News and Updates for Healthcare Professionals

The piece raises several important concerns regarding COVID-19 for specific vulnerable populations.

The National Library of Medicine (NLM), part of the National Institutes of Health, is working on multiple fronts to aid in the COVID-19 response through new initiatives with the global publishing community and artificial intelligence researchers. NLM is expanding access to scientific papers on coronavirus for researchers, care providers, and the public, and for text-mining research. This work makes use of NLM’s PubMed Central® (PMC), a digital archive of peer-reviewed biomedical and life sciences literature. PMC currently provides access to nearly 6 million full-text journal articles.

CDC’s Division of Nutrition, Physical Activity, and Obesity launched a program called Programs to Reduce Obesity in High Obesity Areas, also referred to as HOP, and this collection highlights the program’s approach and describes both overarching and program-specific evaluation findings. Seven of the articles highlight the work of land-grant universities, and one describes HOP’s implementation approach, evaluation framework, and key findings.

SARS-CoV-2 stability similar to original SARS virus.

NIH-funded study reports advance in blood-based detection of ptau181, a biomarker of Alzheimer’s disease.

Variability in sleep duration and timing may represent new and independent heart disease risk factor.

Study enrolling hospitalized adults with COVID-19 in Nebraska.

This report considers issues related to acute and chronic pain management and substance use disorders (SUD). The guidance provided aims to achieve the application of the proper healthcare quality metrics across the U.S. healthcare system. Using the best metrics, in turn, seeks both to continue to reduce opioid deaths verifiably, to encourage the implementation of best practices of pain management, to decrease the incidence of other SUDs, and to decrease illegal drug use by those unable to obtain prescription pain medication.

Researchers have discovered a neural signature that predicts whether individuals with depression are likely to benefit from sertraline, a commonly prescribed antidepressant medication. The findings, published in Nature Biotechnology, suggest that new machine learning techniques can identify complex patterns in a person’s brain activity that correlate with meaningful clinical outcomes.

A new guide to help primary care practices manage patients taking opioids for chronic pain is highlighted in a new post by AHRQ Director Gopal Khanna, M.B.A. The new Self-Service How-To Guide helps practices implement the AHRQ-funded Six Building Blocks, a structured, systems-based approach to treating patients who use long-term opioid therapy. Clinicians and staff, quality improvement personnel, practice coaches, and clinic administrators can use the new guide to implement the Six Building Blocks in a three-stage,15-month timeline. Developing tools and resources to reduce opioid overdoses and the prevalence of opioid use disorder is a priority for the U.S. Department of Health and Human Services and AHRQ.

NIH study shows treatment recommendations impacted by patient and physician factors.

Several health literacy research tools are developed from the funding and support of the federal government. Visit our website to see how the National Institutes of Health, the U.S. Department of Education and others support health literacy research.

The ideas people have about health, the languages they use and the health literacy skills they have, reflect their cultures. Organizations can increase communication effectiveness when they recognize and address cultural differences that may contribute to miscommunication. Our website has resources to help you improve your cross-cultural communications skills.

Community organizations are incorporating health literacy strategies to contribute to the well-being of their community. Check out our website for more resources community organizations offer for your communication needs.

Also, check out the
Clear Communication Index! A research-based tool that helps you develop and assess communication materials for your intended audience.

Safety data analyzed from five NIH inpatient clinical trials

Treatment for Acute Pain: An Evidence Map

Recently, the United States Department of Health and Human Services (HHS) issued new guidance on appropriate tapering or discontinuation of long-term opioid use. The new guide, the HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics, serves as advice to clinicians who are contemplating or initiating a change in opioid dosage for a patient.

The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) has a rich portfolio of public health efforts to reduce the risks of developing chronic disease and to improve the health and quality of life for those living with chronic disease. This collection from Preventing Chronic Disease features 10 articles that offer insights into the development, implementation, and evaluation of population-based interventions to prevent chronic diseases and to control their effects on quality of life, morbidity, and mortality.

The NCCDPHP Program Evaluation collection shares important evaluation findings and lessons learned from public health and clinical interventions implemented by NCCDPHP, its partners, and its awardees.

Table of Contents

• Teacher Physical Education Practices and Student Outcomes in a Sample of Middle Schools Participating in the Presidential Youth Fitness ProgramLucas IR, Harris C, Lee S, Wargo J, Barnes SP, Kauh TJ, et al
• A Faith-Based Intervention to Reduce Blood Pressure in Underserved Metropolitan New York Immigrant CommunitiesYi SS, Wyatt LC, Patel S, Choy C, Dhar R, Zanowiak JM, et al
• A Change-Management Approach to Closing Care Gaps in a Federally Qualified Health Center: A Rural Kentucky Case StudyCarman AL, Vanderpool RC, Stradtman LR, Edmiston EA
• Putting the National Diabetes Prevention Program to Work: Predictors of Achieving Weight-Loss Goals in an Employee PopulationChakkalakal RJ, Connor LR, Rolando LA, Huang Y, Byrne DW, Awalt BM, et al
• Implementation of Liver Cancer Education Among Health Care Providers and Community Coalitions in the Cherokee NationMomin B, Mera J, Essex W, Gahn D, Burkhart M, Nielsen D, et al
• A Media Campaign to Increase Health Care Provider Assistance for Patients Who Smoke CigarettesJuster HR, Ortega-Peluso CA, Brown EM, Hayes KA, Sneegas K, Gopez G, et al
• Single Cigar Price and Availability in Communities With and Without a Cigar Packaging and Pricing RegulationKephart L, Song G, Henley P, Ursprung WS
• Estimating the Relative Impact of Clinical and Preventive Community-Based Interventions: An Example Based on the Community Transformation Grant ProgramYarnoff B, Bradley C, Honeycutt AA, Soler RE, Orenstein D
• A Cohort Review Approach Evaluating Community Health Worker Programs in New York City, 2015–2017Feinberg A, Seidl L, Dannefer R, Wyka K, Drackett E, Brown-Dudley L, et al
• Advancing Tobacco Control Through Point of Sale Policies, Providence, Rhode IslandPearlman DN, Arnold JA, Guardino GA, Welsh EB

In this issue of JAMA, Shrank and colleagues report a thorough review of studies published over the past decade to provide updated estimates on the proportion of US health care spending that is wasteful, defined in 6 broad categories: …

Risk factors for chronic disease are multiple and interrelated, having roots in individuals, families, and communities and requiring coordinated strategies across multiple levels and sectors to create conditions that promote and sustain optimal health.

This collection places emphasis on the fact that public health cannot reduce chronic disease rates alone, and neither can health care. Instead, this collection features 16 articles that explore a wide array of new approaches for improving systems and addressing upstream causes, sharing early outcomes and identifying changes in workflows to ease implementation and promote sustainability of improvements.

AHRQ’s Medication-Assisted Treatment for Opioid Use Disorder (MAT for OUD) Playbook serves as a comprehensive guide for implementing MAT in primary care and other ambulatory care settings. The online, interactive playbook contains the latest guidance, tools and resources to address MAT implementation.

2018 National Healthcare Quality and Disparities Report

After communicating with older adults and addressing health literacy barriers, take one last step and check your work. Ask yourself have I:

• considered their comfort with technology and online health information
• researched the health literacy issues for my older adult population

For more of these tips, visit the Clear Communication Checklist on our website.

Engaging patients in decisions about their care has been shown to contribute to positive health outcomes, but physicians and patients need tools to better guide informed conversations, according to AHRQ grantee Alex H. Krist, M.D., M.P.H.

Dr. Krist, a professor in the department of family medicine and population health at Virginia Commonwealth University (VCU) in Richmond, advocates engaging patients in care decisions that are based on the best available evidence and helping them play a more active role in creating their own care plans. His work as an AHRQ-funded primary care researcher and as a clinician and faculty member in VCU’s family medicine residency program reflects this conviction.

For example, when patients learn about the benefits and risks of screening recommendations, “they can really be active participants in managing their health and working with their care team to get the care they want,” Dr. Krist said. Engaged patients can also ask more informed questions or raise concerns about screenings for breast, prostate, and colon cancer, which collectively account for 10 percent of all U.S. primary care visits, according to Dr. Krist.

He received an AHRQ-funded grant in 2007 to create an interactive preventive health record called MyPreventiveCare that was designed to help patients better understand their care options in a manner that reflects their individual values and concerns. The health record combined information about a patient’s clinical status, family history, and health behaviors with preventive care recommendations, including those from the U. S. Preventive Services Task Force Link to Exit Disclaimer (USPSTF), of which Dr. Krist is a vice chair. Patients had access to a personalized overview of preventive services in plain language, as well as motivational messages, links to additional resources, decision aids, and reminders.

Initially implemented in eight primary care practices in Virginia, the tool helped prepare patients and clinicians for specific conversations or decisions, according to Dr. Krist. “Patients can go in and have a whole different discussion with their clinician, whether it’s a more shared decision, or whether it’s participating more in creating their treatment plans,” he said. The system is now used by nearly 50 practices in five States.

Engaging patients with multiple chronic conditions can be more challenging for physicians, however. These patients have complex needs that can be exacerbated by untreated mental health issues, social needs, or unhealthy behaviors.

That’s why Dr. Krist’s latest AHRQ-funded grant, awarded in 2019, will help primary care physicians better understand how to engage patients with multiple chronic conditions in creating their own care plans, with the larger goal of addressing the root causes of poor health.

In the project, patients will be screened for certain health risks and will work with clinicians to prioritize their health needs. When clinicians engage patients with multiple chronic conditions, patients generally identify one or two concerns that are most important to them, according to Dr. Krist. “There’s a reason they’re identifying it. Maybe it’s something they feel they have an ability to change.” Based on this information, clinicians will create a care plan that reflects patients’ preferences.

Dr. Krist is a fellow of the American Academy of Family Physicians and was elected to the National Academy of Medicine in 2018.