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  1. Article ; Online: Combination EGFR and RET Inhibition in Acquired Resistance to Osimertinib in EGFR-Mutant NSCLC.

    Freydman, Jessica / Henshaw, Lynnette / Patel, Jasmine V / Smith, Claire E / Everett, Peter C

    The Annals of pharmacotherapy

    2021  Volume 56, Issue 4, Page(s) 503–504

    MeSH term(s) Acrylamides/pharmacology ; Acrylamides/therapeutic use ; Aniline Compounds/pharmacology ; Aniline Compounds/therapeutic use ; Drug Resistance, Neoplasm/genetics ; ErbB Receptors/genetics ; Humans ; Lung Neoplasms/drug therapy ; Lung Neoplasms/genetics ; Mutation ; Protein Kinase Inhibitors/pharmacology ; Protein Kinase Inhibitors/therapeutic use ; Proto-Oncogene Proteins c-ret
    Chemical Substances Acrylamides ; Aniline Compounds ; Protein Kinase Inhibitors ; osimertinib (3C06JJ0Z2O) ; EGFR protein, human (EC 2.7.10.1) ; ErbB Receptors (EC 2.7.10.1) ; Proto-Oncogene Proteins c-ret (EC 2.7.10.1) ; RET protein, human (EC 2.7.10.1)
    Language English
    Publishing date 2021-08-03
    Publishing country United States
    Document type Letter
    ZDB-ID 1101370-9
    ISSN 1542-6270 ; 1060-0280
    ISSN (online) 1542-6270
    ISSN 1060-0280
    DOI 10.1177/10600280211036909
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Effects of a True Prophylactic Treatment on Hippocampal and Amygdala Synaptic Plasticity and Gene Expression in a Rodent Chronic Stress Model of Social Defeat.

    Winzenried, Eric T / Everett, Anna C / Saito, Erin R / Miller, Roxanne M / Johnson, Taylor / Neal, Eliza / Boyce, Zachary / Smith, Calvin / Jensen, Chloe / Kimball, Spencer / Brantley, Adam / Melendez, Gabriel / Moffat, Devin / Davis, Erin / Aponik, Lyndsey / Crofts, Tyler / Dabney, Bryson / Edwards, Jeffrey G

    International journal of molecular sciences

    2023  Volume 24, Issue 13

    Abstract: Post-traumatic stress disorder (PTSD) is a complex stress-related disorder induced by exposure to traumatic stress that is characterized by symptoms of re-experiencing, avoidance, and hyper-arousal. While it is widely accepted that brain regions involved ...

    Abstract Post-traumatic stress disorder (PTSD) is a complex stress-related disorder induced by exposure to traumatic stress that is characterized by symptoms of re-experiencing, avoidance, and hyper-arousal. While it is widely accepted that brain regions involved in emotional regulation and memory-e.g., the amygdala and hippocampus-are dysregulated in PTSD, the pathophysiology of the disorder is not well defined and therefore, pharmacological interventions are extremely limited. Because stress hormones norepinephrine and cortisol (corticosterone in rats) are heavily implicated in the disorder, we explored whether preemptively and systemically antagonizing β-adrenergic and glucocorticoid receptors with propranolol and mifepristone are sufficient to mitigate pathological changes in synaptic plasticity, gene expression, and anxiety induced by a modified social defeat (SD) stress protocol. Young adult, male Sprague Dawley rats were initially pre-screened for anxiety. The rats were then exposed to SD and chronic light stress to induce anxiety-like symptoms. Drug-treated rats were administered propranolol and mifepristone injections prior to and continuing throughout SD stress. Using competitive ELISAs on plasma, field electrophysiology at CA1 of the ventral hippocampus (VH) and the basolateral amygdala (BLA), quantitative RT-PCR, and behavior assays, we demonstrate that our SD stress increased anxiety-like behavior, elevated long-term potentiation (LTP) in the VH and BLA, and altered the expression of mineralocorticoid, glucocorticoid, and glutamate receptors. These measures largely reverted to control levels with the administration of propranolol and mifepristone. Our findings indicate that SD stress increases LTP in the VH and BLA and that prophylactic treatment with propranolol and mifepristone may have the potential in mitigating these and other stress-induced effects.
    MeSH term(s) Rats ; Male ; Animals ; Mifepristone/pharmacology ; Rats, Sprague-Dawley ; Rodentia ; Propranolol/pharmacology ; Social Defeat ; Hippocampus/metabolism ; Neuronal Plasticity ; Amygdala/metabolism ; Gene Expression ; Stress, Psychological/complications
    Chemical Substances Mifepristone (320T6RNW1F) ; Propranolol (9Y8NXQ24VQ)
    Language English
    Publishing date 2023-07-07
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms241311193
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Effects of a True Prophylactic Treatment on Hippocampal and Amygdala Synaptic Plasticity and Gene Expression in a Rodent Chronic Stress Model of Social Defeat

    Eric T. Winzenried / Anna C. Everett / Erin R. Saito / Roxanne M. Miller / Taylor Johnson / Eliza Neal / Zachary Boyce / Calvin Smith / Chloe Jensen / Spencer Kimball / Adam Brantley / Gabriel Melendez / Devin Moffat / Erin Davis / Lyndsey Aponik / Tyler Crofts / Bryson Dabney / Jeffrey G. Edwards

    International Journal of Molecular Sciences, Vol 24, Iss 11193, p

    2023  Volume 11193

    Abstract: Post-traumatic stress disorder (PTSD) is a complex stress-related disorder induced by exposure to traumatic stress that is characterized by symptoms of re-experiencing, avoidance, and hyper-arousal. While it is widely accepted that brain regions involved ...

    Abstract Post-traumatic stress disorder (PTSD) is a complex stress-related disorder induced by exposure to traumatic stress that is characterized by symptoms of re-experiencing, avoidance, and hyper-arousal. While it is widely accepted that brain regions involved in emotional regulation and memory—e.g., the amygdala and hippocampus—are dysregulated in PTSD, the pathophysiology of the disorder is not well defined and therefore, pharmacological interventions are extremely limited. Because stress hormones norepinephrine and cortisol (corticosterone in rats) are heavily implicated in the disorder, we explored whether preemptively and systemically antagonizing β-adrenergic and glucocorticoid receptors with propranolol and mifepristone are sufficient to mitigate pathological changes in synaptic plasticity, gene expression, and anxiety induced by a modified social defeat (SD) stress protocol. Young adult, male Sprague Dawley rats were initially pre-screened for anxiety. The rats were then exposed to SD and chronic light stress to induce anxiety-like symptoms. Drug-treated rats were administered propranolol and mifepristone injections prior to and continuing throughout SD stress. Using competitive ELISAs on plasma, field electrophysiology at CA1 of the ventral hippocampus (VH) and the basolateral amygdala (BLA), quantitative RT-PCR, and behavior assays, we demonstrate that our SD stress increased anxiety-like behavior, elevated long-term potentiation (LTP) in the VH and BLA, and altered the expression of mineralocorticoid, glucocorticoid, and glutamate receptors. These measures largely reverted to control levels with the administration of propranolol and mifepristone. Our findings indicate that SD stress increases LTP in the VH and BLA and that prophylactic treatment with propranolol and mifepristone may have the potential in mitigating these and other stress-induced effects.
    Keywords LTP ; long-term potentiation ; post-traumatic stress disorder ; PTSD ; anxiety ; rat ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 150
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Intraoperative Methylprednisolone and Neurodevelopmental Outcomes in Infants After Cardiac Surgery.

    Zyblewski, Sinai C / Martin, Reneé H / Shipes, Virginia B / Hamlin-Smith, Kasey / Atz, Andrew M / Bradley, Scott M / Kavarana, Minoo N / Mahle, William T / Everett, Allen D / Graham, Eric M

    The Annals of thoracic surgery

    2021  Volume 113, Issue 6, Page(s) 2079–2084

    Abstract: Background: Neurodevelopmental impairment is an important consequence for survivors of surgery for critical congenital heart disease. This study sought to determine whether intraoperative methylprednisolone during neonatal cardiac surgery is associated ... ...

    Abstract Background: Neurodevelopmental impairment is an important consequence for survivors of surgery for critical congenital heart disease. This study sought to determine whether intraoperative methylprednisolone during neonatal cardiac surgery is associated with neurodevelopmental outcomes at 12 months of age and to identify early prognostic variables associated with neurodevelopmental outcomes.
    Methods: We performed a planned secondary analysis of a 2-center, double-blind, randomized, placebo-controlled trial of intraoperative methylprednisolone in neonates undergoing cardiac surgery. A brain injury biomarker was measured during surgery. Bayley Scales of Infant and Toddler Development-III (BSID-III) were performed at 12 months of age. Two-sample t tests and generalized linear models were used.
    Results: There were 129 participants (n = 61 methylprednisolone; n = 68 placebo). There were no significant differences in BSID-III scores and brain injury biomarker levels between treatment groups. Participants who underwent a palliative (versus corrective) procedure had lower mean BSID-III cognitive (101 ± 15 versus 106 ± 14; P = .03) and motor scores (85 ± 18 versus 94 ± 16; P < .01). Longer ventilation time was associated with lower motor scores. Longer cardiac intensive care unit stay was associated with lower cognitive, language, and motor scores. Cardiopulmonary bypass time, aortic cross-clamp time, and deep hypothermic circulatory arrest were not associated with BSID-III scores.
    Conclusions: Neurodevelopmental outcomes were not associated with intraoperative methylprednisolone or intraoperative variables. Participants who underwent a neonatal palliative (versus corrective) procedure had longer cardiac intensive care unit stays and worse neurodevelopmental outcomes at 1 year. This work suggests that interventions focused solely on the operative period may not be associated with a long-term neurodevelopmental benefit.
    MeSH term(s) Biomarkers ; Brain Injuries ; Cardiac Surgical Procedures/adverse effects ; Humans ; Infant ; Infant, Newborn ; Methylprednisolone/therapeutic use ; Neurodevelopmental Disorders/epidemiology ; Neurodevelopmental Disorders/etiology ; Prognosis
    Chemical Substances Biomarkers ; Methylprednisolone (X4W7ZR7023)
    Language English
    Publishing date 2021-04-20
    Publishing country Netherlands
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2021.04.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Primary care provider type: Are there differences in patients' intermediate diabetes outcomes?

    Everett, Christine M / Morgan, Perri / Smith, Valerie A / Woolson, Sandra / Edelman, David / Hendrix, Cristina C / Berkowitz, Theodore / White, Brandolyn / Jackson, George L

    JAAPA : official journal of the American Academy of Physician Assistants

    2019  Volume 32, Issue 6, Page(s) 36–42

    Abstract: Growing demand for services is leading primary care organizations to explore new delivery models. One approach incorporates multiple primary care providers on a team. Effective incorporation of multiple clinicians into teams requires well-defined roles, ... ...

    Abstract Growing demand for services is leading primary care organizations to explore new delivery models. One approach incorporates multiple primary care providers on a team. Effective incorporation of multiple clinicians into teams requires well-defined roles, including the usual provider (who provides the majority of primary care) and supplemental providers (who provide a minority of primary care visits). Using data from the Veterans Health Administration, we examined whether differences in diabetes outcomes exist among patients with different types of primary and supplemental providers (physicians, physician assistants (PAs), and NPs). No clinically meaningful differences were observed based on the profession of the usual provider or supplemental provider, or whether physicians provided supplemental care to patients with PAs or NPs as usual providers. These results suggest that physicians, PAs, and NPs can perform a variety of roles depending on the needs of the organization and patient population.
    MeSH term(s) Aged ; Cholesterol, LDL/metabolism ; Diabetes Mellitus/metabolism ; Diabetes Mellitus/therapy ; Disease Management ; Female ; Glycated Hemoglobin A ; Humans ; Male ; Middle Aged ; Nurse Practitioners ; Outcome Assessment, Health Care ; Patient Care Team ; Physician Assistants ; Physicians, Primary Care ; Primary Health Care/organization & administration ; United States ; United States Department of Veterans Affairs
    Chemical Substances Cholesterol, LDL ; Glycated Hemoglobin A ; hemoglobin A1c protein, human
    Language English
    Publishing date 2019-05-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2415226-2
    ISSN 0893-7400 ; 1547-1896
    ISSN (online) 0893-7400
    ISSN 1547-1896
    DOI 10.1097/01.JAA.0000558239.06875.0b
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: A novel missense mutation in the transcription factor FOXF1 cosegregating with infantile hypertrophic pyloric stenosis in the extended pedigree linked to IHPS5 on chromosome 16q24.

    Everett, Kate V / Ataliotis, Paris / Chioza, Barry A / Shaw-Smith, Charles / Chung, Eddie M K

    Pediatric research

    2017  Volume 81, Issue 4, Page(s) 632–638

    Abstract: ... Results: A single novel substitution in FOXF1 (c.416G>A) predicted to result in a missense mutation ...

    Abstract Background: The aim was to identify susceptibility alleles for infantile hypertrophic pyloric stenosis (IHPS) in a pedigree previously linked to IHPS5 on chromosome 16q24.
    Methods: We screened the positional and functional candidate gene FOXF1 by Sanger sequencing in a single affected individual. All family members for whom DNA was available were genotyped to determine cosegregation status of the putative causal variant. Immunofluorescence studies were performed to compare the cellular localization of wildtype and mutant form of the protein. Transcriptional activity was compared using a luciferase assay.
    Results: A single novel substitution in FOXF1 (c.416G>A) predicted to result in a missense mutation (R139Q) was shown to cosegregate with disease trait. It was not seen in 560 control chromosomes nor has it been reported in ExAC or ESP. The R139Q substitution affects a conserved arginine residue within the DNA-binding domain of FOXF1. The transcriptional activity of the mutant FOXF1 protein is significantly reduced in comparison to wild-type.
    Conclusion: These results provide strong evidence that the R139Q substitution in FOXF1 causes IHPS in this family and imply a novel pathological pathway for the condition. They further support a role for FOXF1 in the regulation of embryonic and neonatal development of the gastro-intestinal tract.
    Language English
    Publishing date 2017-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/pr.2016.244
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Interpersonal continuity of primary care of veterans with diabetes: a cohort study using electronic health record data.

    Everett, Christine M / Morgan, Perri / Smith, Valerie A / Woolson, Sandra / Edelman, David / Hendrix, Cristina C / Berkowitz, Theodore / White, Brandolyn / Jackson, George L

    BMC family practice

    2018  Volume 19, Issue 1, Page(s) 132

    Abstract: Background: Continuity of care is a cornerstone of primary care and is important for patients with chronic diseases such as diabetes. The study objective was to examine patient, provider and contextual factors associated with interpersonal continuity of ...

    Abstract Background: Continuity of care is a cornerstone of primary care and is important for patients with chronic diseases such as diabetes. The study objective was to examine patient, provider and contextual factors associated with interpersonal continuity of care (ICoC) among Veteran's Health Administration (VHA) primary care patients with diabetes.
    Methods: This patient-level cohort study (N = 656,368) used electronic health record data of adult, pharmaceutically treated patients (96.5% male) with diabetes at national VHA primary care clinics in 2012 and 2013. Each patient was assigned a "home" VHA facility as the primary care clinic most frequently visited, and a primary care provider (PCP) within that home clinic who was most often seen. Patient demographic, medical and social complexity variables, provider type, and clinic contextual variables were utilized. We examined the association of ICoC, measured as maintaining the same PCP across both years, with all variables simultaneously using logistic regression fit with generalized estimating equations.
    Results: Among VHA patients with diabetes, 22.3% switched providers between 2012 and 2013. Twelve patient, two provider and two contextual factors were associated with ICoC. Patient characteristics associated with disruptions in ICoC included demographic factors, medical complexity, and social challenges (example: homeless at any time during the year OR = 0.79, CI = 0.75-0.83). However, disruption in ICoC was most likely experienced by patients whose providers left the clinic (OR = 0.09, CI = 0.07-0.11). One contextual factor impacting ICoC included NP regulation (most restrictive NP regulation (OR = 0.79 CI = 0.69-0.97; reference least restrictive regulation).
    Conclusions: ICoC is an important mechanism for the delivery of quality primary care to patients with diabetes. By identifying patient, provider, and contextual factors that impact ICoC, this project can inform the development of interventions to improve continuity of chronic illness care.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Continuity of Patient Care/statistics & numerical data ; Diabetes Mellitus/drug therapy ; Electronic Health Records ; Female ; Humans ; Internship and Residency ; Logistic Models ; Male ; Middle Aged ; Nurse Practitioners ; Personnel Turnover ; Physician Assistants ; Physicians, Primary Care ; United States ; United States Department of Veterans Affairs ; Veterans
    Language English
    Publishing date 2018-07-30
    Publishing country England
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ISSN 1471-2296
    ISSN (online) 1471-2296
    DOI 10.1186/s12875-018-0823-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Implications of altered replication fidelity on the evolution and pathogenesis of coronaviruses.

    Smith, Everett C / Denison, Mark R

    Current opinion in virology

    2012  Volume 2, Issue 5, Page(s) 519–524

    Abstract: RNA virus evolution results from viral replication fidelity and mutational robustness in combination with selection. Recent studies have confirmed the impact of increased fidelity on RNA virus replication and pathogenesis; however, the impact of ... ...

    Abstract RNA virus evolution results from viral replication fidelity and mutational robustness in combination with selection. Recent studies have confirmed the impact of increased fidelity on RNA virus replication and pathogenesis; however, the impact of decreased fidelity is less defined. Coronaviruses have the largest RNA genomes, and encode an exoribonuclease activity that is required for high-fidelity replication. Genetically stable exoribonuclease mutants will allow direct testing of viral mutational tolerance to RNA mutagens and other selective pressures. Recent studies support the hypothesis that coronavirus replication fidelity may result from a multi-protein complex, suggesting multiple pathways to disrupt or alter virus fidelity and diversity, and attenuate pathogenesis.
    MeSH term(s) Animals ; Coronavirus/genetics ; Coronavirus/pathogenicity ; Coronavirus/physiology ; Coronavirus Infections/virology ; Evolution, Molecular ; Genome, Viral ; Humans ; Virus Replication
    Keywords covid19
    Language English
    Publishing date 2012-08-01
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2611378-8
    ISSN 1879-6265 ; 1879-6257
    ISSN (online) 1879-6265
    ISSN 1879-6257
    DOI 10.1016/j.coviro.2012.07.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Utilization and Costs by Primary Care Provider Type: Are There Differences Among Diabetic Patients of Physicians, Nurse Practitioners, and Physician Assistants?

    Smith, Valerie A / Morgan, Perri A / Edelman, David / Woolson, Sandra L / Berkowitz, Theodore S Z / Van Houtven, Courtney H / Hendrix, Cristina C / Everett, Christine M / White, Brandolyn S / Jackson, George L

    Medical care

    2020  Volume 58, Issue 8, Page(s) 681–688

    Abstract: Objective: The objective of this study was to compare health care utilization and costs among diabetes patients with physician, nurse practitioner (NP), or physician assistant (PA) primary care providers (PCPs).: Research design and methods: Cohort ... ...

    Abstract Objective: The objective of this study was to compare health care utilization and costs among diabetes patients with physician, nurse practitioner (NP), or physician assistant (PA) primary care providers (PCPs).
    Research design and methods: Cohort study using Veterans Affairs (VA) electronic health record data to examine the relationship between PCP type and utilization and costs over 1 year in 368,481 adult, diabetes patients. Relationship between PCP type and utilization and costs in 2013 was examined with extensive adjustment for patient and facility characteristics. Emergency department and outpatient analyses used negative binomial models; hospitalizations used logistic regression. Costs were analyzed using generalized linear models.
    Results: PCPs were physicians, NPs, and PAs for 74.9% (n=276,009), 18.2% (n=67,120), and 6.9% (n=25,352) of patients respectively. Patients of NPs and PAs have lower odds of inpatient admission [odds ratio for NP vs. physician 0.90, 95% confidence interval (CI)=0.87-0.93; PA vs. physician 0.92, 95% CI=0.87-0.97], and lower emergency department use (0.67 visits on average for physicians, 95% CI=0.65-0.68; 0.60 for NPs, 95% CI=0.58-0.63; 0.59 for PAs, 95% CI=0.56-0.63). This translates into NPs and PAs having ~$500-$700 less health care costs per patient per year (P<0.0001).
    Conclusions: Expanded use of NPs and PAs in the PCP role for some patients may be associated with notable cost savings. In our cohort, substituting care patterns and creating similar clinical situations in which they practice, NPs and PAs may have reduced costs of care by up to 150-190 million dollars in 2013.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Diabetes Mellitus/economics ; Diabetes Mellitus/psychology ; Female ; Health Personnel/economics ; Health Personnel/standards ; Health Personnel/statistics & numerical data ; Humans ; Male ; Middle Aged ; Nurse Practitioners/economics ; Nurse Practitioners/standards ; Nurse Practitioners/statistics & numerical data ; Patient Acceptance of Health Care/statistics & numerical data ; Physician Assistants/economics ; Physician Assistants/standards ; Physician Assistants/statistics & numerical data ; Physicians/economics ; Physicians/standards ; Physicians/statistics & numerical data ; Primary Health Care/economics ; Primary Health Care/methods ; Primary Health Care/statistics & numerical data ; United States ; United States Department of Veterans Affairs/economics ; United States Department of Veterans Affairs/organization & administration ; United States Department of Veterans Affairs/statistics & numerical data
    Language English
    Publishing date 2020-05-11
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 411646-x
    ISSN 1537-1948 ; 0025-7079
    ISSN (online) 1537-1948
    ISSN 0025-7079
    DOI 10.1097/MLR.0000000000001326
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Impact of primary care usual provider type and provider interdependence on outcomes for patients with diabetes: a cohort study.

    Everett, Christine / Christy, Jacob / Batchelder, Heather / Morgan, Perri A / Docherty, Sharron / Smith, Valerie A / Anderson, John B / Viera, Anthony / Jackson, George L

    BMJ open quality

    2023  Volume 12, Issue 2

    Abstract: Background: Interprofessional primary care (PC) teams are key to the provision of high-quality care. PC providers often 'share' patients (eg, a patient may see multiple providers in the same clinic), resulting in between-visit interdependence between ... ...

    Abstract Background: Interprofessional primary care (PC) teams are key to the provision of high-quality care. PC providers often 'share' patients (eg, a patient may see multiple providers in the same clinic), resulting in between-visit interdependence between providers. However, concern remains that PC provider interdependence will reduce quality of care, causing some organisations to hesitate in creating multiple provider teams. If PC provider teams are formalised, the PC usual provider of care (UPC) type (physician, nurse practitioner (NP) or physician assistant/associate (PA)) should be determined for patients with varying levels of medical complexity.
    Objective: To evaluate the impact of PC provider interdependence, UPC type and patient complexity on diabetes-specific outcomes for adult patients with diabetes.
    Design: Cohort study using electronic health record data from 26 PC practices in central North Carolina, USA.
    Participants: Adult patients with diabetes (N=10 498) who received PC in 2016 and 2017.
    Outcome: Testing for diabetes control, testing for lipid levels, mean glycated haemoglobin (HbA1c) values and mean low-density lipoprotein (LDL) values in 2017.
    Results: Receipt of guideline recommended testing was high (72% for HbA1c and 66% for LDL testing), HbA1c values were 7.5% and LDL values were 88.5 mg/dL. When controlling for a range of patient and panel level variables, increases in PC provider interdependence were not significantly associated with diabetes-specific outcomes. Similarly, there were no significant differences in the diabetes outcomes for patients with NP/PA UPCs when compared with physicians. The number and type of a patient's chronic conditions did impact the receipt of testing, but not average values for HbA1c and LDL.
    Conclusions: A range of UPC types on PC multiple provider teams can deliver guideline-recommended diabetes care. However, the number and type of a patient's chronic conditions alone impacted the receipt of testing, but not average values for HbA1c and LDL.
    MeSH term(s) Adult ; Humans ; Cohort Studies ; Glycated Hemoglobin ; Diabetes Mellitus/therapy ; Ambulatory Care Facilities ; Primary Health Care
    Chemical Substances Glycated Hemoglobin
    Language English
    Publishing date 2023-06-13
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ISSN 2399-6641
    ISSN (online) 2399-6641
    DOI 10.1136/bmjoq-2022-002229
    Database MEDical Literature Analysis and Retrieval System OnLINE

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