Journal of general internal medicine
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Inappropriate polypharmacy, prevalent among older patients, is associated with substantial harms. ⋯ EHR-based measures and nudges addressing high-risk polypharmacy were feasible to develop and implement, and warrant further testing.
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The American Board of Internal Medicine Foundation's Choosing Wisely campaign has resulted in a vast number of recommendations to reduce low-value care. Implementation of these recommendations, in conjunction with patient input, remains challenging. ⋯ Specific voting categories, along with the use of patient-friendly language, allowed for the successful co-creation of recommendations.
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Observational Study
Primary Care Behavioral Health Integration and Care Utilization: Implications for Patient Outcome and Healthcare Resource Use.
Behavioral health (BH) integration in primary care (PC) can potentially improve outcomes and reduce cost of care. While different models of integration exist, evidence from real-world examples is needed to demonstrate the effectiveness and value of integration. This study aimed to evaluate the outcomes of six PC practice sites located in Western New York that implemented a primary care behavioral health (PCBH) integration model. ⋯ PCBH integration appears to alter the treatment patterns among patients with BH conditions by shifting patient visits away from ED and PC providers toward BH providers who specialize in treatment of such patients.
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Observational Study
Influenza vaccination and mortality among adults with heart failure in an integrated healthcare delivery system, 2009-2018.
Influenza infection can result in decompensation or exacerbation of heart failure (HF) symptoms, hospitalization, and death. ⋯ Influenza vaccination in HF patients was associated with a lower risk of mortality during the influenza season. Our findings provide support for recommendations of universal influenza vaccination in patients with HF.