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  1. Article ; Online: Lowering A1c Through Integrated Behavioral Health Group Visits.

    Marthi, Siddharth / Handy, Jamie / David, Kristin / Kerzer, Martin

    Rhode Island medical journal (2013)

    2021  Volume 104, Issue 1, Page(s) 47–50

    Abstract: Introduction & objective: Suboptimal adherence to medication and lifestyle modification continues to be a problem in diabetic patients in the US. Previous studies have investigated the potential of group educational visits in improving medication ... ...

    Abstract Introduction & objective: Suboptimal adherence to medication and lifestyle modification continues to be a problem in diabetic patients in the US. Previous studies have investigated the potential of group educational visits in improving medication adherence and short-term health outcomes, but few have done so using a biopsychosocial approach in visits. This study aimed to evaluate the effect that group visits, conducted using an integrated behavioral health model at a primary care practice, had on A1c and distress levels in diabetic adults.
    Methods: Using the Diabetic Distress Scale (DDS), 15 adults were identified as having moderate diabetic distress (> 3.0) between December 2016 and May 2017 and invited to attend a group visit in May 2017 to address identified barriers. Of those, nine attended. The group visit, conducted by a psychologist, sought to reduce diabetic distress by targeting behavioral and social factors, including improving social and familial support, using diabetes online forums, and improving mind-body connection. Repeat A1c and DDS measurements for all nine visit participants were collected three months after.
    Results: Group visit participants experienced a decrease in A1c (p=0.011). All nine participants had a decrease in their post-intervention DDS. Of the six patients who had positive DDS screens but did not attend, three had increased A1c, two had no change, one had a decrease, and one did not have a repeat A1c.
    Conclusions: Multidisciplinary group visits targeting the biopsychosocial model may be an efficient supplement to the individual medical visit to further improve control of diabetic distress and short-term morbidity in Rhode Island.
    MeSH term(s) Behavior Therapy ; Diabetes Mellitus ; Glycated Hemoglobin A/analysis ; Humans ; Medication Adherence ; Rhode Island
    Chemical Substances Glycated Hemoglobin A
    Language English
    Publishing date 2021-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 419430-5
    ISSN 2327-2228 ; 0363-7913
    ISSN (online) 2327-2228
    ISSN 0363-7913
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    Zs.A 222: Show issues Location:
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  2. Article ; Online: Defining the Variance: The Current State of Female and URM Concordance of Urology Resident Workforce to the General U.S. Population.

    Marthi, Siddharth / Enemchukwu, Ekene / Thavaseelan, Simone

    Urology

    2021  Volume 162, Page(s) 116–120

    MeSH term(s) Cultural Diversity ; Female ; Humans ; Male ; Minority Groups ; Prospective Studies ; Urology ; Workforce
    Language English
    Publishing date 2021-07-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2021.06.039
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  3. Article: The Twilight Zone: Oxybutynin Overuse Exacerbating Delirium.

    Marthi, Siddharth / Pomerantz, Madison A / Mernan, Andrea J / Berlow, Yosef A

    Journal of geriatric psychiatry and neurology

    2022  Volume 35, Issue 6, Page(s) 840–845

    Abstract: Anticholinergic medications, such as oxybutynin, are first-line pharmacologic therapies in overactive bladder. However, the cognitive adverse effect profiles of frequently used anticholinergic medications are extensive and limit their use in older ... ...

    Abstract Anticholinergic medications, such as oxybutynin, are first-line pharmacologic therapies in overactive bladder. However, the cognitive adverse effect profiles of frequently used anticholinergic medications are extensive and limit their use in older patients. Additionally, many older patients continue on anticholinergic therapy if adverse effects are not self-reported by the patient or detected by the provider.Here, we present a case of a 73-year-old male with a history of major neurocognitive disorder, in which unreported oxybutynin overuse led to repeated delirious states, erratic driving, and subsequent psychiatric hospitalizations. During his hospitalizations, he displayed progressively more linear thought processes and improved insight without clear etiology. After a more thorough history of his medication use was obtained, he disclosed that he would often take additional doses of oxybutynin to prevent incontinence during car rides and had done so prior to recent hospitalizations.Our example highlights the importance of thorough history taking, medication review, reducing polypharmacy, careful patient education about medications with psychiatric adverse effects, and, importantly, the avoidance of anticholinergic medication prescription in older patients.
    MeSH term(s) Male ; Humans ; Aged ; Mandelic Acids/adverse effects ; Urinary Bladder, Overactive/chemically induced ; Urinary Bladder, Overactive/drug therapy ; Cholinergic Antagonists/adverse effects ; Delirium/chemically induced
    Chemical Substances oxybutynin (K9P6MC7092) ; Mandelic Acids ; Cholinergic Antagonists
    Language English
    Publishing date 2022-04-06
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1035760-9
    ISSN 0891-9887
    ISSN 0891-9887
    DOI 10.1177/08919887221090215
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    Zs.A 2631: Show issues Location:
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  4. Article: Predictors of Mortality in Traumatic Intracranial Hemorrhage: A National Trauma Data Bank Study.

    Wu, Esther / Marthi, Siddharth / Asaad, Wael F

    Frontiers in neurology

    2020  Volume 11, Page(s) 587587

    Abstract: Background/Objective: ...

    Abstract Background/Objective:
    Language English
    Publishing date 2020-11-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2020.587587
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  5. Article ; Online: The state of PSA counseling in male-to-female transgender patients in the U.S.

    Marthi, Siddharth / O'Rourke, Timothy K / Tucci, Christopher / Pareek, Gyan / Hyams, Elias

    The Prostate

    2022  Volume 82, Issue 14, Page(s) 1315–1321

    Abstract: Background: Morbidity and mortality from prostate cancer (PCa) are known to vary heavily based on socioeconomic and demographic risk factors. We sought to describe prescreening PSA (prostate-specific antigen) counseling (PPC) rates amongst male-to- ... ...

    Abstract Background: Morbidity and mortality from prostate cancer (PCa) are known to vary heavily based on socioeconomic and demographic risk factors. We sought to describe prescreening PSA (prostate-specific antigen) counseling (PPC) rates amongst male-to-female transgender (MtF-TG) patients and non-TG patients using the behavioral risk factor surveillance system (BRFSS).
    Methods: We used the survey data from 2014, 2016, and 2018 BRFSS and included respondents aged 40-79 years who completed the "PCa screening" and "sexual orientation and gender identity" modules. We analyzed differences in age, education level, income level, marital status, and race/ethnicity using Pearson's χ
    Results: A total of 175,383 respondents were included, of which 0.3% identified as MtF-TG. Overall, 62.4% of respondents reported undergoing PPC. On univariate analysis, PPC rates were lower among MtF-TG respondents when compared to the non-TG group (58.3% vs. 62.4%, p = 0.03). MtF-TG respondents were also more likely to report lower education level (p < 0.01), lower-income level (p < 0.01), and were less likely to be white (p < 0.01) than non-TG respondents. However, multivariate analysis adjusting for these respondent features demonstrated an association between higher income and higher education levels with increased odds of PPC, but no association was demonstrated between MtF-TG status and PPC rates. PPC rates for the MtF-TG and non-TG populations did not change significantly over time.
    Conclusions: Although PPC was less frequently reported among MtF-TG respondents than in the non-TG group on univariate analysis, this association was not demonstrated when controlling for confounders, including education and income levels. Instead, on multivariate analysis, low education and income levels were more predictive of PPC rates. Further research is needed to ensure equivalent access to prescreening counseling for patients across the socioeconomic and gender identity spectrum.
    MeSH term(s) Counseling ; Female ; Gender Identity ; Humans ; Male ; Mass Screening ; Prostate-Specific Antigen ; Transgender Persons/psychology
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2022-06-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604707-5
    ISSN 1097-0045 ; 0270-4137
    ISSN (online) 1097-0045
    ISSN 0270-4137
    DOI 10.1002/pros.24405
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    Zs.A 1608: Show issues Location:
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  6. Article ; Online: Factors associated with a positive experience at US fertility clinics: the male partner perspective.

    Marthi, Siddharth / Shandley, Lisa M / Ismaeel, Nourhan / Anderson-Bialis, Jake / Anderson-Bialis, Deborah / Kawwass, Jennifer F / Hipp, Heather S / Mehta, Akanksha

    Journal of assisted reproduction and genetics

    2023  Volume 40, Issue 6, Page(s) 1317–1328

    Abstract: Objective: To determine factors associated with a positive male patient experience (PMPE) at fertility clinics among male patients.: Design: Cross-sectional study Setting: Not applicable Patients: Male respondents to the FertilityIQ questionnaire ( ... ...

    Abstract Objective: To determine factors associated with a positive male patient experience (PMPE) at fertility clinics among male patients.
    Design: Cross-sectional study Setting: Not applicable Patients: Male respondents to the FertilityIQ questionnaire ( www.fertilityiq.com ) reviewing the first or only US clinic visited between June 2015 and August 2020.
    Interventions: None Main outcome measures: PMPE was defined as a score of 9 or 10 out of 10 to the question, "Would you recommend this fertility clinic to a best friend?". Examined predictors included demographics, payment details, infertility diagnoses, treatment, and outcomes, physician traits, and clinic operations and resources. Multiple imputation was used for missing variables and logistic regression was used to calculate adjusted odds ratios (aORs) for factors associated with PMPE.
    Results: Of the 657 men included, 60.9% reported a PMPE. Men who felt their doctor was trustworthy (aOR 5.01, 95% CI 0.97-25.93), set realistic expectations (aOR 2.73, 95% CI 1.10-6.80), and was responsive to setbacks (aOR 2.43, 95% CI 1.14-5.18) were more likely to report PMPE. Those who achieved pregnancy after treatment were more likely to report PMPE; however, this was no longer significant on multivariate analysis (aOR 1.30, 95% CI 0.68-2.47). Clinic-related factors, including ease of scheduling appointments (aOR 4.03, 95% CI 1.63-9.97) and availability of same-day appointments (aOR 4.93, 95% CI 1.75-13.86), were associated with PMPE on both univariate and multivariate analysis. LGBTQ respondents were more likely to report PMPE, whereas men with a college degree or higher were less likely to report PMPE; however, sexual orientation (aOR 3.09, 95% CI 0.86-11.06) and higher educational level (aOR 0.54, 95% CI 0.30-1.10) were not associated with PMPE on multivariate analysis.
    Conclusion: Physician characteristics and clinic characteristics indicative of well-run administration were the most highly predictive of PMPE. By identifying factors that are associated with a PMPE, clinics may be able to optimize the patient experience and improve the quality of infertility care that they provide for both men and women.
    MeSH term(s) Adult ; Female ; Humans ; Male ; Pregnancy ; Fertility Clinics ; Infertility, Male/therapy ; Sexual Partners ; United States ; Surveys and Questionnaires
    Language English
    Publishing date 2023-06-13
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1112577-9
    ISSN 1573-7330 ; 1058-0468
    ISSN (online) 1573-7330
    ISSN 1058-0468
    DOI 10.1007/s10815-023-02848-2
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    Zs.A 1985: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  7. Article ; Online: Is the Readability of Spine-Related Patient Education Material Improving?: An Assessment of Subspecialty Websites.

    Eltorai, Adam E M / Cheatham, Morgan / Naqvi, Syed S / Marthi, Siddharth / Dang, Victor / Palumbo, Mark A / Daniels, Alan H

    Spine

    2016  Volume 41, Issue 12, Page(s) 1041–1048

    Abstract: Study design: Analysis of spine-related patient education materials (PEMs) from subspecialty websites.: Objective: The aim of this study was to assess the readability of spine-related PEMs and compare to readability data from 2008.: Summary of ... ...

    Abstract Study design: Analysis of spine-related patient education materials (PEMs) from subspecialty websites.
    Objective: The aim of this study was to assess the readability of spine-related PEMs and compare to readability data from 2008.
    Summary of background data: Many spine patients use the Internet for health information. Several agencies recommend that the readability of online PEMs should be no greater than a sixth-grade reading level, as health literacy predicts health-related quality of life outcomes. This study evaluated whether the North American Spine Society (NASS), American Association of Neurological Surgeons (AANS), and American Academy of Orthopaedic Surgeons (AAOS) online PEMs meet recommended readability guidelines for medical information.
    Methods: All publicly accessible spine-related entries within the patient education section of the NASS, AANS, and AAOS websites were analyzed for grade level readability using the Flesch-Kincaid formula. Readability scores were also compared with a similar 2008 analysis. Comparative statistics were performed.
    Results: A total of 125 entries from the subspecialty websites were analyzed. The average (SD) readability of the online articles was grade level 10.7 (2.3). Of the articles, 117 (93.6%) had a readability score above the sixth-grade level. The readability of the articles exceeded the maximum recommended level by an average of 4.7 grade levels (95% CI, 4.292-5.103; P < 0.001). Compared with 2008, the three societies published more spine-related patient education articles (61 vs. 125, P = 0.045) and the average readability level improved from 11.5 to 10.7 (P = 0.018). Of three examined societies, only one showed significant improvement over time.
    Conclusion: Our findings suggest that the spine-related PEMs on the NASS, AAOS, and AANS websites have readability levels that may make comprehension difficult for a substantial portion of the patient population. Although some progress has been made in the readability of PEMs over the past 7 years, additional improvement is necessary.
    Level of evidence: 2.
    MeSH term(s) Health Literacy/methods ; Health Literacy/standards ; Humans ; Internet/standards ; Patient Education as Topic/methods ; Patient Education as Topic/standards ; Reading ; Societies, Medical/standards ; Spinal Diseases/diagnosis ; Spinal Diseases/therapy
    Language English
    Publishing date 2016-03-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 752024-4
    ISSN 1528-1159 ; 0362-2436
    ISSN (online) 1528-1159
    ISSN 0362-2436
    DOI 10.1097/BRS.0000000000001446
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