Journal of general internal medicine
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The COVID-19 pandemic exacerbated access barriers for patients with opioid use disorder. Telehealth presents an opportunity to improve access, treatment quality, and patient outcomes. ⋯ Our findings suggest that telehealth-initiated buprenorphine treatment is associated with reduced opioid overdose rate and improved patient engagement. Our findings strengthen the case for extending telehealth exemptions and prescribing flexibilities for treatment.
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Observational Study
Nurse Practitioner Care Environments and Racial and Ethnic Disparities in Hospitalization Among Medicare Beneficiaries with Coronary Heart Disease.
Nurse practitioners care for patients with cardiovascular disease, particularly those from racial and ethnic minority groups, and can help assure equitable health outcomes. Yet, nurse practitioners practice in challenging care environments, which limits their ability to care for patients. ⋯ Unfavorable care environments were associated with higher hospitalization rates among Black than among White beneficiaries with coronary heart disease. Racial disparities in hospitalization rates were not detected in practices with high-quality care environments, suggesting that improving nurse practitioner care environments could reduce racial disparities in hospitalizations.
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Randomized Controlled Trial
Automated Reminders Enhance Mailed Fecal Immunochemical Test Completion Among Veterans: a Randomized Controlled Trial.
The Veterans Affairs (VHA) is working to establish a population-based colorectal cancer screening program for average-risk patients using mailed fecal immunochemical testing (FIT). However, low response rates to mailed FIT may hinder success. Key features of mailed FIT programs, including the use of reminders, differ among various national programs, with limited evidence among veterans. ⋯ Automated reminders increased colorectal cancer screening completion among average-risk veterans. An automated phone call or text message was equally effective. VHA facilities seeking to implement a mailed FIT program should consider using phone or text reminders, depending on available resources.
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Food insecurity (FI) often co-exists with other social risk factors, which makes addressing it particularly challenging. The degree of association between FI and other social risk factors across different levels of income and before and during the COVID-19 pandemic is currently unknown, impeding the ability to design effective interventions for addressing these co-existing social risk factors. ⋯ Future research should explore how access to a variety of social safety net programs may impact the association between social risk factors. With the expiration of most pandemic-related social supports, further research and monitoring are also needed to examine FI in the context of increasing food and housing costs. Our findings may also have implications for the expansion of income-based program eligibility criteria and screening for social risk factors across all patients and not only low-income people.