Increased Health Care Costs Research Articles

Cardiovascular Adverse Events and Associated Costs of CDK4/6 Inhibitors in Patients With Breast Cancer.

Cardiotoxicity and cardiovascular (CV) adverse events associated with CDK4/6 inhibitors have raised concerns in the treatment of advanced breast cancer, impacting patient safety and increasing health care costs. This study compares the incidence of hypertension and major adverse cardiovascular events (MACE) in patients with breast cancer receiving CDK4/6 inhibitors and estimates the incremental health care costs associated with these conditions. This retrospective cohort study utilized the 2017-2021 Merative MarketScan Research Database. Women with breast cancer who initiated CDK4/6 inhibitors (palbociclib, ribociclib, or abemaciclib) were included in 2 cohorts. The hypertension cohort comprised patients with no prior hypertension in the 12 months before initiating CDK4/6 inhibitors, whereas the MACE cohort included those with no prior hypertension or MACE during the same period. The primary outcomes were the incidence of hypertension and MACE, with secondary outcomes being the incremental health care costs associated with these conditions. A total of 2,780 patients were included in the hypertension cohort and 2,043 in the MACE cohort. Compared with ribociclib, neither abemaciclib (hazard ratio [HR], 0.791; 95% CI, 0.507-1.232) nor palbociclib (HR, 0.723; 95% CI, 0.493-1.060) showed a statistically significant difference in hypertension risk. For MACE, palbociclib was associated with a statistically significant lower risk (HR, 0.636; 95% CI, 0.454-0.892), whereas abemaciclib was not (HR, 0.795; 95% CI, 0.540-1.169). Patients who developed hypertension and MACE incurred higher health care costs, averaging $2,964 and $4,010 per patient per month, respectively. Palbociclib was associated with a significantly lower risk of MACE compared with ribociclib in patients with breast cancer. Patients who developed hypertension or MACE incurred substantially higher health care costs. These findings underscore the importance of minimizing CV adverse events in patients with breast cancer treated with CDK4/6 inhibitors.

Reduced Returns to ED With Post-Tonsillectomy and Adenoidectomy Chat Program: Outcomes and Costs.

Patients who participate in the post-surgical chat programs will have lower rates of emergency department (ED) visits when compared to those who do not participate. Data from a texting program was used to stratify patients into those participating versus those not participating with the program. Individual patients' charts were reviewed for demographic information, if a postoperative ED visit related to surgery occurred, and if the ED visit was caused by a failure of patient education regarding the treatment plan or by expected postoperative symptoms. Odds ratios compared the ED visit rates between participating and non-participating families. Cost was analyzed by comparing published data on ED visit costs with internal data on chat program cost. During the study (2/2022-3/2023), 1059 unique patients (children/caregiver dyads) were enrolled in the chat. Five hundred and fifty-eight patients (52.7%) participated in one or more chats while 501 patients (47.3%) did not participate. Of note, patients with public insurance were less likely to participate. Non-participants were 9.12 times more likely to visit the ED postoperatively due to a communication lapse (p = 0.047). Estimated savings from 1 year of avoided ED visits did not outweigh the chat program's expense. Utilization of an automated messaging system for frequently asked questions after pediatric tonsillectomy demonstrated a statistically significant reduction in ED visits and readmissions related to postoperative complications and questions, but an increase in health care costs.

Indian women’s settlement experiences and the impact on their health: a narrative study in Brampton, Ontario

IntroductionWomen who have immigrated from India experience health decline during settlement in Canada. However, little is known about how their settlement experiences impact their health. Accordingly, our study examined the...

A societal cost-benefit analysis of falls prevention in community-dwelling older people in the Netherlands.

A societal cost-benefit analysis of falls prevention in community-dwelling older people in the Netherlands.

Medication Administration Errors and Contributing Factors Among Nurses in Tertiary Hospitals; A Cross-Sectional Study in Peshawar KP.

Introduction Medication administration errors (MAEs) are a significant concern in healthcare, leading to patient harm and increased healthcare costs. Contributing factors include high workloads, inadequate training, poor communication, and disruptive environments, all of which can compromise patient safety and care quality. Addressing these errors requires targeted interventions, education, and cultural changes within healthcare settings. Methodology: This study utilized a descriptive cross-sectional design to explore medication administration errors among nurses in two teaching hospitals over six months. A sample of 267 registered nurses was selected through convenience sampling. Data were collected using a structured questionnaire and analysed with SPSS. Ethical considerations were addressed, including obtaining institutional review board approval and informed consent from participants. Result: The study revealed a high prevalence of MAEs among the predominantly young female nurses with 1-6 years of experience. Nearly half of the nurses reported MAEs in the past year, with common errors including wrong doses and incorrect administration routes. These errors were mainly attributed to similar-looking drugs and heavy workloads. Conclusion: Strategies to reduce MAEs include raising awareness, improving training, and fostering supportive work environments, underscoring the need for enhanced safety protocols and reporting systems.

Co-creation of staff training to address health-related social needs in emergencies

BackgroundHealth-related social needs (HRSN), such as housing and transportation barriers, contribute to poor health outcomes and increased healthcare costs. Patient navigators help connect patients to community resources, but workforce training gaps are a challenge. The Strengthening Peer AHC Navigation (SPAN) study aimed to enhance navigation training during the COVID-19 Public Health Emergency.MethodsUsing a stakeholder-driven peer planning approach, SPAN co-developed a quality improvement plan for patient navigation training. Training focused on housing and transportation navigation and included didactic sessions, hands-on case studies, and biweekly expert consultations. Self-efficacy surveys measured navigator confidence pre- and post-training, and changes in navigation case resolution rates were assessed.ResultsSeventeen navigators participated in training. Self-efficacy scores improved, particularly in housing and transportation navigation. Resolved navigation cases increased by 29% (p = 0.001) over 6 months post-training. Participants reported increased confidence, knowledge, and empathy for patients with HRSN.ConclusionThe SPAN peer planning model successfully developed and implemented an adaptive navigation training program, improving navigator confidence and patient outcomes. Findings highlight the value of stakeholder-driven training and ongoing expert support in strengthening the social needs workforce. Further research should explore sustainable models for workforce development in healthcare settings.

Can fracture non-union be predicted using deep learning?

Fracture non-union remains a significant clinical challenge despite considerable advances in diagnostic imaging and treatment modalities. Unpredictable healing, repeated interventions, and prolonged disability contribute to high patient morbidity and increased healthcare costs. Early and reliable prediction of non-union is therefore essential for timely intervention. This review discusses traditional radiographic assessment using the Radiologic Union Scale for the Tibia (RUST), its inherent limitations, and the emerging role of artificial intelligence (AI) and deep learning in fracture analysis. In addition, we review recent studies—including Bayesian classifiers and simulation models—that integrate AI for early prediction of non-union, and we provide an updated summary table of key studies.

Socioeconomic inequalities and diabetes complications: an analysis of administrative data from Hungary.

Diabetes complications are associated with increased healthcare costs and worsened patient outcomes. In this paper, we analyse how individual-level demographic and territorial-level socioeconomic and healthcare variables influence the presence and severity of diabetes complications and their relationship with mortality. Our study utilizes anonymized administrative healthcare data on all diabetes patients of Hungary between 2010 and 2017. We construct settlement-year level and individual-year level panel datasets to analyse diabetes prevalence, incidence and complications, employing Poisson and logit models to explore associations between complications and the explanatory variables. The adapted Diabetes Complications Severity Index (aDCSI) is employed to quantitatively evaluate the severity of complications by aggregating individual complication scores from ICD-10 diagnosis codes. We find that diabetes prevalence and incidence are higher in settlements with above-median unemployment rates, where patients exhibit more severe complications, as shown by higher average aDCSI scores. Among socioeconomic factors, unemployment rate is particularly associated with increased aDCSI scores, while better healthcare access is associated with lower aDCSI scores in unadjusted but with higher scores in adjusted models. The presence and severity of complications, especially renal, cardiovascular and peripheral vascular ones, substantially increase 5-year inpatient mortality. Most of the mortality difference by settlement-level unemployment rate disappears when complications are accounted for. We conclude that socioeconomic inequalities, particularly higher unemployment rates, are strongly linked to diabetes complications and associated mortality risk. Addressing these disparities through improved healthcare accessibility and targeted public health strategies could play a crucial role in reducing the burden of diabetes-related complications and improving patient outcomes.

Associations of sex on economic burden in patients with symptomatic obstructive hypertrophic cardiomyopathy: results from medical and pharmacy claims data

BackgroundPrevious studies of patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) have reported worse clinical burden for female patients; whether this translates to an increase in healthcare resource use (HRU) and cost is unknown. Therefore, we evaluated the impact of sex on economic burden in symptomatic oHCM.MethodsMedical and pharmacy claims data were assessed from 2016 to 2021 to identify (ICD-10 code) adult patients with symptomatic oHCM in the United States. Generalized linear models were used to estimate HCM-related cost and generalized estimating equations for HRU [both reported as mean per-person-per-year (PPPY)] for healthcare categories: inpatient, outpatient, emergency room (ER), urgent care, and pharmacy. Cox proportional hazard regressions were used to compare differences in male and female patients with symptomatic HCM.ResultsAmong 9,490 patients with symptomatic oHCM, 5,309 (55.9%) were female. Female patients were older (64 ± 13 vs. 59 ± 14), with a higher Charlson Comorbidity Index (1.9 vs. 1.7) compared to males, respectively. After adjusting for patient characteristics, female patients had significantly greater number of HCM-related hospitalizations (0.24 vs. 0.20 PPPY, p = 0.0014), LOS (5.08 vs. 4.30 PPPY; p = 0.0235), number of outpatient visits (4.98 vs. 4.59 PPPY; p = 0.0387), and number of distinct drugs (0.59 vs. 0.55 PPPY; p = 0.0010), compared with males, respectively. In adjusted models, only HCM-related pharmacy costs were significant, with female patients having slightly higher costs compared to males ($70 vs. $61 PPPY; p = 0.0465). There were no significant differences in all-cause costs of care between male and female patients with oHCM. ConclusionsFemale patients with symptomatic oHCM experience greater rates of HCM-related and all-cause hospitalizations and number of prescriptions, and HCM-related length of stay, outpatient visits, and pharmacy costs compared to male patients.

Development of a multivariable prognostic prediction model for skin tears in older nursing home residents

Skin tears are traumatic wounds and are among the most prevalent skin conditions in older adults, particularly those in long-term care facilities. These injuries can lead to complications such as infection, pain, reduced quality of life, and increased healthcare costs. This study aimed to identify risk factors for skin tear development in nursing home residents aged 65 years or older and to develop a predictive prognostic model. A secondary data analysis was performed on long-term care nursing home residents ≥ 65 years who participated in a cluster-randomized controlled clinical trial conducted in Berlin, Germany, from April 2019 to June 2021. A total of 101 residents were included. At week 12, 19 residents (18.8%) developed at least one skin tear. The best-fit predictive model identified lower Body Mass Index, lower Barthel Index scores, presence of xerosis cutis on the legs, and regular corticosteroid use as significant risk factors for skin tear development. The model demonstrated good discriminatory ability (area under the curve: 0.823), with sensitivity and specificity rates of 73.7% and 74.4%, respectively. These risk factors could help identify at-risk individuals, enabling targeted preventive measures. However, the model requires validation in a prospective cohort to confirm its applicability in clinical practice.

Investigating Myogenic Potency of Proteolipids Contained Within Fertilized Gallus gallus domesticus Egg Yolk

Abstract Purpose To identify novel fertilized egg yolk–derived compounds that enhance myoblast differentiation, we used a myosin light chain (MLC) luciferase C2C12 reporter cell line to quantify myotube formation, an indicator of myoblast differentiation, in response to adding three different fractions: granule, lipid, and aqueous. Methods A C2C12 MLC-luciferase reporter myoblast cell line was cultured in media supplemented with three different egg yolk–derived fractions. Cellular assays and fluorescence imaging were conducted to determine the viability, morphology, and myotube formation in response to the egg yolk fraction additives. Fertilized and unfertilized egg yolk fractions were examined for their protein MW profile to determine if there were differences in the protein populations. Results None of the fractions had a negative effect on cellular viability measured on days 0, 3, 7, and 10. Two fractions showed increased differentiation compared to the null control (1%): the granule and the lipid. Comparison of the MW profiles of the fractions confirmed differences in protein populations between them with apo-LDLs, apo-HDLs, and phosvitin being the major bands present in the granule and lipid groups. No differences in protein profiles were observed between the fertilized and unfertilized groups. Conclusion Granule- and lipid-fertilized egg yolk–derived fractions show potential for use as differentiating agents for myotube formation in C2C12 myoblasts supporting their nutritional value for treatment of sarcopenia or to enhance myoblast differentiation for tissue engineering. Lay Summary Sarcopenia or muscle wasting is a prevalent problem in the elderly population which leads to increased healthcare costs. We have separated fertilized egg yolk into fractions to test their potential to increase muscle formation by adding them to muscle progenitor cells. Some of these fractions show great potential for increase differentiation of muscle tissue in treatment of sarcopenia or for muscle tissue engineering.

Randomised controlled trial of audit-and-feedback strategies to reduce imaging overutilisation in the emergency department

BackgroundEvaluation of neck trauma is a common reason for emergency department (ED) visits. There are several validated clinical decision rules, such as the National Emergency X-Radiography Utilization Study (NEXUS) Cervical...

Protocol of the PROMOTE study: characterization of the microbiome, the immune response, and one-carbon metabolism in preconceptional and pregnant women with and without obesity (an observational subcohort of the Rotterdam Periconception cohort).

Preconceptional and maternal obesity are well-known risk factors for pregnancy and fetal complications including gestational diabetes, hypertensive disorders, and macrosomia. Maternal obesity is associated with offspring obesity and increased healthcare costs. To disrupt the cycle of obesity, we aim to investigate the impact of the composition of the maternal microbiota (bacteria and viruses) throughout preconception and pregnancy and the associations with the immune responses and one-carbon metabolism (1-CM) as an underlying mechanism in the pathophysiology of increased adverse pregnancy outcomes in maternal obesity. The PROMOTE study is a subcohort of the Rotterdam Periconceptional Cohort, a hospital-based observational cohort study. We will include 70 women per BMI group: ≥ 30 kg/m2 or 18.5-25 kg/m2, at different time points in each group: 10 preconceptional, 50 in the first trimester (with longitudinal follow-up during pregnancy, delivery and postpartum) and 10 in the third trimester of pregnancy. Which makes a total of 140 inclusions. Vaginal and rectal bacteriome, virome, and blood samples are collected. In the third trimester inclusions, only faecal samples are collected. Microbiota samples will be analysed using 16S rRNA sequencing. Bacteriome and virome profiles are compared between the BMI subgroups, associations with general immune responses and 1-CM markers will be shown. ClinicalTrials.gov (NCT05754645).

Patterns of Change in Healthcare Use and Cost Before and During Psychotherapy.

Previous research has found an increase in healthcare costs before psychotherapy, followed by a decrease thereafter-a pattern also observed in our sample. However, research on the patterns of change is still lacking. Healthcare quarterly cost patterns of change were examined in a field study of 1508 patients before and during outpatient psychotherapy. Several models assess the patterns of change of the entire sample and in subgroups of those undergoing prolonged psychiatric treatment versus the rest. An exponential pattern (increasing rate of change) had the best fit during the waiting period for the prolonged psychiatric treatment group. A linear pattern was selected for the rest. A logarithmic pattern (decreasing rate of change) best fits the prolonged pharmacotherapy group during therapy. A linear pattern was selected for the rest. The economic implication of the findings is that the prolonged psychiatric treatment group is expected to have the highest return on investment when the waiting period for treatment is shortened. This unique pattern of change may also be a marker of increasing distress in this group while waiting for treatment and the rapid effect that the start of psychotherapy has on this. Therefore this group should be the focus of attention.

Enhancing fall detection and classification using Jarratt‐butterfly optimization algorithm with deep learning

Falls pose significant risk to the health and safety of individuals, specifically for vulnerable populations as the elderly and those with specific medical conditions. The repercussions of falls can be severe, leading to injuries, loss of independence, and increased healthcare costs. Consequently, the development of effective fall detection systems is crucial for providing timely assistance and enhancing the overall well-being of affected individuals. Recent advancements in deep learning (DL) have opened new avenues for automating fall detection through the analysis of sensor data and video footage. DL algorithms are especially well-suited for this task because they can automatically learn complex features and patterns from raw data, eliminating the need for extensive manual feature engineering. This article introduces a novel approach to fall detection and classification, termed the fall detection and classification using Jarratt‐butterfly optimization algorithm with deep learning (FDC-JBOADL) algorithm. The FDC-JBOADL technique employs a median filtering (MF) method to mitigate noise and utilizes the EfficientNet model for robust feature extraction, capturing both motion patterns and appearance characteristics of individuals. Furthermore, the classification of fall events is achieved through a long short-term memory (LSTM) classifier, with hyperparameter optimization facilitated by Jarratt‐butterfly optimization algorithm (JBOA). Through a comprehensive series of experiments, the efficacy of FDC-JBOADL technique is validated, demonstrating superior performance compared to existing methodologies in the domain of fall detection.

966 CLABSI Prevention in Focus: Shaping a Future of Zero

Abstract Introduction Central-line-associated bloodstream infections (CLABSIs) are found to cause longer hospital stays, increased healthcare costs, and higher morbidity rates for patients. Burn patients are especially susceptible to CLABSIs because they often require central lines for an extended amount of time. Also, the central lines may need to be placed on or near the wounds, which limits our ability to maintain an occlusive dressing. These factors place burn patients at a high risk for CLABSIs. Our goal is to find a way to decrease or eliminate the occurrence of CLABSIs in burn patients. Methods Protocols were initiated that required bedside staff to perform a CHG bath on non-burned areas of skin on a daily basis for all patients with a central line. Burn patients who are hemodynamically stable must have a linen change at least once per shift to limit exposure to infectious agents. Monthly monitoring and chart audits are performed to ensure compliance with protocols and offer opportunities for further education for staff when necessary. Results CLABSI rates have gone from 3 in 2022 and continued to zero as of August 2024. Conclusions Daily CHG baths and twice-daily linen changes have decreased exposure to infectious agents in burn patients, thus limiting the number of CLABSIs present. Auditing documentation allows us to ensure protocol compliance and assess the need for further education. Furthermore, no longer rotating insertion sites for central lines have decreased the likelihood of introducing new microbes into the bloodstream during insertion. Applicability of Research to Practice Limiting the number of CLABSIs will help reduce patients’ hospital stays, leading to lower mortality rates and better patient outcomes overall. Funding for the Study N/A

Climate risks, multi-tier medical insurance systems, and health inequality: evidence from China’s middle-aged and elderly populations

BackgroundAgainst the backdrop of increasing population aging, the uncertainty and irreversibility of climate change have a significant impact on the health and healthcare burden of the elderly. However, it remains uncertain whether the multi-tiered medical insurance system disproportionately influences the health impacts of climate risks.MethodsUsing data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, matched with urban climate risk variables, we employ a multi-dimensional panel fixed effects model and an instrumental variable model to examine the impact of climate risks on the health of the middle-aged and elderly, while also investigating the unequal effects of the multi-tiered medical insurance system.ResultsClimate risks significantly worsened the self-reported health of the middle-aged and elderly (β = 0.073, P = 0.089), and increased both total medical costs (β = 2.570, P = 0.012) and out-of-pocket expenses (β = 2.652, P = 0.003). Notably, the increases in hospitalization costs (β = 0.721, P = 0.004) and out-of-pocket hospitalization expenses (β = 0.706, P = 0.036) are particularly prominent. The current multi-tiered medical insurance system results in unequal impacts of climate risks on health and medical costs. Specifically, urban employee medical insurance and commercial medical insurance effectively improve the health outcomes of elderly individuals affected by climate risks. Urban residents’ medical insurance significantly reduces both total medical costs and out-of-pocket expenses for the elderly, whereas the new rural cooperative medical insurance shows no significant mitigating effect. Additionally, there is no evidence to suggest that the integration of urban and rural resident medical insurance can reduce the medical burden on rural elderly populations caused by climate risks. Our long-term projections indicate that, under both the SSP245 and SSP585 scenarios, the increase in elderly healthcare costs due to climate risks is irreversible. However, restrictive climate policies would yield significant health benefits, potentially reducing per capita medical costs for the elderly by nearly 50%.ConclusionsThe decentralized multi-tier medical insurance system leads to significant inequality in the health impacts of climate risks. Our study emphasizes the critical role of reforming the existing social medical insurance system and implementing climate policies to protect the health of elderly populations.

Severe COVID-19 in Patients with Immune-Mediated Rheumatic Disorders: A Case-Control Study.

To assess the impact of severe COVID-19 in patients with immune-mediated rheumatic diseases (im-RD) and compare their morbidity, mortality, hospitalization issues, post-COVID-19 sequelae, and the financial burden of COVID-19 with those of patients without im-RD. We conducted a retrospective case-control study that included 132 consecutive patients with im-RD who visited the Rheumatology Department of a public hospital in the Emirate of Dubai and were hospitalized for COVID-19 infection between March 1st, 2020, and December 31st, 2021, (cases). We included 264 and 132 age- and sex-matched patients without im-RD in matched-I and matched-II control groups, respectively. The median age of patients and controls was 48.5 years, and 74.2% were female. Patients with im-RD were paired with an unforced nearest neighbor match using a caliper width of 0.2 standard deviations of the matched-II control group's propensity score. We compared the relative risk of death, disease progress, use of medical resources, and financial impact of COVID-19 between patients and controls. Patients with im-RD had higher mortality rates than the matched-I (odds ratio, OR: 11.2, p < 0.000) and matched-II (OR: 16.8, p < 0.006) control groups. The overall complication rate was also significantly higher in patients with im-RD than in matched-I (OR = 2.9, p < 0.000) and matched-II (OR = 2.8, P < 0.0001) control groups. Lastly, patients with im-RD required more frequent visits to the clinic, a longer recovery time following hospital discharge, and increased healthcare costs compared to the control groups. COVID-19 infection in patients with im-RD is associated with increased morbidity and mortality, exerting a significant burden on the healthcare system.

Impacts of the diagnosis-intervention packet reform on costs and healthcare resource utilization: evidence from Guangzhou, China

BackgroundThe diagnosis-intervention packet (DIP) payment reform, utilizing big data for patient classification and payment standardization, was initially developed and piloted in China. Guangzhou, the pilot mega-city, rolled out DIP payment reform in 2018 to regulate medical expenditures. We estimated the impacts of DIP on costs and healthcare resource utilization in Guangzhou using a nine-year panel data set of Guangzhou and other regions between 2018 and 2020.MethodsBy employing the synthetic difference-in-difference (SDID) method, we captured changes in outcome variables before and after DIP implementation in Guangzhou and non-reforming regions.ResultsDIP payment reform increased per-episode inpatient costs by CNY 1574.735 (95% CI: 148.330 to 3001.140, P < 0.05), CNY 1583.413 (95% CI: 247.356 to 2919.470, P < 0.05), and CNY 1448.065 (95% CI: -132.051 to 3028.181.140, P < 0.1) among all hospitals, public hospitals, and private hospitals, respectively. In contrast, DIP had little effect on the average length of stay (LOS) among all hospitals from 2018 to 2020. Although DIP did not impact in-hospital mortality (IHM) overall, it increased IHM by 0.330 percentage points (95% CI: 0.008 to 0.652, P < 0.05) and 0.311 percentage points (95% CI: 0.158 to 0.463, P < 0.01) among private hospitals and secondary hospitals.ConclusionsOur results suggest that the effects of DIP payment reform were mixed. While it did increase healthcare costs, its impacts on quality and operation efficiency varied significantly across different types of hospitals.

Enhancing Psychomotor Skills in Medical Interns: An Evaluation of Training Methods

Background: Proficiency in psychomotor skills is crucial for medical interns transitioning from theoretical knowledge to practical application. Traditional teaching methods often lack sufficient hands-on experience and critical feedback, resulting in procedural errors and increased healthcare costs. This study evaluates the effectiveness of the Demonstrate-Observe-Assist-Perform (DOAP) method in teaching urinary male bladder catheterization (MBC). Methods: A clinical descriptive longitudinal study was conducted with 40 intern doctors. Participants were initially assessed on traditional urinary catheterization method in male patients. The DOAP method was then employed, involving demonstration, observation, assistance and supervised performance. After three weeks of training and supervised performance, participants were re-evaluated using direct observation of procedural skills (DOPS) method with checklists and questionnaires tool. Statistical analysis performed and compared preand post-training proficiency. Results: Significant improvements were observed post-DOAP training. Awareness of critical steps increased from 67.5% to 97.5% (p=0.001), confidence in performing MBC rose from 70% to 95% (p=0.003) and understanding of the 'No Touch technique' improved from 82.5% to 100% (p=0.012). Faculty evaluations showed enhanced ability to perform MBC with all critical steps from 20% to 82.5% (p=0.000) and increased counselling skills from 52.5% to 92.5% (p=0.000). Conclusion: The DOAP method significantly enhances the psychomotor skills of intern doctors, improving both knowledge, practical performance and communication skills. Integrating DOAP into medical training programs is recommended to enhance clinical competence and patient care quality.