 75 [range 70-88] years) were randomized (n=108/107 in the intervention/control group) between September 2021 and September 2023. There were no differences between two groups in patient background characteristics including the prevalence of GA impairments. The number of conversations about aging-related concerns was significantly higher in the intervention group than in the control group (mean [SD] 2.95 [1.53] vs. 1.90 [1.49], p&lt;0.0001). The number of high-quality conversations and number of conversations about GAM recommendations were also significantly higher in the intervention group than in the control group (1.73 [1.40] vs. 1.12 [1.16], p=0.001; 0.57 [0.74] vs. 0.28 [0.47], p=0.001, respectively). Conclusions: Our program providing GAM recommendations and communication support successfully facilitated aging-related communications between patients and their oncologists. We will further examine whether facilitated communication leads to actual implementation of GAM and improved patient health outcomes in a follow-up study. Clinical trial information: UMIN000045428 .

Diagnosis of obstructive sleep apnoea in primary care.

Obstructive sleep apnoea (OSA) is a highly prevalent condition associated with significant adverse health consequences affecting multiple organ systems. As the first point of contact for most patients with OSA, general practitioners (GPs) have an important role in the diagnosis of this common sleep disorder. The aim of this paper is to improve awareness of common risk factors for andclinical presentation of OSA in primary care to improve patient health outcomes. We seek to understand how screening tools, such as the OSA50 questionnaire and the Epworth Sleepiness Scale, can help GPs identify patients who are at high risk for OSA with significant daytime sleepiness. Patients at high risk of symptomatic moderate-severe OSA should proceed to further investigation with sleep study testing. Referral to a sleep physician should be considered for patients with complex presentations or other suspected sleep disorders, commercial drivers, and those who fail to comply with or respond to initial OSA treatments.

QPGx-CARES: Qatar pharmacogenetics clinical applications and research enhancement strategies.

Pharmacogenetic (PGx)-informed medication prescription is a cutting-edge genomic application in contemporary medicine, offering the potential to overcome the conventional "trial-and-error" approach in drug prescription. The ability to use an individual's genetic profile to predict drug responses allows for personalized drug and dosage selection, thereby enhancing the safety and efficacy of treatments. However, despite significant scientific and clinical advancements in PGx, its integration into routine healthcare practices remains limited. To address this gap, the Qatar Genome Program (QGP) has embarked on an ambitious initiative known as QPGx-CARES (Qatar Pharmacogenetics Clinical Applications and Research Enhancement Strategies), which aims to set a roadmap for optimizing PGx research and clinical implementation on a national scale. The goal of QPGx-CARES initiative is to integrate PGx testing into clinical settings with the aim of improving patient health outcomes. In 2022, QGP initiated several implementation projects in various clinical settings. These projects aimed to evaluate the clinical utility of PGx testing, gather valuable insights into the effective dissemination of PGx data to healthcare professionals and patients, and identify the gaps and the challenges for wider adoption. QPGx-CARES strategy aimed to integrate evidence-based PGx findings into clinical practice, focusing on implementing PGx testing for cardiovascular medications, supported by robust scientific evidence. The current initiative sets a precedent for the nationwide implementation of precision medicine across diverse clinical domains.