Journal articleJ Am Geriatr Soc · April 2026
BACKGROUND: Despite longstanding concern about an increase in use of invasive mechanical ventilation among persons living with dementia (PLWD), no studies have examined trends in mechanical ventilation use among PLWD in Veterans Affairs (VA) facilities. In ...
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Journal articleJ Am Geriatr Soc · April 2026
BACKGROUND: Advance care planning (ACP) supports seriously ill individuals in identifying and communicating their values and preferences for future care. However, disparities in ACP engagement persist, particularly among African American older adults. This ...
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Journal articleJCO Oncol Pract · December 2025
PURPOSE: The Veterans Affairs Health Administration (VA) has experience using telehealth (TH) to deliver care to 10 million enrolled Veterans for many clinical care needs. The VA National TeleOncology Service (NTO) was established in 2020 to provide specia ...
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Journal articleJ Pain Symptom Manage · December 2025
BACKGROUND: A poor prognosis is an important trigger for advance care planning (ACP) conversations, but clinicians often overestimate prognosis. OBJECTIVE: To determine whether ACP note documentation increases by notifying inpatient physicians that a patie ...
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Journal articleJMIR Form Res · November 17, 2025
BACKGROUND: Long-term adherence to weight loss behaviors is challenging, as most individuals who achieve significant weight loss regain 1-2 kg per year. Financial incentives can reinforce weight-loss initiation and maintenance behaviors, but optimal strate ...
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Journal articleAnn Am Thorac Soc · November 2025
Rationale: Lifetime trauma is common and may affect interactions with the healthcare system. Objectives: To measure the prevalence of lifetime trauma and its association with family-clinician interpersonal outcomes in the intensive care unit (ICU). Methods ...
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Journal articleContemp Clin Trials · September 2025
Although behavioral weight-loss programs are efficacious for achieving clinically significant weight loss, adherence to such programs is variable. Positive reinforcement through small financial incentives has shown promise for increasing adherence to behav ...
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Journal articleContemp Clin Trials · September 2025
BACKGROUND: Pain, fatigue, and distress are highly prevalent co-occurring symptoms in patients with stage IV cancer. Emerging evidence suggests these patients may benefit from Acceptance and Commitment Therapy (ACT), a Cognitive-Behavioral Therapy (CBT) ap ...
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Journal articleJ Am Geriatr Soc · June 2025
BACKGROUND: Psychological resilience has been characterized as the ability to recover from stressful life events. Not well studied is whether self-reported measures of psychological resilience are associated with physical function recovery. Therefore, we e ...
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Journal articleJAMA Intern Med · February 1, 2025
IMPORTANCE: Few person-centered, scalable models of collaborative intensive care unit (ICU) clinician-palliative care specialist care exist. OBJECTIVE: To evaluate the effect of a collaborative palliative care intervention compared to usual care among fami ...
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Journal articleDiabetes Ther · November 2024
INTRODUCTION: Patients with type 2 diabetes (T2D), particularly those from historically marginalized racial and ethnic groups, are at high risk of poor outcomes from metabolic dysfunction-associated steatotic liver disease (MASLD). Evidence-based managemen ...
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Journal articleJAMA Intern Med · November 1, 2024
IMPORTANCE: Cognitive behavioral therapy for insomnia (CBTi) is the standard of care for treating insomnia disorder, but access is limited. Alternative approaches are needed to expand access to the standard of care. OBJECTIVE: To examine the effectiveness ...
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Journal articleMed Care · October 1, 2024
The Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale comparative effectiveness clinical trials evaluating palliative care (PC) and advance care planning (ACP) healthcare delivery models. This article provides an overview of ...
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Journal articleAm J Kidney Dis · August 2024
RATIONALE & OBJECTIVE: Although functional impairment is common among older adults with chronic kidney disease (CKD), functional reserve before an acute health event and physical resilience after the event have not been characterized in this population. Th ...
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Journal articleJ Am Geriatr Soc · July 2024
BACKGROUND: Seriously ill patients rely on spiritual and existential beliefs to support coping and approach crucial treatment and healthcare decisions. Yet, we lack gold standard, validated approaches to gathering information on those spiritual beliefs. Th ...
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Journal articleEndocr Pract · July 2024
OBJECTIVE: To assess frequency of evidence-based management (EBM) of metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes (T2D), and to examine for racial/ethnic disparities in the receipt of EBM. METHODS: We co ...
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Journal articleJAMA Intern Med · July 1, 2024
IMPORTANCE: Although psychological distress is common among survivors of critical illness, there are few tailored therapies. OBJECTIVE: To determine the optimal method for delivering a mindfulness intervention via a mobile app for critical illness survivor ...
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Journal articleCHEST Crit Care · June 2024
BACKGROUND: Psychological distress symptoms are present and persistent among many patients who survive a critical illness like COVID-19. RESEARCH QUESTION: Could a self-directed mobile app-delivered mindfulness intervention be feasibly and rapidly implemen ...
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Journal articleJ Pain Symptom Manage · June 2024
CONTEXT: Driven by concerns about care quality, patient experience, and national metrics, health systems are increasingly focusing on identifying risk factors for patients who are hospitalized in the last month of life. OBJECTIVE: To evaluate patient facto ...
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Journal articleStat (Int Stat Inst) · June 2024
Data-intensive research continues to expand with the goal of improving healthcare delivery, clinical decision-making, and patient outcomes. Quantitative scientists, such as biostatisticians, epidemiologists, and informaticists, are tasked with turning data ...
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Journal articlePatient Educ Couns · February 2024
OBJECTIVE: Many have reported racial disparities in self-reported trust in clinicians but have not directly assessed expressions of trust and distrust in physician-patient encounters. We created a codebook to examine racial differences in patient trust and ...
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Journal articleJAMA Netw Open · January 2, 2024
IMPORTANCE: Unmet and racially disparate palliative care needs are common in intensive care unit (ICU) settings. OBJECTIVE: To test the effect of a primary palliative care intervention vs usual care control both overall and by family member race. DESIGN, S ...
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Journal articleFront Med (Lausanne) · 2024
INTRODUCTION: Clinician implicit racial bias (IB) may lead to lower quality care and adverse health outcomes for Black patients. Educational efforts to train clinicians to mitigate IB vary widely and have insufficient evidence of impact. We developed and p ...
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Journal articleContemp Clin Trials · December 2023
BACKGROUND: Many patients with advanced cancer describe pain as a debilitating symptom that greatly interferes with daily activities and enjoyment of life. Psychosocial interventions can improve cancer-related pain but rarely address spiritual concerns (e. ...
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Journal articleBMJ Open Diabetes Res Care · November 29, 2023
INTRODUCTION: Metabolic dysfunction-associated steatohepatitis (MASH) is highly prevalent in type 2 diabetes (T2D). Pioglitazone and glucagon-like peptide-1 receptor agonists (GLP-1RA) are medications used in T2D that can resolve MASH and should be conside ...
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Journal articleAnn Am Thorac Soc · October 2023
Rationale: The coronavirus disease (COVID-19) pandemic exacerbated psychological distress and burnout in frontline healthcare workers. Interventions addressing psychological distress and burnout among these workers are lacking. Objectives: To determine the ...
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Journal articleKidney360 · October 1, 2023
KEY POINTS: There are three distinct classes of symptoms, functional impairment, and medication burden among older adults with advanced kidney disease. One class with Complex Needs with pain and psychological symptoms, functional difficulties, and polyphar ...
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Journal articleObes Sci Pract · August 2023
INTRODUCTION: Obtaining body weights remotely could improve feasibility of pragmatic trials. This investigation examined whether weights collected via cellular scale or electronic health record (EHR) correspond to gold standard in-person study weights. MET ...
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Journal articleMil Med · July 22, 2023
INTRODUCTION: Peer support is a well-established part of veteran care and a cost-effective way to support individuals pursuing health behavior change. Common models of peer support, peer coaching, and mutual peer support have limitations that could be mini ...
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Journal articlePsychooncology · July 2023
OBJECTIVE: For patients with advanced cancer, pain is a common and debilitating symptom that can negatively impact physical, emotional, and spiritual well-being. This trial examined the feasibility and initial effects of Meaning-Centered Pain Coping Skills ...
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Journal articleAnn Am Thorac Soc · June 2023
Rationale: Psychological distress symptoms are common among patients recently hospitalized with cardiorespiratory failure, yet there are few effective postdischarge therapies that are relevant to their experiences. Objectives: To determine the feasibility ...
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Journal articleJAMA Intern Med · June 1, 2023
IMPORTANCE: Communication between cardiologists and patients can significantly affect patient comprehension, adherence, and satisfaction. To our knowledge, a coaching intervention to improve cardiologist communication has not been tested. OBJECTIVE: To eva ...
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Journal articleContemp Clin Trials · February 2023
BACKGROUND: Cognitive Behavioral Therapy for Insomnia (CBTi) is recommended as first-line treatment for insomnia, yet patient access to CBTi is limited. Self-help CBTi could increase patient access. Self-help CBTI with provider sup]port is more effective a ...
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Journal articleJ Pain Symptom Manage · January 2023
Collaboration with a statistician about the design of a statistical analysis plan can be enhanced by illustrating how statisticians conceptualize their task. This conceptualization can be represented by a directed acyclic graph (DAG), which illustrates the ...
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Journal articleCrit Care Med · January 1, 2023
OBJECTIVES: While palliative care needs are assumed to improve during ICU care, few empiric data exist on need trajectories or their impact on long-term outcomes. We aimed to describe trajectories of palliative care needs during ICU care and to determine i ...
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Journal articleOphthalmol Glaucoma · 2023
PURPOSE: To assess the relationship between glaucoma knowledge and disease severity. DESIGN: Substudy of a randomized controlled trial at a single Veterans Affairs (VA) eye clinic. PARTICIPANTS: Veterans with medically treated open-angle glaucoma who self- ...
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Journal articleOphthalmic Res · 2023
INTRODUCTION: We conducted a secondary, real-world clinical assessment of a randomized controlled trial to determine how a glaucoma medication adherence intervention impacted the clinical outcomes of participants at 12 months post-randomization. Participan ...
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Journal articleOphthalmol Glaucoma · 2023
OBJECTIVE: In the Medication Adherence In Glaucoma To Improve Care trial, 200 veterans with medically-treated glaucoma were randomized to an intervention designed to improve glaucoma medication adherence or to usual care. In the 6 months after intervention ...
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Journal articleBMC Nephrol · December 31, 2022
BACKGROUND: The purpose of this manuscript is to introduce reserve and resilience as novel concepts in chronic kidney disease (CKD) research and present baseline data from a unique prospective cohort study designed to characterize recovery from functional ...
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Journal articleAm J Ophthalmol · December 2022
PURPOSE: To assess the within-trial cost-effectiveness of a behavioral intervention to improve glaucoma medication adherence. DESIGN: Prospective cost-effectiveness analysis of randomized, controlled trial data. METHODS: The study setting was a Veterans Af ...
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Journal articlePatient Educ Couns · December 2022
OBJECTIVES: Examine the association of coder ratings of cardiologist behaviors and global scores of cardiologist communication style with patient participation in clinic encounters. METHODS: We coded transcripts of clinic encounters for patient participato ...
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Journal articlePediatrics · December 1, 2022
OBJECTIVES: To evaluate racial and ethnic differences in communication quality during family centered rounds. METHODS: We conducted an observational study of family-centered rounds on hospital day 1. All enrolled caregivers completed a survey following rou ...
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Journal articleBMJ Support Palliat Care · September 27, 2022
OBJECTIVE: Because the heterogeneity of patients in intensive care units (ICUs) and family members represents a challenge to palliative care delivery, we aimed to determine if distinct phenotypes of palliative care needs exist. METHODS: Prospective cohort ...
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Journal articleBehav Sci (Basel) · September 27, 2022
OBJECTIVES: Clinician burnout poses risks not just to clinicians but also to patients and the health system. Cardiologists might be especially prone to burnout due to performing high-risk procedures, having to discuss serious news, and treating diseases th ...
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Journal articleAnn Surg · August 1, 2022
OBJECTIVE: In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), initiation of (ie, incident) and persistence of (ie, continuation of preoperative) depression treatment are compared ...
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Journal articleJ Gerontol A Biol Sci Med Sci · April 1, 2022
BACKGROUND: While social distancing policies protect older adults with advanced chronic kidney disease (CKD) from exposure to COVID-19, reduced social interaction may also have unintended consequences. METHODS: To identify subgroups of patients at risk for ...
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Journal articleHosp Pediatr · February 1, 2022
OBJECTIVE: Despite widespread adoption of family-centered rounds, few have investigated differences in the experience of family-centered rounds by family race and ethnicity. The purpose of this study was to explore racial and ethnic differences in caregive ...
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Journal articleJAMA Netw Open · January 4, 2022
IMPORTANCE: Palliative care consultations in intensive care units (ICUs) are increasingly prompted by clinical characteristics associated with mortality or resource utilization. However, it is not known whether these triggers reflect actual palliative care ...
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Journal articleOphthalmol Glaucoma · 2022
PURPOSE: To test the effectiveness of an intervention designed to improve glaucoma medication adherence. DESIGN: Randomized, controlled trial at a Veterans Affairs (VA) eye clinic. PARTICIPANTS: Veterans with medically treated glaucoma who reported poor ad ...
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Journal articleOphthalmol Glaucoma · 2022
PURPOSE: To assess the relationship between health literacy and successful glaucoma drop administration. DESIGN: Substudy of a single-site interventional randomized controlled trial. PARTICIPANTS: Veterans receiving care at the Durham Veterans Affairs Eye ...
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Journal articleHealth Services and Outcomes Research Methodology · December 1, 2021
Methods for identifying heterogeneity of treatment effects in randomized trials have seen recent advances, yet applying these methods to health services intervention trials has not been well investigated. Our objective was to compare two approaches—predict ...
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Journal articlePatient Educ Couns · August 2021
OBJECTIVES: Examine the association of patient perceptions of care with hemoglobin A1c (HbA1c), medication adherence, and missed appointments in non-Hispanic Black (NHB) and White (NHW) patients with type 2 diabetes (T2DM). METHODS: We used linear and logi ...
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Journal articleJ Clin Sleep Med · July 1, 2021
STUDY OBJECTIVES: The objectives of this study were to examine the proportion of study participants screening positive for insomnia disorder and/or sleep apnea in veterans engaged in routine health care and known to be at risk for cardiovascular disease an ...
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Journal articleJ Pain Symptom Manage · June 2021
CONTEXT: Women with metastatic breast cancer (MBC) experience a significant symptom burden, including cancer pain. Yoga is a mind-body discipline that has shown promise for alleviating cancer pain, but few studies have included patients with metastatic dis ...
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Journal articleClin Trials · June 2021
BACKGROUND: Glaucoma treatment requires patients to follow daily, often times complex, eye drop regimens, but adherence is poor for many patients, putting them at risk for irreversible vision loss. A comprehensive approach is needed to address the challeng ...
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Journal articleObes Sci Pract · June 2021
INTRODUCTION: Long-term effects of behavioral weight loss maintenance interventions need to be assessed in order to understand their durability of effects. This can be evaluated with the use of weights recorded in the electronic medical record. The goal of ...
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Journal articleContemp Clin Trials · June 2021
Given the role of effective communication in improving patient adherence and satisfaction, high quality patient-clinician communication is critical. Building on previous communication interventions in oncology and pediatrics, we developed a tailored commun ...
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Journal articleJ Pain Symptom Manage · April 2021
This is a short tutorial on two key questions that pertain to cluster randomized trials (CRTs): 1) Should I perform a CRT? and 2) If so, how do I derive the sample size? In summary, a CRT is the best option when you "must" (e.g., the intervention can only ...
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Journal articleContemp Clin Trials · April 2021
INTRODUCTION: The technologies used to treat the millions who receive care in intensive care unit (ICUs) each year have steadily advanced. However, the quality of ICU-based communication has remained suboptimal, particularly concerning for Black patients a ...
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Journal articleHealth Equity · 2021
Purpose: We explored the association between perception of care, as measured by the Interpersonal Processes of Care (IPC) survey, and patient-level factors, including (1) Trust in physicians; (2) Perceived empathy; (3) Stereotype threat; (4) Perceived ever ...
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Journal articleHealth Equity · 2021
Purpose: Research suggests that providers contribute to racial disparities in health outcomes. Identifying modifiable provider perspectives that are associated with decreased racial disparities will help in the design of effective educational interventions ...
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Journal articlePalliat Support Care · December 2020
OBJECTIVE: Compare the efficacy of two interventions addressing emotional and existential well-being in early life-limiting illness. METHOD: Primary trial analysis (n = 135) included patients with advanced cancer, congestive heart failure, or end-stage ren ...
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Journal articleJAMA Netw Open · December 1, 2020
IMPORTANCE: Bariatric surgical procedures have been associated with increased risk of unhealthy alcohol use, but no previous research has evaluated the long-term alcohol-related risks after laparoscopic sleeve gastrectomy (LSG), currently the most used bar ...
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Journal articleObesity (Silver Spring) · November 2020
OBJECTIVE: This study aimed to compare weight collected at clinics and recorded in the electronic health record (EHR) with primary study-collected trial weights to assess the validity of using EHR data in future pragmatic weight loss or weight gain prevent ...
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Journal articleContemp Clin Trials · November 2020
INTRODUCTION: The number of older adults who receive life support in an intensive care unit (ICU), now 2 million per year, is increasing while survival remains unchanged. Because the quality of ICU-based palliative care is highly variable, we developed a m ...
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Journal articleContemp Clin Trials · September 2020
INTRODUCTION: Although as many as 75% of the >2 million annual intensive care unit (ICU) survivors experience symptoms of psychological distress that persist for months to years, few therapies exist that target their symptoms and accommodate their unique n ...
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Journal articleContemp Clin Trials Commun · September 2020
UNLABELLED: Protocol adherence in behavioral intervention clinical trials is critical to trial success. There is increasing interest in understanding which patients are more likely to adhere to trial protocols. The objective of this study was to demonstrat ...
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Journal articleSurg Obes Relat Dis · August 2020
BACKGROUND: Opioid analgesics are often prescribed to manage pain after bariatric surgery, which may develop into chronic prescription opioid use (CPOU) in opioid-naïve patients. Bariatric surgery may affect opioid use in those with or without presurgical ...
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Journal articleOptom Vis Sci · June 2020
SIGNIFICANCE: Outpatient vision rehabilitation improves function in veterans with vision impairment, but the prevalence of cognitive impairment and the degree to which it may affect rehabilitation outcomes in the Veterans Affairs system are unknown. PURPOS ...
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Journal articleJ Gen Intern Med · May 2020
BACKGROUND: Short-term health care costs following completion of health risk assessments and coaching programs in the VA have not been assessed. OBJECTIVE: To compare VA health care expenditures among veterans who participated in a behavioral intervention ...
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Journal articleHealth Psychol · May 2020
OBJECTIVE: This study describes early-phase development of a behavioral intervention to reduce weight regain following bariatric surgery. We utilized the Obesity-Related Behavioral Intervention Trials model to guide intervention development and evaluation. ...
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Journal articleJAMA Surg · December 1, 2019
IMPORTANCE: Bariatric surgery has been associated with improvements in health in patients with severe obesity; however, it is unclear whether these health benefits translate into lower health care expenditures. OBJECTIVE: To examine 10-year health care exp ...
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Journal articleSupport Care Cancer · November 2019
PURPOSE: Patients with metastatic breast cancer (MBC) experience high levels of symptoms. Yoga interventions have shown promise for improving cancer symptoms but have rarely been tested in patients with advanced disease. This study examined the acceptabili ...
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Journal articleCurr Eye Res · October 2019
Purpose/Aim: To determine if an upper extremity functional survey may identify which patients will have eye drop administration difficulty. Materials and Methods: Participants with glaucoma treated at a Veterans Affairs Eye Clinic who did not self-report 1 ...
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Journal articleContemp Clin Trials Commun · September 2019
In a two-arm randomized trial where both arms receive active treatment (i.e., treatments A and B), often the primary goal is to determine which of the treatments, on average, is more effective. A supplementary objective is to understand possible heterogene ...
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Journal articleJ Palliat Med · September 2019
Advance care planning (ACP) improves end-of-life care for patients and their caregivers. However, only one-third of adults have participated in ACP and rates are substantially lower among African Americans than among whites. Importantly, ACP improves many ...
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Journal articleWomens Health Issues · June 25, 2019
INTRODUCTION: Sex- and gender-specific science is essential to inform patient-centered, evidence-based care. Developing such evidence requires adequate inclusion of both women and men in trials. We sought to describe study participation of women and men in ...
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Journal articleJ Gen Intern Med · April 2019
BACKGROUND: Health coaching is an effective behavior change strategy. Understanding if there is a differential impact of health coaching on patients with low health literacy has not been well investigated. OBJECTIVE: To determine whether a telephone coachi ...
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Journal articleAnn Intern Med · March 5, 2019
BACKGROUND: Treatment decisions commonly have to be made in intensive care units (ICUs). These decisions are difficult for surrogate decision makers and often lead to decisional conflict, psychological distress, and treatments misaligned with patient prefe ...
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Journal articleHealth Sci Rep · March 2019
BACKGROUND AND AIMS: Since May 2011, over 23Â 000 caregivers of Veterans seriously injured on or after September 11, 2001 have enrolled in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC provides caregivers training, a stipend, ...
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Journal articleMed Care Res Rev · February 2019
This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how ...
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Journal articleJ Behav Med · February 2019
Behavioral weight loss interventions are often delivered in groups. Group cohesion may enhance program attendance and, thereby, weight loss. In this secondary analysis, our goals were to: (1a) assess whether group cohesion measured early in a behavioral we ...
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Journal articleThorax · January 2019
BACKGROUND: Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. METHODS: Pilot randomised cli ...
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Journal articleObesity (Silver Spring) · January 2019
OBJECTIVE: This study aims to describe geographic variation in veterans' prevalence of obesity, participation in Veterans Health Administration's behavioral weight management program (MOVE!), and receipt of bariatric surgery in fiscal year (FY) 2016. METHO ...
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Journal articleFront Public Health · 2019
Introduction: In May 2010, the Caregivers and Veterans Omnibus Health Services Act of 2010, was signed into law in the United States, establishing the Program of Comprehensive Assistance for Family Caregivers (PCAFC) provided through the VA Caregiver Suppo ...
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Journal articleEat Weight Disord · October 2018
PURPOSE: Identification of patient characteristics that are associated with behavioral weight loss success among bariatric surgery candidates could inform selection of optimal bariatric surgery candidates. We examined the associations between psychosocial ...
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Journal articleJ Gen Intern Med · September 2018
BACKGROUND: A large proportion of deaths and chronic illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. OBJECTIVE: To test whether telephone-based health coaching after completion of a co ...
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Journal articleHealth Psychol · September 2018
OBJECTIVE: Including partners in interventions to increase physical activity (PA) could promote better adherence and longer-term effects. In preparation for a future large-scale randomized controlled trial (RCT), this randomized pilot trial tested the acce ...
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Journal articleHealth Serv Res · August 2018
OBJECTIVE: To compare different strategies for analyzing longitudinal expenditure data that have a point mass at $0. We provide guidance on parameter interpretation, research questions, and model selection. DATA SOURCES, STUDY DESIGN, AND DATA COLLECTION: ...
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Journal articleAm Heart J · May 2018
BACKGROUND: Comprehensive programs addressing tailored patient self-management and pharmacotherapy may reduce barriers to cardiovascular disease (CVD) risk reduction. METHODS: This is a 2-arm (clinical pharmacist specialist-delivered, telehealth interventi ...
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Journal articleAm J Respir Crit Care Med · January 1, 2018
RATIONALE: Many survivors of critical illness and their family members experience significant psychological distress after patient discharge. OBJECTIVES: To compare the effects of a coping skills training (CST) program with an education program on patient ...
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Journal articleInquiry · 2018
Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and communit ...
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Journal articleBMJ Open Ophthalmol · 2018
OBJECTIVE: To investigate whether electronically measured medication adherence is associated with vision-related quality of life (VRQoL) in patients with open-angle glaucoma. METHODS AND ANALYSIS: This is a 3-year prospective cohort study of 79 subjects wi ...
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Journal articleJ Pain Symptom Manage · December 2017
CONTEXT: Few interventions exist to address patients' existential needs. OBJECTIVES: Determine whether an intervention to address seriously ill patients' existential concerns improves preparation, completion (elements of quality of life [QOL] at end of lif ...
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Journal articleAm J Manag Care · September 1, 2017
OBJECTIVES: Elevated low-density lipoprotein cholesterol (LDL-C) is a major modifiable risk factor for cardiovascular disease, a leading cause of death in the United States. Our goal was to evaluate a simple, scalable, and affordable medication packaging m ...
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Journal articlePsychooncology · July 2017
OBJECTIVE: This study aims to test the feasibility and preliminary efficacy of a couple-based communication intervention for advanced GI cancer delivered via videoconference. METHODS: Thirty-two couples were randomly assigned to either couples communicatio ...
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Journal articleJ Womens Health (Larchmt) · July 2017
BACKGROUND: Compared with men, women have poorer lipid control. Although potential causes of this disparity have been explored, it is unknown whether patient-centered factors such as satisfaction and confidence contribute. We evaluated (1) whether satisfac ...
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Journal articleAnn Intern Med · April 4, 2017
BACKGROUND: Weight regain after successful weight loss interventions is common. OBJECTIVE: To establish the efficacy of a weight loss maintenance program compared with usual care in obese adults. DESIGN: 2-group, parallel, randomized trial stratified by in ...
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Journal articleContemp Clin Trials · April 2017
INTRODUCTION: A large proportion of deaths and many illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. Health risk assessments (HRAs) are widely available online but have not been consist ...
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Journal articleBMC Complement Altern Med · March 13, 2017
BACKGROUND: Women with metastatic breast cancer (MBC) have average life expectancies of about 2Â years, and report high levels of disease-related symptoms including pain, fatigue, sleep disturbance, psychological distress, and functional impairment. There i ...
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Journal articlePatient Educ Couns · March 2017
OBJECTIVE: We tested an uncertainty self-management telephone intervention (SMI) with patients awaiting liver transplant and their caregivers. METHODS: Participants were recruited from four transplant centers and completed questionnaires at baseline, 10, a ...
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Journal articleAm J Med Qual · 2017
Deficiencies in resident diabetes care quality may relate to continuity clinic design. This retrospective analysis compared diabetes care processes and outcomes within a traditional resident continuity clinic structure (2005) and after the implementation o ...
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Journal articleWomens Health Issues · 2017
BACKGROUND: Women veterans are at increased risk for cardiovascular disease (CVD), but little is known about comorbidities and healthcare preferences associated with CVD risk in this population. METHODS: We describe the prevalence of CVD-relevant health be ...
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Journal articleObes Sci Pract · December 2016
OBJECTIVE: A weight loss maintenance trial involving weight loss prior to randomization is challenging to implement due to the potential for dropout and insufficient weight loss. We examined rates and correlates of non-initiation, dropout, and insufficient ...
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Journal articleJAMA Surg · November 1, 2016
IMPORTANCE: Bariatric surgery induces significant weight loss for severely obese patients, but there is limited evidence of the durability of weight loss compared with nonsurgical matches and across bariatric procedures. OBJECTIVES: To examine 10-year weig ...
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Journal articlePalliat Support Care · October 2016
OBJECTIVE: When caring for a loved one with a life-limiting illness, a caregiver's own physical, emotional, and spiritual suffering can be profound. While many interventions focus on physical and emotional well-being, few caregiver interventions address ex ...
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Journal articleJ Subst Abuse Treat · October 2016
INTRODUCTION: The primary objective of this project was to examine the effectiveness of an Internet-based smoking cessation intervention combined with a tele-health medication clinic for nicotine replacement therapy (NRT) compared to referral to clinic-bas ...
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Journal articleContemp Clin Trials · September 2016
INTRODUCTION: Smoking is the most preventable cause of morbidity and mortality in U.S. veterans. Rural veterans in particular have elevated risk for smoking and smoking-related illness. However, these veterans underutilize smoking cessation treatment, whic ...
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Journal articleMusculoskeletal Care · June 2016
INTRODUCTION: Decision aids (DAs) can improve multiple decision-making outcomes, but it is not known whether different formats of delivery differ in their effectiveness or acceptability. The present study compared the effectiveness and acceptability of int ...
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Journal articleJ Clin Hypertens (Greenwich) · April 2016
Telemedicine-based medication management improves hypertension control, but has been evaluated primarily in patients with low antihypertensive drug counts. Its impact on patients taking three or more antihypertensive agents is not well-established. To addr ...
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Journal articleSupport Care Cancer · January 2016
PURPOSE: We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients. METHODS: We recruited adult patients in oncology units and t ...
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Journal articleBehav Ther · January 2016
Posttraumatic stress disorder (PTSD) and smoking are often comorbid, and both problems are in need of improved access to evidence-based treatment. The combined approach could address two high-priority problems and increase patient access to both treatments ...
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Journal articleSleep · January 1, 2016
OBJECTIVES: To test a collaborative care model for interfacing sleep specialists with primary care providers to enhance patients' sleep disorders management. METHODS: This study used a randomized, parallel group, clinical intervention trial design. A total ...
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Journal articleJ Ocul Pharmacol Ther · 2016
PURPOSE: Glaucoma medications reduce the risk of progressive visual field loss, but adherence to these medications is often poor. A better understanding of the appropriate metrics for quantifying glaucoma medication adherence is needed. We describe and com ...
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Journal articleJ Behav Med · June 2015
Recent evidence suggests that sleep disturbance may play an important role in the development of cardiovascular disease (CVD). Despite the prevalence of sleep complaints among service members of recent military conflicts, few studies have examined associat ...
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Journal articleJ Manag Care Spec Pharm · June 2015
BACKGROUND: Many patients experience barriers that make it difficult to take cardiovascular disease (CVD)-related medications as prescribed. The Cardiovascular Intervention Improvement Telemedicine Study (CITIES) was a tailored behavioral pharmacist-admini ...
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Journal articleJ Hum Nutr Diet · February 2015
BACKGROUND: Identifying pretreatment dietary habits that are associated with weight-loss intervention outcomes could help guide individuals' selection of weight-loss approach among competing options. A pretreatment factor that may influence weight-loss out ...
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Journal articleJAMA · January 6, 2015
IMPORTANCE: Accumulating evidence suggests that bariatric surgery improves survival among patients with severe obesity, but research among veterans has shown no evidence of benefit. OBJECTIVE: To examine long-term survival in a large multisite cohort of pa ...
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Journal articleContemp Clin Trials · September 2014
BACKGROUND: Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that beh ...
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Journal articleContemp Clin Trials · July 2014
Within the Veterans Health Administration (VHA), the largest integrated health care system in the US, approximately 8.5 million Veteran patients receive informal care. Despite a need for training, half of VHA caregivers report that they have not received t ...
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Journal articleJ Am Geriatr Soc · June 2014
OBJECTIVES: To compare the prevalence and predictors of caregiver esteem and burden during two different stages of care recipients' illnesses-advanced chronic illness and the last year of life. DESIGN: Longitudinal, observational cohort study. SETTING: Com ...
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Journal articleCirc Cardiovasc Qual Outcomes · March 2014
BACKGROUND: Hypertension self-management has been shown to improve systolic blood pressure (BP) control, but longer-term economic and clinical impacts are unknown. The purpose of this article is to examine clinical and economic outcomes 18 months after com ...
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Journal articleTelemed J E Health · February 2014
BACKGROUND: Hypertension, hyperlipidemia, and diabetes are significant, but often preventable, contributors to cardiovascular disease (CVD) risk. Medication and behavioral nonadherence are significant barriers to successful hypertension, hyperlidemia, and ...
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Journal articleWomens Health Issues · 2014
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality for U.S. women. Racial minorities are a particularly vulnerable population. The increasing female veteran population has an higher prevalence of certain cardiovascular risk factors ...
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Journal articleDiabetes Obes Metab · January 2014
We analysed participants with type 2 diabetes (n = 46) within a larger weight loss trial (n = 146) who were randomized to 48 weeks of a low-carbohydrate diet (LCD; n = 22) or a low-fat diet + orlistat (LFD + O; n = 24). At baseline, mean body mass index (B ...
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Journal articleJ Am Geriatr Soc · September 2013
OBJECTIVES: To determine predictors of repeat health service use in older veterans treated and released from the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Veterans Affairs Medical Center (VAMC) EDs. PARTICIPANTS: Nationally re ...
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Journal articleCommunity Ment Health J · August 2013
Consumers' satisfaction with inpatient mental health care is recognized as a key quality indicator that prospectively predicts functional and clinical outcomes. Coercive treatment experience is a frequently cited source of dissatisfaction with inpatient ca ...
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Journal articleAm Heart J · July 2013
BACKGROUND: Cardiovascular disease (CVD) and diabetes account for one-third of the mortality difference between African American and white patients. We evaluated the effect of a CVD risk reduction intervention in African Americans with diabetes. METHODS: W ...
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Journal articlePreventing chronic disease · June 17, 2013
Overweight and obesity are public health issues in the United States, and veterans have a higher rate of overweight and obesity than the general population. Our objective was to examine whether copayment elimination increased use of a weight loss clinic by ...
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Journal articleAm J Crit Care · May 2013
PURPOSE: To describe the association of intensive care with trajectories of functional, emotional, social, and physical well-being in patients with 3 common advanced illnesses. METHODS: Cross-sectional cohort study of 42 patients admitted to the intensive ...
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Journal articlePrev Chronic Dis · April 4, 2013
INTRODUCTION: Overweight and obesity are public health issues in the United States, and veterans have a higher rate of overweight and obesity than the general population. Our objective was to examine whether copayment elimination increased use of a weight ...
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Journal articleAm Heart J · April 2013
BACKGROUND: Patients with co-occurrence of hypertension, hyperlipidemia, and diabetes have an increased risk of cardiovascular disease (CVD) events. Comprehensive programs addressing both tailored patient self-management and pharmacotherapy are needed to a ...
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Journal articleJ Gen Intern Med · January 2013
BACKGROUND: Clinicians have difficulty in identifying patients that are unlikely to adhere to hypertension self-management. Identifying non-adherence is essential to addressing suboptimal blood pressure control and high costs. OBJECTIVES: 1) To identify ri ...
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Journal articleObes Res Clin Pract · 2013
The objective of this study was to identify determinants of significant weight loss one year after gastric bypass surgery among United States veterans. Using data from the Veterans Affairs (VA) Surgical Quality Improvement Program, we identified 516 vetera ...
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Journal articlePreventing chronic disease · 2013
Overweight and obesity are public health issues in the United States, and veterans have a higher rate of overweight and obesity than the general population. Our objective was to examine whether copayment elimination increased use of a weight loss clinic by ...
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Journal articleJ Gen Intern Med · December 2012
BACKGROUND: African Americans are significantly more likely than whites to have uncontrolled hypertension, contributing to significant disparities in cardiovascular disease and events. OBJECTIVE: The goal of this study was to examine whether there were dif ...
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Journal articleJ Pain Symptom Manage · September 2012
CONTEXT: Three important causes of death in the U.S. (cancer, congestive heart failure, and chronic obstructive pulmonary disease) are preceded by long periods of declining health; often, family members provide most care for individuals who are living with ...
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Journal articleHealth Econ · August 2012
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OBJECTIVES: Outpatient visit co-payments have increased in recent years. We estimate the patient response to a price change for specialty care, based on a co-payment increase from $15 to $50 per visit for veterans with hypertension. DESIGN, SETTING, AND PA ...
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Journal articleAm Heart J · June 2012
BACKGROUND: Half of patients with hypertension have poor blood pressure (BP) control. Recent models for treating hypertension have integrated disease monitoring and telephone-based interventions delivered in patients' homes. This study evaluated the costs ...
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Journal articleSleep Med · February 2012
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Missing data, e.g. patient attrition, are endemic in sleep disorder clinical trials. Common approaches for dealing with this situation include complete-case analysis (CCA) and last observation carried forward (LOCF). Although these methods are simple to im ...
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Journal articleAnn Intern Med · November 1, 2011
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BACKGROUND: Quality cancer care requires addressing patients' emotions, which oncologists infrequently do. Multiday courses can teach oncologists skills to handle emotion; however, such workshops are long and costly. OBJECTIVE: To test whether a brief, com ...
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Journal articleArch Gen Psychiatry · October 2011
CONTEXT: Distinctive diagnostic classification schemes for insomnia diagnoses are available, but the optimal insomnia nosology has yet to be determined. OBJECTIVES: To test the reliability and validity of insomnia diagnoses listed in the American Psychiatr ...
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Journal articleHypertension · October 2011
Clinical inertia represents a barrier to hypertension management. As part of a hypertension telemanagement trial designed to overcome clinical inertia, we evaluated study physician reactions to elevated home blood pressures. We studied 296 patients from th ...
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Journal articleJ Pain Symptom Manage · September 2011
CONTEXT: At advanced stages, cancer, congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD) produce high rates of hospitalization, disability, and annual mortality. Despite similar prognoses, patients with cancer often are treated ...
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Journal articlePsychooncology · September 2011
OBJECTIVE: To test the effects of patient and patient-oncologist relationship factors on the time spent communicating about health-related quality of life (HRQOL) during outpatient clinic encounters between oncologists and their patients with advanced canc ...
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Journal articleArch Intern Med · July 11, 2011
BACKGROUND: To determine which of 3 interventions was most effective in improving blood pressure (BP) control, we performed a 4-arm randomized trial with 18-month follow-up at the primary care clinics at a Veterans Affairs Medical Center. METHODS: Eligible ...
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Journal articleJ Gen Intern Med · July 2011
BACKGROUND: Anxiety and depression are common in seriously ill patients and may be associated with spiritual concerns. Little research has examined how concerns in different domains of spirituality are related to anxiety and depression. OBJECTIVE: To exami ...
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Journal articleAnn Intern Med · June 21, 2011
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BACKGROUND: The optimal setting and number of blood pressure (BP) measurements that should be used for clinical decision making and quality reporting are uncertain. OBJECTIVE: To compare strategies for home or clinic BP measurement and their effect on clas ...
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Journal articleAm J Gastroenterol · June 2011
OBJECTIVES: Existing cross-sectional quality measures for colorectal cancer (CRC) screening do not assess longitudinal adherence and thus may overestimate the quality of care. Our goal was to evaluate the adherence to repeated yearly fecal occult blood tes ...
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Journal articleAm J Manag Care · June 1, 2011
OBJECTIVE: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-andrelease ED visit in patients from Veterans Affairs Medical Centers (VAMCs). STUDY DESIGN: Retrospective cohort ...
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Journal articleAmerican Journal of Managed Care · June 1, 2011
Objective: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-and-release ED visit in patients from Veterans Affairs Medical Centers (VAMCs). Study Design: Retrospective cohort ...
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Journal articleAm J Med · May 2011
BACKGROUND: Only one half of Americans have their blood pressure controlled, and there are significant racial differences in blood pressure control. The goal of this study was to examine the effectiveness of 2 patient-directed interventions designed to imp ...
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Journal articleAm Heart J · April 2011
BACKGROUND: Current guidelines recommend global risk assessment to guide vascular risk factor management; however, most provider-patient communication focuses on individual risk factors in isolation. We sought to evaluate the impact of personalized coronar ...
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Journal articleJ Trauma Dissociation · 2011
A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (m ...
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Journal articleSupport Care Cancer · January 2011
PURPOSE: Patients with advanced cancer often experience negative emotion; clinicians' empathic responses can alleviate patient distress. Much is known about how physicians respond to patient emotion; less is known about non-physician clinicians. Given that ...
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Journal articleSupport Care Cancer · November 2010
PURPOSE: Most patients with advanced cancer experience negative emotion. When patients express emotions, oncologists rarely respond empathically. Oncologists may respond more empathically to some patients, and patients may perceive different levels of empa ...
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Journal articleObesity (Silver Spring) · September 2010
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Although obese individuals utilize health care at higher rates than their normal weight counterparts, they may be less likely to receive certain preventive services. We conducted a retrospective cohort study of veterans with visits to 136 national Veterans ...
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Journal articleAm Heart J · August 2010
BACKGROUND: Few telemedicine programs have undergone cost analyses, impeding their implementation into practice. We report on the economic analysis of a nurse-administered intervention designed to improve blood pressure control among hypertensive veterans. ...
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Journal articleImplement Sci · July 16, 2010
BACKGROUND: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success. OBJECTIVES: We describe the design of a 'translational' study that examines the implemen ...
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Journal articlePsychooncology · May 2010
OBJECTIVE: To describe the content and frequency of communication about health-related quality of life (HRQOL) during outpatient encounters between oncologists and their patients with advanced cancer. METHODS: We coded for HRQOL talk in a subset of audio-r ...
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Journal articleAm J Hypertens · February 2010
BACKGROUND: The Take Control of Your Blood Pressure trial evaluated the effect of a multicomponent telephonic behavioral lifestyle intervention, patient self-monitoring, and both interventions combined compared with usual care on reducing systolic blood pr ...
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Journal articleJ Physician Assist Educ · 2010
PURPOSE: Although research shows that empathic communication improves patient outcomes, physicians often fail to respond empathically to patients. Nurses and physician assistants (PAs) may be able to help fill the need for empathic communication. Our study ...
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Journal articleAnn Intern Med · November 17, 2009
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BACKGROUND: Fewer than 40% of persons with hypertension in the United States have adequate blood pressure (BP) control. OBJECTIVE: To compare 2 self-management interventions for improving BP control among hypertensive patients. DESIGN: A 2 x 2 randomized t ...
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Journal articleCrit Care Med · November 2009
OBJECTIVE: To compare prolonged mechanical ventilation decision-makers' expectations for long-term patient outcomes with prospectively observed outcomes and to characterize important elements of the surrogate-physician interaction surrounding prolonged mec ...
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Journal articlePatient Educ Couns · October 2009
OBJECTIVE: Assess use of and reactions to an interactive, tailored CD-ROM to enhance oncologist-patient communication. METHODS: Participating oncologists (n=48) agreed to have patient interactions audio recorded, be randomly assigned to receive/not receive ...
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Journal articleAm Heart J · September 2009
BACKGROUND: Cardiovascular disease (CVD) and diabetes account for over one third of the mortality difference between African Americans and white patients. The increased CVD risk in African Americans is due in large part to the clustering of multiple CVD ri ...
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Journal articlePatient Educ Couns · July 2009
OBJECTIVE: To examine how type and severity of patients' negative emotions influence oncologists' responses and subsequent conversations. METHODS: We analyzed 264 audio-recorded conversations between advanced cancer patients and their oncologists. Conversa ...
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Journal articleAm J Med · July 2009
BACKGROUND: Most patient chronic disease self-management interventions target single-disease outcomes. We evaluated the effect of a tailored hypertension self-management intervention on the unintended targets of glycosylated hemoglobin (HbA1c) and low-dens ...
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Journal articleSleep · April 2009
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OBJECTIVE: This study was conducted to evaluate the efficacy of cognitive behavioral therapy (CBT) against a sleep hygiene education control therapy in patients with primary or comorbid insomnia. DESIGN AND SETTING: Randomized, parallel-group, clinical tri ...
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Journal articleAm Heart J · March 2009
BACKGROUND: Less than one third of the 65 million Americans with hypertension have adequate blood pressure (BP) control. This study examined the effectiveness of 2 interventions for improving patient BP control. METHODS: This was a 2-level (primary care pr ...
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Journal articleJ Telemed Telecare · 2009
We examined the feasibility of using home blood pressure (BP) telemonitoring devices for managing patients with poor BP control. We enrolled 591 subjects with a diagnosis of hypertension. Patients were randomized to usual care (n = 147) or to the intervent ...
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Journal articleStat Med · December 20, 2008
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Frequently, studies are conducted in a real clinic setting. When the outcome of interest is collected longitudinally over a specified period of time, this design can lead to unequally spaced intervals and varying numbers of assessments. In our study, these ...
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Journal articleJ Palliat Med · November 2008
BACKGROUND: Significant palliative care intervention has focused on physical pain and symptom control; yet less empirical evidence supports efforts to address the psychosocial and spiritual dimensions of experience. OBJECTIVE: To evaluate the impact of an ...
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Journal articleBMC Health Serv Res · October 23, 2008
BACKGROUND: Limited literacy is common among patients with chronic conditions and is associated with poor health outcomes. We sought to determine the association between literacy and blood pressure in primary care patients with hypertension and to determin ...
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Journal articleSupport Care Cancer · September 2008
GOALS OF WORK: Advanced cancer patients' perceptions of prognosis, which are often overly optimistic compared to oncologist estimates, influence treatment preferences. The predictors of patients' perceptions and the effect of oncologist communication on pa ...
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Journal articleSupport Care Cancer · July 2008
OBJECTIVE: Cancer patients have high levels of distress, yet oncologists often do not recognize patients' concerns. We sought to describe how patients with advanced cancer verbally express negative emotion to their oncologists. MATERIALS AND METHODS: As pa ...
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Journal articleJ Gen Intern Med · May 2008
OBJECTIVE: The objective of the study was to identify potential explanatory factors for racial differences in blood pressure (BP) control. DESIGN: The design of the study was a cross-sectional study PATIENTS/PARTICIPANTS: The study included 608 patients wi ...
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Journal articleJ Clin Hypertens (Greenwich) · April 2008
The purposes of this study were to determine whether there is a significant correlation between the perceived and actual stroke risk among hypertensive patients and to identify patient characteristics associated with inaccurate estimation of stroke risk. T ...
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Journal articlePatient Educ Couns · March 2008
OBJECTIVE: Evaluating a randomized controlled trial involving a tailored behavioral intervention conducted to improve blood pressure control. METHODS: Adults with hypertension from two outpatient primary care clinics were randomly allocated to receive a nu ...
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Journal articlePrim Care Companion J Clin Psychiatry · 2008
OBJECTIVE: To determine whether a subset of depressive symptoms could be identified to facilitate diagnosis of depression in older adults in primary care. METHOD: Secondary analysis was conducted on 898 participants aged 60 years or older with major depres ...
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Journal articleJ Clin Oncol · December 20, 2007
INTRODUCTION: Cancer care involves addressing patient emotion. When patients express negative emotions, empathic opportunities emerge. When oncologists respond with a continuer statement, which is one that offers empathy and allows patients to continue exp ...
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Journal articleEur J Clin Nutr · December 2007
OBJECTIVE: To examine the effects of low-carbohydrate, ketogenic (LCKD) and low-fat (LFD) diets on acid-base status. DESIGN: Prospective analysis of volunteers from two clinical trials. PARTICIPANTS: Subset of 39 volunteers from a randomized trial comparin ...
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Journal articleInt Psychogeriatr · December 2007
BACKGROUND: Research with nondepressed adults suggests that social networks and social support are stable over the life course until very late age. This may not hold true for older adults with depression. We examined baseline status and trajectories of soc ...
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Journal articleAm Heart J · June 2007
BACKGROUND: Only 31% of Americans with hypertension have their blood pressure (BP) under effective control. We describe a study that tests 3 different interventions in a randomized controlled trial using home BP telemedicine monitoring. METHODS: A sample o ...
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Journal articleInternational Journal of Forensic Mental Health · January 1, 2007
Involuntary psychiatric treatment is sometimes necessary and beneficial, but may also exert negative effects. The impact of involuntary commitment on subsequent mental health treatment experience is poorly understood. We examined whether history of involun ...
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Journal articleCrit Care · 2007
INTRODUCTION: The outcomes of patients ventilated for longer than average are unclear, in part because of the lack of an accepted definition of prolonged mechanical ventilation (PMV). To better understand the implications of PMV provision, we compared one- ...
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Journal articleContemp Clin Trials · January 2007
BACKGROUND: Among the 65 million Americans with hypertension, only approximately 31% have their blood pressure under control (<140/90 mm/Hg). Despite the damaging impact of hypertension and the availability of evidence-based target values for blood pressur ...
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Journal articlePalliat Med · December 2006
BACKGROUND: In order to improve the state of science in palliative care, we must increase our ability to document the real-time experience of patients and families as they traverse the end of life. Yet, frequently, prospective measurement is impeded by dif ...
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Journal articlePalliat Med · December 2006
STUDY OBJECTIVE: Most oncologists have not received adequate training in physician-patient communication, and existing effective courses tend to be time and resource intensive. We are developing and testing a tailored CD-ROM educational intervention that i ...
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Journal articleJ Gen Intern Med · July 2006
BACKGROUND: Integrative medicine is an individualized, patient-centered approach to health, combining a whole-person model with evidence-based medicine. Interventions based in integrative medicine theory have not been tested as cardiovascular risk-reductio ...
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Journal articleInt J Cardiol · June 16, 2006
BACKGROUND: Low-carbohydrate, ketogenic diets (LCKD) are effective for weight loss, but concerns remain regarding cardiovascular risk. The purpose of this study was to determine the effect of an LCKD program on serum lipoprotein subclasses. METHODS: This w ...
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Journal articleJ Clin Rheumatol · June 2006
BACKGROUND AND OBJECTIVES: Few studies have examined patterns of pain and coping among patients with osteoarthritis (OA). This pilot study used a daily diary approach to examine pain and coping strategy use among white and nonwhite veterans with OA. METHOD ...
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Journal articleAm J Med · January 2006
PURPOSE: Poor blood pressure control remains a common problem that contributes to significant cardiovascular morbidity and mortality, particularly among African Americans. We explored antihypertensive medication adherence and other factors that may explain ...
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Journal articleJ Clin Psychiatry · August 2005
BACKGROUND: The purpose of this analysis was to assess rates of symptomatic remission in patients with bipolar mania receiving risperidone in a double-blind, parallel-group, multicenter, placebo-controlled trial conducted in India. METHOD: Two hundred nine ...
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Journal articleJ Gen Intern Med · July 2005
BACKGROUND: Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Clinical trials implement strict protocols, whereas clinical practices and studies that assess quality of care utilize a less rigorous protocol for BP ...
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Journal articleArch Intern Med · June 27, 2005
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BACKGROUND: Increased body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) is a risk factor for coronary heart disease and is associated with lower preventive services utilization. The relationship between BMI ...
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Journal articlePatient Educ Couns · April 2005
OBJECTIVES: A randomized controlled trial involving a nurse administered patient-tailored intervention is being conducted to improve blood pressure (BP) control. METHODS: Veterans with hypertension from an outpatient primary care clinic completed a baselin ...
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Journal articleContemp Clin Trials · April 2005
BACKGROUND: Among the 60 million Americans with hypertension, only approximately 31% have their blood pressure (BP) under control (<140/90 mm Hg). Despite the damaging impact of hypertension and the availability of evidence-based target values for BP, inte ...
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Journal articleGen Hosp Psychiatry · 2005
BACKGROUND: Depression is common in older adults and often coexists with multiple chronic diseases, which may complicate its diagnosis and treatment. OBJECTIVE: To determine whether or not the presence of multiple comorbid medical illnesses affects patient ...
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Journal articleJ Gen Intern Med · December 2004
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BACKGROUND: There is controversy surrounding the issue of whether, and how, to screen adults for type 2 diabetes. Our objective was to measure the incidence of new diabetes among outpatients enrolled in a health care system, and to determine whether hemogl ...
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Journal articleControl Clin Trials · August 2004
BACKGROUND: Racial distribution of clinical trial participants is important because results from these studies serve to define evidence-based practice. This report summarizes the experience of the VA Cooperative Studies Program (CSP) in enrolling white, bl ...
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Journal articleAnn Intern Med · May 18, 2004
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BACKGROUND: Low-carbohydrate diets remain popular despite a paucity of scientific evidence on their effectiveness. OBJECTIVE: To compare the effects of a low-carbohydrate, ketogenic diet program with those of a low-fat, low-cholesterol, reduced-calorie die ...
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Journal articleBehav Sleep Med · 2004
Polysomnography (PSG), the gold standard sleep-assessment methodology, is impractical for many applications. Although alternative assessment methodologies are available, it is not clear which most correlates with PSG measures. This study compared sleep log ...
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Journal articleInt J Geriatr Psychiatry · December 2003
OBJECTIVE: To examine the relationship between depression and hypertension in an elderly population and how psychosocial variables influence this relationship. METHODS: The study included 293 subjects, who met DSM-IV criteria for unipolar depression, and 1 ...
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Journal articleArch Intern Med · September 22, 2003
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BACKGROUND: Complications of Staphylococcus aureus bacteremia (SAB) are often difficult to identify. The ability to accurately predict the likelihood of these complications would impact patient management. This investigation sought to define readily availa ...
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Journal articleJ Womens Health (Larchmt) · May 2003
OBJECTIVE: To examine access to and utilization of primary healthcare services with respect to gender. Greater family and child-rearing responsibilities are possible barriers to healthcare access and utilization for women with HIV infection. METHODS: This ...
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Journal articleDiabetes Care · February 2003
OBJECTIVE: Screening for diabetes has the potential to be an effective intervention, especially if patients have intensive treatment of their newly diagnosed diabetes and comorbid hypertension. We wished to determine the process and quality of diabetes car ...
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Journal articleObes Res · October 2002
OBJECTIVE: Few studies examining the relationship between obesity and health-related quality of life (HRQOL) have used a medical outpatient population or demonstrated a relationship in men. Furthermore, most studies have not adequately considered comorbid ...
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Journal articleDiabetes Care · June 2002
OBJECTIVE: Diagnosis of a chronic illness can have a negative impact on patients' perception of their well-being ("labeling" effect). We sought to determine the effects of a new diagnosis of diabetes, discovered by systematic screening, on patients' health ...
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Journal articleJ Gen Intern Med · January 2002
BACKGROUND: Opportunistic disease screening is the routine, asymptomatic disease screening of patients at the time of a physician encounter for other reasons. While the prevalence of unrecognized diabetes in community populations is well known, the prevale ...
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Journal articleJournal of the American Statistical Association · June 1, 2001
A semicontinuous variable has a portion of responses equal to a single value (typically 0) and a continuous, often skewed, distribution among the remaining values. In cross-sectional analyses, variables of this type may be described by a pair of regression ...
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Journal articleQual Life Res · 2000
The relationship between perceived social support and domain-specific health-related quality of life (HRQOL) was examined in a sample of cardiac catheterization patients after considering age, gender, race, education, and coronary artery disease (CAD) seve ...
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Journal articleMultivariate Behavioral Research · January 1, 1998
Analyses of multivariate data are frequently hampered by missing values. Until recently, the only missing-data methods available to most data analysts have been relatively ad hoc practices such as listwise deletion. Recent dramatic advances in theoretical ...
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