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Article ; Online: Conservative Kidney Management in Kidney Transplant Populations.

Murakami, Naoka / Reich, Amanda J / Pavlakis, Martha / Lakin, Joshua R

2023 Volume 43, Issue 1, Page(s) 151401

Abstract: Conservative kidney management (CKM) has been increasingly accepted as a therapeutic option for seriously ill patients with advanced chronic kidney disease. CKM is active medical management of advanced chronic kidney disease without dialysis, with a ... ...

Abstract	Conservative kidney management (CKM) has been increasingly accepted as a therapeutic option for seriously ill patients with advanced chronic kidney disease. CKM is active medical management of advanced chronic kidney disease without dialysis, with a focus on delaying the worsening of kidney disease and minimizing symptom burden. CKM may be considered a suitable option for kidney transplant recipients with poorly functioning and declining allografts, defined as patients with low estimated glomerular filtration rate (<20 mL/min per 1.73 m
MeSH term(s)	Humans ; Kidney Transplantation ; Renal Insufficiency, Chronic/surgery ; Renal Insufficiency, Chronic/epidemiology ; Renal Dialysis ; Glomerular Filtration Rate ; Kidney ; Kidney Failure, Chronic/therapy
Language	English
Publishing date	2023-07-25
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604652-6
ISSN	1558-4488 ; 0270-9295
ISSN (online)	1558-4488
ISSN	0270-9295
DOI	10.1016/j.semnephrol.2023.151401
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Article ; Online: Advance Care Planning: The Authors Reply.

Ladin, Keren / Gazarian, Priscilla K / Reich, Amanda J / Weissman, Joel S / Rodgers, Phillip E

Health affairs (Project Hope)

2022 Volume 41, Issue 7, Page(s) 1061

Language	English
Publishing date	2022-07-05
Publishing country	United States
Document type	Letter
ZDB-ID	632712-6
ISSN	1544-5208 ; 0278-2715
ISSN (online)	1544-5208
ISSN	0278-2715
DOI	10.1377/hlthaff.2022.00617
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Article ; Online: Project AquiLá: Community-engaged Planning to Explore the Relationship between Culture and Health.

Sprague Martinez, Linda / Negrón, Rosalyn / Brinkerhoff, Cristina Araujo / Tracy, Natalicia / Troncoso, Magalis / Reich, Amanda J / Eduardo Siqueira, Carlos

Progress in community health partnerships : research, education, and action

2023 Volume 17, Issue 2, Page(s) 307–317

Abstract: Background: Elements of charrette planning were employed to develop and examine the relationship between transnationalism, culture and health.: Objective: This paper describes the partnership, the first two stages of the planning charrette and ... ...

Abstract	Background: Elements of charrette planning were employed to develop and examine the relationship between transnationalism, culture and health. Objective: This paper describes the partnership, the first two stages of the planning charrette and lessons learned. Methods: During charrette planning phase 1 we collected data through social network interviews (n = 58), cultural conversations (n = 88), and photovoice (n = 9). In the second phase we performed five charrette planning meetings. Data were synthesized by the planning team. Lessons learned: The issue centered focus facilitated trust among partners. The holistic, iterative process to planning and interpreting preliminary data provided a deeper understanding of the issues under investigation. Community partners at the table held us accountable to the communities we were studying and infused an undercurrent of social justice in our work. Conclusions: There are advantages in employing a community engaged transdisciplinary team-based approach to the study of transnationalism, culture and health.
MeSH term(s)	Humans ; Animals ; Eagles ; Community-Based Participatory Research ; Communication ; Trust
Language	English
Publishing date	2023-07-18
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2275483-0
ISSN	1557-055X ; 1557-0541
ISSN (online)	1557-055X
ISSN	1557-0541
DOI	10.1353/cpr.2023.a900211
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Article ; Online: A Conduit for a Culturally Competent Consent: Medical Interpreters' Perspectives on Surgical Informed Consent Discussions.

Allar, Benjamin G / Ponce, Cristina / Wallace, James / Ortega, Gezzer / Reich, Amanda J / Gold-Gomez, Shari / Gangadharan, Sidhu P / Kent, Tara S

Annals of surgery

2023

Abstract: Objective: To understand medical interpreter's perspectives on surgical informed consent discussions and provide feedback for surgeons on improving these conversations.: Summary background data: Informed consent is a critical component of patient- ... ...

Abstract	Objective: To understand medical interpreter's perspectives on surgical informed consent discussions and provide feedback for surgeons on improving these conversations. Summary background data: Informed consent is a critical component of patient-centered surgical decision-making. For patients with limited English proficiency (LEP), this conversation may be less thorough, even with a medical interpreter, leaving patients with an inadequate understanding of their diagnosis or treatment options. Methods: A semi-structured interview guide was developed with input from interpreters and a qualitative research expert. We purposively sampled medical interpreters representing multiple languages until thematic saturation was achieved. Participants discussed their experience with the surgical consent discussion and process. Interview transcripts were analyzed using emergent thematic analysis. Results: Among 22 interpreters, there were ten languages represented and an average experience of 15 years (range 4-40 y). Four major themes were identified. First, interpreters consistently described their roles as patient advocates and cultural brokers. Second, interpreters reported unique patient attributes that influence the discussion, often based on patients' cultural values/expectations, anticipated decisional autonomy, and family support. Third, interpreters emphasized the importance of surgeons demonstrating compassion and patience, using simple terminology, conversing around the consent, providing context about the form/process, and initiating a pre-encounter discussion. Finally, interpreters suggested reducing legal terminology on consent forms and translation into other languages. Conclusions: Experienced interpreters highlighted multiple factors associated with effective and culturally tailored informed consent discussions. Surgeons should recognize interpreters' critical and complex roles, be cognizant of cultural variations among patients with LEP, and improve interpersonal and communication skills to facilitate effective understanding.
Language	English
Publishing date	2023-11-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000006160
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Article ; Online: Evidence-Based Medicine in Otolaryngology Part 16: Qualitative and Quantitative Methods-Contrasting and Complementary Approaches.

Ikeda, Allison K / Suarez-Goris, Dany / Reich, Amanda J / Pattisapu, Prasanth / Raol, Nikhila P / Randolph, Gregory W / Shin, Jennifer J

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2023

Abstract: Qualitative methods have been increasingly applied in our literature, providing richness to data and incorporating the nuances of patient and family perspectives. These qualitative research techniques provide breadth and depth beyond what can be gleaned ... ...

Abstract	Qualitative methods have been increasingly applied in our literature, providing richness to data and incorporating the nuances of patient and family perspectives. These qualitative research techniques provide breadth and depth beyond what can be gleaned through quantitative methods alone. When both quantitative and qualitative approaches are coupled, their findings provide complementary information which can further substantiate study conclusions. We thus aim to provide insight into qualitative and quantitative methods in comparison and contrast to each other, as well as guidance on when each approach is most apt. In relation, we also describe mixed methods and the theory supporting their framework. In doing so, we provide the foundation for an ensuing, more detailed exposition of qualitative methods.
Language	English
Publishing date	2023-09-05
Publishing country	England
Document type	Journal Article
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1002/ohn.469
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Article ; Online: Perspectives on Referral Pathways for Timely Head and Neck Cancer Care.

Batool, Sana / Hansen, Elisabeth E / Sethi, Rosh K V / Rettig, Eleni M / Goguen, Laura A / Annino, Donald J / Uppaluri, Ravindra / Edwards, Heather A / Faden, Daniel L / Schnipper, Jeffrey L / Dohan, Daniel / Reich, Amanda J / Bergmark, Regan W

JAMA otolaryngology-- head & neck surgery

2024

Abstract: Importance: Timely diagnosis and treatment are of paramount importance for patients with head and neck cancer (HNC) because delays are associated with reduced survival rates and increased recurrence risk. Prompt referral to HNC specialists is crucial ... ...

Abstract	Importance: Timely diagnosis and treatment are of paramount importance for patients with head and neck cancer (HNC) because delays are associated with reduced survival rates and increased recurrence risk. Prompt referral to HNC specialists is crucial for the timeliness of care, yet the factors that affect the referral and triage pathway remain relatively unexplored. Therefore, to identify barriers and facilitators of timely care, it is important to understand the complex journey that patients undertake from the onset of HNC symptoms to referral for diagnosis and treatment. Objective: To investigate the referral and triage process for patients with HNC and identify barriers to and facilitators of care from the perspectives of patients and health care workers. Design, participants, and setting: This was a qualitative study using semistructured interviews of patients with HNC and health care workers who care for them. Participants were recruited from June 2022 to July 2023 from HNC clinics at 2 tertiary care academic medical centers in Boston, Massachusetts. Data were analyzed from July 2022 to December 2023. Main outcomes and measures: Themes identified from the perspectives of both patients and health care workers on factors that hinder or facilitate the HNC referral and triage process. Results: In total, 72 participants were interviewed including 42 patients with HNC (median [range] age, 60.5 [19.0-81.0] years; 27 [64%] females) and 30 health care workers (median [range] age, 38.5 [20.0-68.0] years; 23 [77%] females). Using thematic analysis, 4 major themes were identified: the HNC referral and triage pathway is fragmented; primary and dental care are critical for timely referrals; efficient interclinician coordination expedites care; and consistent patient-practitioner engagement alleviates patient fear. Conclusions and relevance: These findings describe the complex HNC referral and triage pathway, emphasizing the critical role of initial symptom recognition, primary and dental care, patient information flow, and interclinician and patient-practitioner communication, all of which facilitate prompt HNC referrals.
Language	English
Publishing date	2024-05-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701825-8
ISSN	2168-619X ; 2168-6181
ISSN (online)	2168-619X
ISSN	2168-6181
DOI	10.1001/jamaoto.2024.0917
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Article ; Online: Use of Advance Care Planning Codes Among Transgender Medicare Beneficiaries.

Reich, Amanda J / Manful, Adoma / Candrian, Carey / Semco, Robert S / Ladin, Keren / Prigerson, Holly G / Weissman, Joel S

LGBT health

2022 Volume 9, Issue 7, Page(s) 520–524

Abstract: ... Purpose: ... We examined the use of advance care planning (ACP) among Medicare beneficiaries who were identified as transgender. ... Methods: ... This study is a cross-sectional analysis of Medicare claims from 2016 to 2018, comparing ACP ...

Abstract	*Purpose:* We examined the use of advance care planning (ACP) among Medicare beneficiaries who were identified as transgender. *Methods:* This study is a cross-sectional analysis of Medicare claims from 2016 to 2018, comparing ACP visits between transgender and other beneficiaries. *Results:* Beneficiaries identified as transgender were slightly more likely than those who were dual eligible for Medicaid and Medicare, and the remaining fee-for-service Medicare population, to have received a claim for ACP. However, racial and ethnic differences exist and transgender beneficiaries were more likely to receive an ACP claim from hospice/palliative care clinicians compared with primary care clinicians relative to other beneficiaries. *Conclusions:* Differences in ACP provision may exacerbate disparities in access to ACP benefits faced by transgender patients.
MeSH term(s)	Advance Care Planning ; Aged ; Cross-Sectional Studies ; Fee-for-Service Plans ; Humans ; Medicare ; Transgender Persons ; United States
Language	English
Publishing date	2022-06-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2727303-9
ISSN	2325-8306 ; 2325-8292
ISSN (online)	2325-8306
ISSN	2325-8292
DOI	10.1089/lgbt.2021.0340
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Article ; Online: Disparities in Travel-Related Barriers to Accessing Health Care From the 2017 National Household Travel Survey.

Labban, Muhieddine / Chen, Chang-Rong / Frego, Nicola / Nguyen, David-Dan / Lipsitz, Stuart R / Reich, Amanda J / Rebbeck, Timothy R / Choueiri, Toni K / Kibel, Adam S / Iyer, Hari S / Trinh, Quoc-Dien

JAMA network open

2023 Volume 6, Issue 7, Page(s) e2325291

Abstract: Importance: Geographic access, including mode of transportation, to health care facilities remains understudied.: Objective: To identify sociodemographic factors associated with public vs private transportation use to access health care and identify ... ...

Abstract	Importance: Geographic access, including mode of transportation, to health care facilities remains understudied. Objective: To identify sociodemographic factors associated with public vs private transportation use to access health care and identify the respondent, trip, and community factors associated with longer distance and time traveled for health care visits. Design, setting, and participants: This cross-sectional study used data from the 2017 National Household Travel Survey, including 16 760 trips or a nationally weighted estimate of 5 550 527 364 trips to seek care in the United States. Households that completed the recruitment and retrieval survey for all members aged 5 years and older were included. Data were analyzed between June and August 2022. Exposures: Mode of transportation (private vs public transportation) used to seek care. Main outcomes and measures: Survey-weighted multivariable logistic regression models were used to identify factors associated with public vs private transportation and self-reported distance and travel time. Then, for each income category, an interaction term of race and ethnicity with type of transportation was used to estimate the specific increase in travel burden associated with using public transportation compared a private vehicle for each race category. Results: The sample included 12 092 households and 15 063 respondents (8500 respondents [56.4%] aged 51-75 years; 8930 [59.3%] females) who had trips for medical care, of whom 1028 respondents (6.9%) were Hispanic, 1164 respondents (7.8%) were non-Hispanic Black, and 11 957 respondents (79.7%) were non-Hispanic White. Factors associated with public transportation use included non-Hispanic Black race (compared with non-Hispanic White: adjusted odds ratio [aOR], 3.54 [95% CI, 1.90-6.61]; P < .001) and household income less than $25 000 (compared with ≥$100 000: aOR, 7.16 [95% CI, 3.50-14.68]; P < .001). The additional travel time associated with use of public transportation compared with private vehicle use varied by race and household income, with non-Hispanic Black respondents with income of $25 000 to $49 999 experiencing higher burden associated with public transportation (mean difference, 81.9 [95% CI, 48.5-115.3] minutes) than non-Hispanic White respondents with similar income (mean difference, 25.5 [95% CI, 17.5-33.5] minutes; P < .001). Conclusions and relevance: These findings suggest that certain racial, ethnic, and socioeconomically disadvantaged populations rely on public transportation to seek health care and that reducing delays associated with public transportation could improve care for these patients.
MeSH term(s)	Female ; Humans ; Male ; Cross-Sectional Studies ; Health Services Accessibility ; Surveys and Questionnaires ; Travel ; United States ; Middle Aged ; Aged
Language	English
Publishing date	2023-07-03
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.25291
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Article ; Online: Personal Social Networks and Care-Seeking for Head and Neck Cancer: A Qualitative Study.

Batool, Sana / Hansen, Elisabeth E / Sethi, Rosh K V / Rettig, Eleni M / Goguen, Laura A / Annino, Donald / Uppaluri, Ravindra / Edwards, Heather A / Faden, Daniel L / Dohan, Daniel / Dhand, Amar / Reich, Amanda J / Bergmark, Regan W

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2023 Volume 170, Issue 2, Page(s) 457–467

Abstract: Objectives: To investigate the role of patients' personal social networks (SNs) in accessing head and neck cancer (HNC) care through patients' and health care workers' (HCWs) perspectives.: Study design: Qualitative study.: Setting: Tertiary HNC ... ...

Abstract	Objectives: To investigate the role of patients' personal social networks (SNs) in accessing head and neck cancer (HNC) care through patients' and health care workers' (HCWs) perspectives. Study design: Qualitative study. Setting: Tertiary HNC centers at 2 academic medical centers, including 1 safety net hospital. Methods: Patients with newly diagnosed HNC, and HCWs caring for HNC patients, aged ≥18 years were recruited between June 2022 and July 2023. Semistructured interviews were conducted with both patients and HCWs. Inductive and deductive thematic analysis was performed with 2 coders (κ = 0.82) to analyze the data. Results: The study included 72 participants: 42 patients (mean age 57 years, 64% female, 81% white), and 30 HCWs (mean age 42 years, 77% female, 83% white). Four themes emerged: (1) Patients' SNs facilitate care through various forms of support, (2) patients may hesitate to seek help from their networks, (3) obligations toward SNs may act as barriers to seeking care, and (4) the SN composition and dedication influence care-seeking. Conclusion: Personal SNs play a vital role in prompting early care-seeking among HNC patients. SN-based interventions could enhance care and improve outcomes for HNC patients.
MeSH term(s)	Humans ; Female ; Adolescent ; Adult ; Middle Aged ; Male ; Patient Acceptance of Health Care ; Qualitative Research ; Head and Neck Neoplasms/therapy ; Health Personnel ; Social Networking
Language	English
Publishing date	2023-12-11
Publishing country	England
Document type	Journal Article
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1002/ohn.602
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Article ; Online: Prevalence of unpaid caregiving, pain, and depression in older seriously ill patients undergoing elective surgery.

Hu, Frances Y / Wang, Yihan / Abbas, Muhammad / Bollens-Lund, Evan / Reich, Amanda J / Lipsitz, Stuart R / Gray, Tamryn F / Kim, Dae / Ritchie, Christine / Kelley, Amy S / Cooper, Zara

Journal of the American Geriatrics Society

2023 Volume 71, Issue 7, Page(s) 2151–2162

Abstract: Introduction: Serious illness is a life-limiting condition negatively impacting daily function, quality of life, or excessively straining caregivers. Over 1 million older seriously ill adults undergo major surgery annually, and national guidelines ... ...

Abstract	Introduction: Serious illness is a life-limiting condition negatively impacting daily function, quality of life, or excessively straining caregivers. Over 1 million older seriously ill adults undergo major surgery annually, and national guidelines recommend that palliative care be available to all seriously ill patients. However, the palliative care needs of elective surgical patients are incompletely described. Understanding baseline caregiving needs and symptom burden among seriously ill older surgical patients could inform interventions to improve outcomes. Methods: Using Health and Retirement Study data (2008-2018) linked to Medicare claims, we identified patients ≥66 years who met an established serious illness definition from administrative data and underwent major elective surgery using Agency for Healthcare Research and Quality (AHRQ) criteria. Descriptive analyses were performed for preoperative patient characteristics, including: unpaid caregiving (no or yes); pain (none/mild or moderate/severe); and depression (no, CES-D < 3, or yes, CES-D ≥ 3). Multivariable regression was performed to examine the association between unpaid caregiving, pain, depression, and in-hospital outcomes, including hospital days (days admitted between discharge date and one-year post-discharge), in-hospital complications (no or yes), and discharge destination (home or non-home). Results: Of the 1343 patients, 55.0% were female and 81.6% were non-Hispanic White. Mean age was 78.0 (SD 6.8); 86.9% had ≥2 comorbidities. Before admission, 27.3% of patients received unpaid caregiving. Pre-admission pain and depression were 42.6% and 32.8%, respectively. Baseline depression was significantly associated with non-home discharge (OR 1.6, 95% CI 1.2-2.1, p = 0.003), while baseline pain and unpaid caregiving needs were not associated with in-hospital or post-acute outcomes in multivariable analysis. Conclusions: Prior to elective surgery, older adults with serious illnesses have high unpaid caregiving needs and a prevalence of pain and depression. Baseline depression alone was associated with discharge destinations. These findings highlight opportunities for targeted palliative care interventions throughout the surgical encounter.
MeSH term(s)	Humans ; Female ; Aged ; United States/epidemiology ; Male ; Depression/epidemiology ; Quality of Life ; Prevalence ; Aftercare ; Patient Discharge ; Medicare ; Caregivers ; Pain
Language	English
Publishing date	2023-03-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.18316
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