Journal of general internal medicine
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While many older adults with type 2 diabetes have tight glycemic control beyond guideline-recommended targets, deintensifying (stopping or dose-reducing) diabetes medications rarely occurs. ⋯ Optimizing deintensification requires patient education that describes both individualized glycemic targets and how they will change over the lifespan. Deintensification is an opportunity for shared decision-making, but providers must understand patients' beliefs about their medications and address misconceptions. Hypoglycemia prevention may be a helpful framing for discussing deintensification.
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Understanding experiences with private important to improving the quality of health care coverage. ⋯ Cost-related access barriers, medical debt, and dissatisfaction with care were common among individuals with private insurance and most pronounced among those with fair and poor health who likely need and use their health insurance the most.
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The COVID-19 pandemic led to significant disruptions in healthcare and rapid increases in virtual healthcare delivery. The full effects of these shifts remain unknown. Understanding effects of these disruptions is particularly relevant for patients with chronic pain, which typically requires consistent engagement in treatment to maximize benefit, and for Black patients, given documented racial disparities in pain treatment and telehealth delivery. ⋯ Black patients with chronic pain described mostly negative effects from the shift to telecare after the pandemic's onset. Given existing disparities and likely persistence of virtual care, research on the longer-term effects of virtual pain care for Black patients is needed.
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Recent USDA Economic Research Service Population Survey cites a stabilization of food insecurity overall in the USA between 2019 and 2020, but Black, Hispanic, and all households with children cited increases - underscoring that the COVID-19 pandemic caused severe disruptions to food insecurity for historically disenfranchised populations. ⋯ The Providence CTK case study provides a blueprint for how healthcare organizations could design a model of culinary nutrition education that is immersive, empowering, and inclusive.