Providing Patient Education Research Articles

Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States

BackgroundSARS-CoV-2 has spread rapidly resulted in a global pandemic and public health crisis. The internet is a frequently used resource for providing patient education materials (PEMs). The aim of this study was to evaluate the readability, content, and quality of web-based PEMs on COVID-19 from US academic medical centers.MethodsThe names of US medical schools were obtained from the Association of American Medical Colleges website (n = 145). Institutional, hospital, and heath encyclopedia websites associated with each schools’ medical center were identified using Google. Readability of COVID-19 PEMs was calculated using three validated indices: (1) Flesh-Kincaid Grade Level, (2) Simple Measure of Gobbledygook, and (3) Gunning Frequency of Gobbledygook. Content was evaluated using a scoring matrix based on materials available on the Center for Disease Control website. The Patient Education Material Assessment Tool for Print (PEMAT-P) was used to assess usability and actionability.ResultsA total of 141 (97%) PEMs met inclusion criteria and were analyzed for readability, content, and quality. The mean readability was above the recommended sixth grade reading level (P < .001). Content was variable across PEMs. The PEMAT-P scores reflected good understandability with a median score of 83% (IQR 75%-87%), while actionability was poor with a median score of 41% (IQR 40%-60%).ConclusionsDespite availability of web-based PEMs for COVID-19, the readability was significantly higher than the National Institute of Health and US Department of Health and Human Services recommended sixth grade reading level and actionability of PEMs was low. It is critical to provide readable PEMs on COVID-19 to effectively disseminate accurate information and facilitate patients’ understanding of the virus, how it spreads, and how to protect themselves.

Exploring the dimensions of patient experience for community-based care programmes in a multi-ethnic Asian context.

IntroductionThe aim of this study is to explore patients’ experiences with community-based care programmes (CCPs) and develop dimensions of patient experience salient to community-based care in Singapore. Most countries like Singapore are transforming its healthcare system from a hospital-centric model to a person-centered community-based care model to better manage the increasing chronic disease burden resulting from an ageing population. It is thus critical to understand the impact of hospital to community transitions from the patients’ perspective. The exploration of patient experience will guide the development of an instrument for the evaluation of CCPs for quality improvement purposes.MethodsA qualitative exploratory study was conducted where face-to-face in-depth interviews were conducted using a purposive sampling method with patients enrolled in CCPs. In total, 64 participants aged between 41 to 94 years were recruited. A deductive framework was developed using the Picker Patient Experience instrument to guide our analysis. Inductive coding was also conducted which resulted in emergence of new themes.ResultsOur findings highlighted eight key themes of patient experience: i) ensuring care continuity, ii) involvement of family, iii) access to emotional support, vi) ensuring physical comfort, v) coordination of services between providers, vi) providing patient education, vii) importance of respect for patients, and viii) healthcare financing.ConclusionOur results demonstrated that patient experience is multi-faceted, and dimensions of patient experience vary according to healthcare settings. As most patient experience frameworks were developed based on a single care setting in western populations, our findings can inform the development of a culturally relevant instrument to measure patient experience of community-based care for a multi-ethnic Asian context.

Study of the Awareness of Adoption as a Family-Building Option Among Oncofertility Stakeholders in Japan.

The oncofertility decision tree was developed by the oncofertility consortium as a tool to support healthcare professionals and patients through the complicated process of deciding the most appropriate fertility preservation strategy for patients with cancer. Various strategies include oocyte retrieval, oocyte donation, use of a gestational carrier and adoption. However, differences in the cultural and legal landscape present serious barriers to utilizing some of these strategies in Japan. We surveyed Japanese oncofertility stakeholders including 60 cancer survivors, 27 oncology facilities, 78 reproductive medicine facilities and 15 adoption agencies by a questionnaire to characterize awareness among oncofertility stakeholders in Japan about parenting options including adoption to inform work to establish guidelines for decision-making by cancer survivors in an oncofertility. Our results indicate that oncologists and reproductive endocrinologists in Japan have an insufficient understanding of adoption that prevents them from adequately informing their patients. Japanese cancer survivors self-describe a lack in confidence in finding a suitable partner and raising a child. Contrastingly, of the 9 adoption agencies which responded, no agency included being a cancer survivor as a criterion for disqualification and 4 of 9 (44%) adoption agencies reported at least 1 adoption to a cancer survivor in the last year. Our work demonstrates that a cancer survivor's medical history itself is not a hurdle to adoption and investment in patient-provider education could be a viable strategy to improve the utilization of adoption as a fertility preservation strategy in Japan.

The Consequences of Cannabis Use: A Review of Self-Reported Use and Experiences Among College Students.

Healthy People 2020 has introduced a new initiative focused on adolescent health, ages 10-17, and young adults, ages 18-25, due to health and social problems starting or peaking during these years. The initiative focuses on decreasing such problems including substance use. Cannabis is one of the most popular illegal substances used among young adults for recreation in the United States. Multiple consequences of cannabis use are well documented in the literature including the development of medical problems, developmental delays, and social issues. Furthermore, academic success is linked to overall health outcomes. The aim of this study was to explore cannabis use and knowledge of consequences among college students at a university in southwest Texas. Secondary analysis of survey results from students at a small, private university. The Core Alcohol and Drug Survey, a self-report questionnaire, was utilized to measure alcohol and drug usage, attitudes, perceptions, and opinions regarding drug and alcohol usage. The survey was distributed to all 6,537 undergraduate students. The survey results were collected over a 3-month period and provided to the authors for interpretation. Eighty-two survey responses were received. Analysis indicated that 24.7% of the students used marijuana in the past year, and 16% had used cannabis within 30 days of the survey. Of the respondents surveyed, 13.3% reported they used cannabis occasionally and 38.7% reported they used cannabis regularly. Furthermore, survey results indicated that 12.7% of respondents reported some of the consequences from cannabis use experienced within the past year included public misconduct, such as fighting, arguing, and vandalism. In addition, 13.9% reported having experienced serious personal problems due to cannabis use at least once during the past year including injuries, suicidal thoughts, and sexual assault. Reported attitudes and perceptions of cannabis use include 13.3% perceived great risk associated with cannabis use. Moreover, 62.3% of respondents believe that their friends would disapprove of cannabis use. A negative correlation was identified between cannabis use within the previous 30 days and low grades. The consequences of cannabis use are well documented in the literature, yet cannabis remains a popularly used illegal substance among college students. Despite experiencing known consequences of cannabis use, much of the sample reported regular use of the substance. Results of the study may be used to improve education and interventions aimed at reducing cannabis use among college students. In addition, providers may use the information to provide patient education at routine visits.

Factors Associated With Patient Satisfaction After Opening-Wedge High Tibial Osteotomy.

Background:Opening-wedge high tibial osteotomy (OWHTO) is expected to result in higher patient satisfaction compared with knee arthroplasty due to joint preservation. However, patient satisfaction rates as well as factors associated with satisfaction after OWHTO remain unclear.Purpose:To evaluate patient subjective satisfaction after OWHTO and determine factors associated with patient satisfaction after OWHTO.Study Design:Case-control study; Level of evidence, 3.Methods:This study enrolled 123 patients (123 knees) who underwent unilateral OWHTO. Clinical parameters, including range of motion (ROM), visual analog scale (VAS) score for pain, Knee injury and Osteoarthritis Outcome Score (KOOS), weightbearing line ratio (WBLR), and medial proximal tibial angle (MPTA), were assessed before surgery and at the final follow-up at a minimum of 2 years. Patient satisfaction was evaluated using a 5-point scale regarding (1) surgery, (2) pain relief, (3) knee mobility, (4) daily living function, and (5) lower extremity alignment. The mean overall satisfaction scores for the 5 questions were calculated, and the sample was divided into 2 main groups (satisfied or unsatisfied). Preoperative characteristics, physical activity level, patient expectations for surgery, ROM, and KOOS were compared between the groups. Cartilage regeneration was assessed at the time of plate removal, and WBLR and MPTA were also assessed. Factors associated with patient satisfaction were analyzed using multivariable logistic regression analysis.Results:The mean ± SD follow-up was 54.6 ± 20.6 months. The mean WBLR significantly changed from 20.7% ± 11.8% preoperatively to 66.9% ± 10.2% at the final follow-up, and all KOOS subscale scores significantly improved after surgery. Of the 123 patients, 109 (88.6%) were graded as satisfied. Factors associated with patient satisfaction were expectations met (odds ratio, 17.4; P = .026), better postoperative KOOS Pain score (odds ratio, 1.30; P = .001), and better postoperative KOOS Activities of Daily Living score (odds ratio, 1.36; P = .002).Conclusion:OWHTO is an effective treatment in terms of subjective satisfactory outcomes. Patient expectations for surgery have a significant effect on patient satisfaction. Surgeons should consider patient expectations before OWHTO and provide patient education to improve patient satisfaction.

Impact of a multidisciplinary workflow on safety and management of patients with heparin-induced thrombocytopenia.

Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin administration. Management strategies are complex and include discontinuing heparin products, initiating alternative anticoagulants, interpreting laboratory test results, documenting heparin allergies, and providing patient education. Medication error reports and a retrospective review conducted at an academic medical center revealed an opportunity for a quality improvement initiative and led to the creation of a multidisciplinary workflow for the management of HIT. In a pre-post study, the impact of the multidisciplinary workflow on the safety and management of HIT was evaluated. The preimplementation group consisted of adult patients tested for suspected HIT from April 4, 2014, through May 31, 2016; the postimplementation group consisted of adult patients tested from November 1, 2016, through October 31, 2018. The primary outcome was the incidence of heparin product administration while HIT testing was ongoing. The secondary outcome was the rate of appropriate heparin allergy documentation. The incidence of heparin product administration while HIT testing results were pending was significantly reduced, from 54.2% to 20.0% (P < 0.001), after workflow implementation. The rate of appropriate heparin allergy documentation significantly increased, from 95.0% to 100% (P < 0.001). Implementation of a multidisciplinary workflow for the management of HIT significantly reduced the incidence of heparin administration while testing was ongoing and improved the rate of appropriate heparin allergy documentation.

Acceptability of pharmacist-led interventions to resolve drug-related problems in patients with chronic myeloid leukaemia.

Chronic myeloid leukaemia (CML) patients on long-term tyrosine kinase inhibitor (TKI) therapy are susceptible to drug-related problems (DRPs). This study aimed to evaluate the acceptability and outcomes of pharmacist-led interventions on DRPs encountered by CML patients. This study included participants from the intervention arm of a randomised controlled trial which was conducted to evaluate the effects of pharmacist-led interventions on CML patients treated with TKIs. Participants were recruited and followed up in the haematology clinics of two hospitals in Malaysia from March 2017 to January 2019. A pharmacist identified DRPs and helped to resolve them. Patients were followed-up for six months, and their DRPs were assessed based on the Pharmaceutical Care Network Europe Classification for DRP v7.0. The identified DRPs, the pharmacist's interventions, and the acceptance and outcomes of the interventions were recorded. A Poisson multivariable regression model was used to analyse factors associated with the number of identified DRPs per participant. A total of 198 DRPs were identified from 65 CML patients. The median number of DRPs per participants was 3 (interquartile range: 2, 4). Most participants (97%) had at least one DRP, which included adverse drug events (45.5%), treatment ineffectiveness (31.5%) and patients' treatment concerns or dissatisfaction (23%). The 228 causes of DRPs identified comprised the following: lack of disease or treatment information, or outcome monitoring (47.8%), inappropriate drug use processes (23.2%), inappropriate patient behaviour (19.9%), suboptimal drug selection (6.1%), suboptimal dose selection (2.6%) and logistic issues in dispensing (0.4%). The number of concomitant medications was significantly associated with the number of DRPs (adjusted Odds Ratio: 1.100; 95% CI: 1.005, 1.205; p = 0.040). Overall, 233 interventions were made. These included providing patient education on disease states or TKI-related side effects (75.1%) and recommending appropriate instructions for taking medications (7.7%). Of the 233 interventions, 94.4% were accepted and 83.7% were implemented by the prescriber or patient. A total of 154 DRPs (77.3%) were resolved. The pharmacist-led interventions among CML patients managed to identify various DRPs, were well accepted by both TKI prescribers and patients, and had a high success rate of resolving the DRPs.

Assessment of online patient education materials designed for people with age-related macular degeneration

BackgroundAge-related macular degeneration (AMD) is a chronic eye condition that leads to permanent vision loss in the central visual field. AMD makes reading challenging and inefficient. People with AMD often find it difficult to access, process and understand written patient education materials (PEMs). To promote health literacy, the demands of written PEMs must match the literacy capacities of the target audience. This study aims to evaluate the readability (grade level) and suitability (appropriateness) of online PEMs designed for people with AMD.MethodsOnline PEMs were sourced from websites of national organizations providing patient education materials designed for people with AMD. The Flesch-Kincaid Grade Level formula and the Suitability Assessment of Materials instrument were used to assess the readability and suitability of PEMs. Descriptive statistics were used to compare online PEMs by organization based on national guidelines for readability level (≤ sixth grade) and the recommended suitability score (≥ 70%) for “superior” material.ResultsOne hundred online PEMs were evaluated from websites of 16 professional organizations. The mean readability level was 9.3 (range 5.0–16.6). The mean suitability score was 53% (range 18–78%). Only six (6%) of PEMs achieved the recommended guidelines for readability level and suitability score.ConclusionThe majority of online PEMs designed for people with AMD were written above the recommended readability level, and below the suggested suitability score. To promote health literacy, the demands of written health information must match the reading capacities of the target audience. Heeding to evidence-based guidelines for providing written information to patients with low health literacy and low vision is beneficial for both patients and health care providers. Future research is warranted.

Effects of Predischarge Patient Education Combined With Postdischarge Follow-Ups on Self-Care, Readmission, Sleep, and Depression in Patients With Heart Failure.

Patients with heart failure rarely engage in adequate self-care. Greater emphasis on self-care discharge readiness is needed. This study examined the effects of a predischarge educational program combined with 1 year of postdischarge follow-up on self-care behaviors, readmission, sleep quality, and depression in patients with heart failure. A longitudinal, nonequivalent two-group pretest-posttest design was used. The intervention group received tailored education and follow-ups, whereas the control group received routine predischarge heart-failure education from direct care nurses only. Measurements included the self-care maintenance and self-care management subscales of the Self-Care of Heart Failure Index, Pittsburg Sleep Quality Index, Patient Health Questionnaire-9, and readmission rate. Data obtained at baseline and at 1, 3, 6, and 12 months postdischarge were analyzed using linear mixed models with both intention-to-treat and per-protocol approaches. The propensity score was used to adjust for the confounding effects of the New York Heart Association functional class and left ventricular ejection fraction. Of the 62 patients with heart failure (28 in the intervention group and 34 in the control group) who were sampled at baseline, 47 (n = 25 vs. n = 22) provided data over the entire course of this 1-year study (76% retention rate). The per-protocol analysis did not find significant differences for any variables. However, the intention-to-treat analysis showed that the intervention group significantly improved in self-care maintenance at 6 months and self-care management at 12 months after hospital discharge, with fewer, albeit not significantly fewer, first and subsequent hospital readmissions than the control group. The effect of this intervention was not found to be substantial, indicating a need to design more efficacious and powerful interventions. Hospitalized patients must receive patient education before discharge to foster their self-care knowledge and skills regarding self-care at home. Strategies are needed to help nurses provide patient education in a time-efficient manner.

Patient education about recovery after colorectal surgery: systematic scoping review.

Enhanced recovery after surgery (ERAS) protocols aim to optimize recovery through a series of evidence-based recommendations. A key component of ERAS is the provision of patient education. Whilst the recommendation for this is strong, the evidence to inform its format, timing and delivery is unclear. The aim of this review was to describe previous educational interventions used to improve recovery after colorectal surgery and to explore opportunities for future research. A systematic scoping review was performed. MEDLINE and Embase databases were searched between 1 January 1990 and 12 February 2020. Studies which described or assessed the effectiveness of a patient education or information resource to improve recovery after colorectal surgery were eligible. Outcomes of interest included the format, timing and delivery of interventions, as well as key features of intervention and study design. A narrative synthesis of data was produced through a process of charting and summarizing key results. A total of 1298 papers were inspected, and 11 were eligible for inclusion. Five papers were reports of randomized controlled trials, and others reported a mix of non-randomized and qualitative studies. The design of educational interventions included audio-visual resources (n=3), smartphone device applications (n=3) and approaches to facilitate person-to-person counselling (n=5). Most of the counselling interventions reported positive outcomes (mainly in length of hospital stay), whereas the other types reported mixed results. Patients and the public were seldom involved as collaborators in the design of interventions. Patient education is generally advantageous, but there is insufficient evidence to optimize its design and delivery in the setting of colorectal surgery.

MHealth adoption among primary care physicians in Malaysia and its associated factors: a cross-sectional study.

mHealth apps potentially improve health care delivery and patient outcomes, but the uptake of mHealth in primary care is challenging, especially in low-middle-income countries. To measure factors associated with mHealth adoption among primary care physicians (PCPs) in Malaysia. A cross-sectional study using a self-administered questionnaire was conducted among PCPs. The usage of mHealth apps by the PCPs has divided into the use of mHealth apps to support PCPs' clinical work and recommendation of mHealth apps for patient's use. Factors associated with mHealth adoption were analysed using multivariable logistic regression. Among 217 PCPs in the study, 77.0% used mHealth apps frequently for medical references, 78.3% medical calculation and 30.9% interacting with electronic health records (EHRs). Only 22.1% of PCPs frequently recommended mHealth apps to patients for tracking health information, 22.1% patient education and 14.3% use as a medical device. Performance expectancy and facilitating conditions were associated with mHealth use for medical references. Family medicine trainees, working in a government practice and performance expectancy were the facilitators for the use of mHealth apps for medical calculation. Internet connectivity, performance expectancy and use by colleagues were associated with the use of mHealth with EHR. Performance expectancy was associated with mHealth apps' recommendation to patients to track health information and provide patient education. PCPs often used mHealth apps to support their clinical work but seldom recommended mHealth apps to their patients. Training for PCPs is needed on the appraisal and knowledge of the mHealth apps for patient use.

Understanding the Attitudes of Clinicians and Patients Toward a Self-Management eHealth Tool for Atrial Fibrillation: Qualitative Study.

BackgroundAtrial fibrillation (AF) is the most common heart rhythm disorder and poses a growing disease burden worldwide because of an aging population. A multidisciplinary approach with an emphasis on patient education and self-management has been demonstrated to improve outcomes for AF through the engagement of patients in their own care. Although electronic tools (e-tools) such as apps have been proposed to provide patient education and facilitate self-management, there have been few studies to guide the development of these tools for patients with AF.ObjectiveThis study aims to explore the perceptions of patients and health care providers (HCPs) and their attitudes toward the use of e-tools for the self-management of AF. It also seeks to elicit the factors that contribute to these attitudes.MethodsSemistructured qualitative interviews with HCPs and patients were conducted to understand the interpretations and expectations of an e-tool that would be used for the self-management of AF. Interview data were analyzed using an exploratory thematic analysis approach to uncover emergent themes and infer ideas of preferred features in a device. A modified technology acceptance model was developed as a framework to help interpret these findings. Data from the HCPs and patients were compared and contrasted.ResultsBoth patients and HCPs thought that an e-tool would be useful in the self-management of AF. Although both groups favored educational content and monitoring of blood pressure, patients expressed more passivity toward self-care and an ambivalence toward the use of technology to monitor their medical condition. This appears to be related to factors such as a patient’s age, social support, and their attitudes toward technology. Instead, they favored using the app to contact their HCPs.ConclusionsThis study provides insights into significant differences in the attitudes of patients and HCPs toward the use of e-tools for self-care against their priorities. Understanding patients’ motivations and their needs are key to ensuring higher acceptance of such tools.

A Randomized Controlled Trial of a Multimedia Patient Education Tool for Stress Versus Urgency Urinary Incontinence.

The aim of this study was to determine whether there was a difference in patient education when comparing traditional conversation-based patient counseling with multimedia-based patient counseling about stress and urgency urinary incontinence. Patients seeking treatment for urinary incontinence were randomized to traditional, conversation-based counseling from a physician regarding stress and urgency urinary incontinence (control group) or view a video (multimedia) as their counseling (treatment group). A vignette-based assessment of the patient's knowledge of stress and urgency urinary incontinence was administered as a pretest, immediate posttest, and 6- to 8-week delayed posttest. The Incontinence Impact Questionnaire, short form, was used to assess quality of life and was administered at the initial visit and at the 6- to 8-week follow-up call. Patient satisfaction was recorded at the end of the initial visit using a continuous visual analog scale, and health literacy was evaluated using the Rapid Estimate of Adult Literacy in Medicine-Short Form or Short Assessment of Health Literacy-Spanish. In the 98 participants, immediate posttest scores trended toward significance between the control and treatment groups (P = 0.086). This trend was lost at the delayed posttest (P = 0.122). Both methods of education showed a significant difference between pretest, immediate posttest, and delayed posttest (P < 0.001). There were no demographic differences between groups. Multimedia-based patient education represents an effective method of providing patient education regarding urinary incontinence because those who received video education showed comparable comprehension of this topic when compared with standard physician counseling. Video education can feasibly be used as an alternative to, or in conjunction with, current patient education practices in a urogynecology setting.

Development and Evaluation of an Atopic Dermatitis Care Plan for Providers.

Background/Significance of problem: Atopic Dermatitis (AD) is a common, chronic, inflammatory dermatosis and skin disease that follows a relapsing pattern and requires a dynamic stepwise approach to management. Providers feel comfortable treating chronic disease states with a guided tool or care plan in many chronic diseases. Care plans used in many chronic diseases such as asthma, diabetes, and COPD have demonstrated effectiveness in disease and healthcare provider management. There is an unmet need for a universal AD care plan for providers. Clinical question/project purpose: A universal AD care plan was developed to improve AD disease management and patient outcomes. Post-implementation of providers & perceptions was assessed for how the AD universal care plan affected their ability to provide patient education. Search of literature/best evidence: Review of literature includes: CINAHL, ProQuest Health, PubMed, Fusion, and UpToDate databases from 2008-2018.Search terms included: Atopic Dermatitis, Eczema, care plans, care plan use in chronic disease. Clinical appraisal of literature/best evidence: Analysis of the evidence supported the need for AD education, which then supported the need for a universal AD care plan for providers. Integration into practice: "Your Eczema Care Plan" was used by thirty-five healthcare providers to improve patient outcomes in a similar manner as other evidence-based care plans.Evaluation of evidenced-based practice: Post-implementation of providers & perceptions were evaluated on how the AD care plan tool affected their ability to provide patient education. Results suggest patient education, disease management, and QOL are all improved when utilizing "Your Eczema Action Plan." J Drugs Dermatol. 2020;19(10): 950-955. doi:10.36849/JDD.2020.5090.

Expanding Pharmacy Services With an Intern Program at an Academic Medical Center

Background: Organizations that implement pharmacy services to provide patient education have reduced hospital readmissions and improved the patient experience. The term “pharmacy extender” has been used to describe pharmacy technicians and pharmacy students who alleviate the workload of a pharmacist, enhance pharmacy visibility throughout an organization, and foster professional development for the individual. Objective: The objective of this pharmacy intern-driven program is to increase pharmacy reach for medication teaching. Methods: This is a single-center, IRB-approved retrospective cohort analysis. Pharmacist-led medication teaching is currently available to select high-risk populations including solid organ transplant and bone marrow transplant recipients at our organization. Clinicians working in the pharmacy satellites have structured operational and distributional workflow responsibilities, which precludes them from directly engaging with patients. Pharmacy interns can serve as extenders that can participate in medication teaching. An internally created digital medication teaching tool will be employed to expand the pharmacy reach for medication education. Results: During the period of study, the pharmacy interns screened 3,993 patients and educated 2,868 patients. Two-thirds of the pharmacy interns that participated in the program pursued post-graduate residency or fellowship training, while the rest assumed hospital pharmacist positions. Conclusion: Deploying pharmacy interns as extenders for distribution of an internally created digital tool that provides general medication teaching has shown positive outcomes including greater pharmacy presence and visibility, better patient experience, and higher patient satisfaction. Continuous data collection and monitoring are warranted to demonstrate the benefits of the program once sustained and potentially justify more resources for further expansion.

Epidemiological Study of Risk Factors in Myocardial Infarction Patients

Introduction: Recent ecological study for major CVD risk factors and mortality indicates a high correlation between expected and observed mortality rates for three major risk factors- hypertension, diabetes, smoking. Survivor of MI are at higher risk of recurrent infarction than in people who don’t have coronary heart disease. Objectives: To evaluate the risk factors of Myocardial Infarction among cardiac patients and provide patient education in order to minimize risk factors. Methods: A prospective and observational study was conducted on 500 medical records of cardiac department. Data was collected by using a case report form from September 2019 to December 2019 and then analyzed using statistical package for social science (SPSS) version 20.0 software. Results: We have assessed around 500 myocardial infarction cases, Out of which higher proportion of risk factors in myocardial infarction patients has been observed in Coronary Artery Disease (31%), Hypertension (20.9%), followed by Diabetes Mellitus (15.01%), Smoking (12.5%), Alcohol consumption (12.3%), Obesity (3.09%) and any coexisting diseases (4.75%). Conclusion: On the whole, this study indicates that evaluation of risk factors provides new scope for the development of more effective approaches to prevent the recurrent chances of myocardial infarction by providing patient education and life style modification. Key words: Hypertension, Myocardial Infarction, Patient education, Risk factors.

Implementing a high-risk medication education introductory pharmacy practice experience

Background and purposeThe purpose of this project was to implement a sustainable high-risk medication education (HRME) experience for student pharmacists, assess the impact on institutional metrics, and evaluate student competence. Educational activity and settingStudents completed a longitudinal introductory pharmacy practice experience (IPPE) to provide patient education on anticoagulant and antiplatelet medications. Data collected included student feedback on the experience, the achievement of applicable pre-advanced pharmacy practice experience (APPE) core domains, student effect on number of patients counseled, and number of patient interactions per student. FindingsStudent feedback of the HRME experience indicated that 98% either strongly agreed or agreed to meeting defined parameters. Ninety-seven percent of students completing the experience demonstrated achievement of all applicable domain abilities. Over a three-year period, students educated 1055 patients. SummaryThe creation of a sustainable HRME experience for student pharmacists allowed for the achievement of applicable pre-APPE core domains. It also enhanced institutional metrics by greatly increasing the number of patient touches and providing students with direct patient care opportunities on a consistent basis.

Comparison of Health Outcomes in Diabetic and Non-Diabetic Patients Undergoing Maintenance Hemodialysis

Though several studies have assessed Health Related Quality of Life (HRQoL) and factors affecting HRQoL in maintenance haemodialysis (MHD) patients, there are limited data about health outcomes in diabetic and non-diabetic patients on MHD in Indian setup.The study aimed to compare Health Related Quality of Life (HRQoL) in diabetic and non-diabetic patients undergoing maintenance haemodialysis (MHD), to assess the effect of patient education on HRQoL, and factors affecting HRQoL in diabetic and non-diabetic patients undergoing MHD. This eight month prospective interventional study on ambulatory haemodialysis patients assessed HRQoL using the kidney disease quality of life (KDQoLTM-36) questionnaire at baseline, 3 months and 6 months. Comprehensive patient education was provided to patients during study period. Patient responses to questionnaire were compared between baseline and two follow-ups for all patients and between diabetic and nondiabetic patients.89 patients were enrolled into this study and 69 (30 diabetics and 39 non-diabetics) were followed up. The mean age of the study population was 46 ± 12 years. It was observed non-diabetic patients had better HRQoL than diabetic patients undergoing MHD. An improvement in HRQoL from baseline was observed after providing patient education. Male gender (p=0.032), high school education or lesser (p=0.049), smoking history (p=0.031) and dialysis for &lt; three years (p=0.035) were factors with significant influence on HRQoL. Non-diabetic patients had better HRQoL when compared to diabetic patients undergoing MHD. Patient care focussed on factors contributing to lower HRQoL in patients undergoing MHD may improve health outcomes.

JA:2021-41. CS-CASH Pilot Grant: Improving Agricultural Worker Health and Safety Awareness through Multimodal, Case-Based Physician Assistant Education

ABSTRACT Purpose: Agricultural workers, especially those who farm full-time, are at substantial risk for developing long-term health problems related to occupational dust, chemical, and vibratory noise exposures. There is clear evidence of risk factors for acute agricultural injury; however, literature regarding risk factors for long-term occupational health problems, including noise-induced hearing loss (NIHL), agricultural chemical exposure (ACE), and inhalation injury, is more limited. The literature poses conflicting information on agricultural workers and personal protective equipment (PPE); agricultural workers understand the importance of PPE use, yet the lack of PPE use is pervasive in agricultural workers across numerous studies. Education of agricultural workers on the role of PPE in chronic disease prevention has shown promise. Methods: Our research seeks to identify a replicable model of Physician Assistant (PA) student education on agricultural worker health and safety, including patient education and disease prevention. This model will equip future health-care providers with the knowledge and skills to provide patient education on farming-associated, preventable chronic diseases, as it is a documented tool for increasing PPE use. Didactic curriculum objectives include agriculturally related respiratory health issues, chemical exposure, and noise-induced hearing loss. Curricular content delivery includes traditional classroom learning as well as adjunctive small group and simulation activities. Upon completion of the didactic phase, students complete a 15-month clinical learning phase, including a 12-week primary care rotation in a rural setting, serving many agricultural workers throughout the Midwest. Student logs of patient encounters track diagnoses related to agricultural exposure, as well as monitor agricultural patient treatment modalities, including patient education on PPE use. Distribution of patient education and PPE materials occurs through clinical site visits to primary care rotation sites. Practical Application: Our educational model intends to improve health outcomes of patients in the rural Midwest. Our ongoing research will collect data on agriculturally related diagnoses in the Midwest and patient-provider communication, ideally enhancing patient awareness of risk factors and compliance with treatment plans, as well as decreasing chronic disease severity. The measured effects of this educational intervention will serve as a basis for future research and health-care provider education.

Development of an Online Health Care Assessment for Preventive Medicine: A Machine Learning Approach.

BackgroundIn the era of information explosion, the use of the internet to assist with clinical practice and diagnosis has become a cutting-edge area of research. The application of medical informatics allows patients to be aware of their clinical conditions, which may contribute toward the prevention of several chronic diseases and disorders.ObjectiveIn this study, we applied machine learning techniques to construct a medical database system from electronic medical records (EMRs) of subjects who have undergone health examination. This system aims to provide online self-health evaluation to clinicians and patients worldwide, enabling personalized health and preventive health.MethodsWe built a medical database system based on the literature, and data preprocessing and cleaning were performed for the database. We utilized both supervised and unsupervised machine learning technology to analyze the EMR data to establish prediction models. The models with EMR databases were then applied to the internet platform.ResultsThe validation data were used to validate the online diagnosis prediction system. The accuracy of the prediction model for metabolic syndrome reached 91%, and the area under the receiver operating characteristic (ROC) curve was 0.904 in this system. For chronic kidney disease, the prediction accuracy of the model reached 94.7%, and the area under the ROC curve (AUC) was 0.982. In addition, the system also provided disease diagnosis visualization via clustering, allowing users to check their outcome compared with those in the medical database, enabling increased awareness for a healthier lifestyle.ConclusionsOur web-based health care machine learning system allowed users to access online diagnosis predictions and provided a health examination report. Users could understand and review their health status accordingly. In the future, we aim to connect hospitals worldwide with our platform, so that health care practitioners can make diagnoses or provide patient education to remote patients. This platform can increase the value of preventive medicine and telemedicine.