Discharge information and support for veterans Receiving Outpatient Care in the Emergency Department: Study design and methods

Hastings, S. Nicole; Betts, Elizabeth; Schmader, Kenneth E.; Weinberger, Morris; Houtven, Courtney Harold Van; Hendrix, Cristina C.; Stechuchak, Karen M.; Weiner, Madeline; Morris, K.; Kessler, Chad; Oddone, Eugene Z.

doi:10.1016/j.cct.2014.10.008

Cited by 6 publications

(12 citation statements)

References 21 publications

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“…These eight trials started recruitment between 2011 and 2014. Of these trials, one included dyads of patients and caregivers (Van Houtven et al, 2014), four targeted cardiovascular disease risk factors including obesity and hypertension (Jackson et al, 2016;Oddone et al, 2017;Voils et al, 2014;Voils et al, 2016;Zullig et al, 2014;Zullig et al, 2015), one addressed smoking cessation (Wilson et al, 2016), one addressed emergency department follow-up (Hastings et al, 2014), and one addressed osteoarthritis of the knee and hip (Allen et al, 2012; Table 1). The mean participant age was 57.7 years for women and 65.9 years for men.…”

Section: Resultsmentioning

confidence: 99%

“…In doing so, we found that the proportion of women ranged from 5.1% to 13.3% at the initial data pull, 4.4%-11.7% for mailed recruitment letters, 4.4%-19.2% during attempted to contact for screening, 3.3%-22.0% of those consented, and 3.3%-22.2% of those participants who completed the final outcome assessment. Five studies consented more than 10% women (Hastings et al, 2014;Oddone et al, 2017;Voils et al, 2014;Wilson et al, 2016;Zullig et al, 2014), and all but one of those targeted conditions that are not inherently tied to the patient's age (e.g., smoking, obesity, inactivity, or emergency department use). The one study that did target age-related conditions, specifically hypertension and hyperlipidemia, also aimed to increase recruitment of women (Zullig et al, 2014).…”

Section: Resultsmentioning

confidence: 99%

“…The one study that did target age-related conditions, specifically hypertension and hyperlipidemia, also aimed to increase recruitment of women (Zullig et al, 2014). Of the five studies with available numbers for participants completing screening and refusals, the proportion of women who refused participation was lower in three studies (Hastings et al, 2014;Oddone et al, 2017;Wilson et al, 2016), similar in one (Allen et al, 2012), and greater in one (Van Houtven et al, 2014). Of those who consented to study participation, 63.2%-100% of women completed the primary outcome assessment compared with 61.4%-99.6% of men; these proportions were generally similar within specific studies (data not shown).…”

Section: Resultsmentioning

confidence: 99%

“…Six of the eight studies required an in-person visit to complete the informed consent process. Two studies had all recruitment processes handled by women study team members (Hastings et al, 2014;Oddone et al, 2017). One study stratified randomization by sex and used a midcourse plan to increase the recruitment of women (Zullig et al, 2014).…”

Section: Resultsmentioning

confidence: 99%

“…All but two studies had women-only interventionists (Wilson et al, 2016;Zullig et al, 2014). Two studies collected primary outcomes via administrative data (Hastings et al, 2014;Van Houtven et al, 2014), five required inperson visits (Allen et al, 2012;Jackson et al, 2016;Oddone et al, 2017;Voils et al, 2014;Zullig et al, 2014), and one used phone and mail methods (Wilson et al, 2016). Across all studies, there were three to five study outcome assessments, but two studies used remote or phone assessments only (Hastings et al, 2014;Wilson et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

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Enrollment and Retention of Men and Women in Health Services Research and Development Trials

Goldstein

Duan-Porter

Alkon

et al. 2019

Women's Health Issues

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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 Department of Veterans Affairs Health Services Research and Development trials. Methods: We identified recent health services research trials from one Health Services Research and Development Center of Innovation and compared the participation of women and men from trial recruitment to study completion. We also calculated the participation to prevalence ratio (PPR) by sex for each trial. Results: We included eight trials that started recruitment between 2011 and 2014. Only one study purposefully attempted to boost the recruitment of women. Overall, the PPR for women ranged from 0.2 to 4.5, with seven studies having a PPR of greater than 1, indicating that women participated in these trials at proportions greater than their prevalence in the disease population within the Department of Veterans Affairs. The PPR for men ranged from 0.8 to 1.1. Retention was best with those studies that used administrative data for final outcomes assessment. No studies provided results stratified by sex or conducted analyses to explore treatment effect by sex. Conclusions: At a single site, women participated in Health Services Research and Development trials at similar or greater rates to men without cross-study efforts to enrich the recruitment or retention of women. Adding strategic recruitment approaches could further boost the proportion of women in Department of Veterans Affairs trials and enable adequately powered sex-based analyses. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health. Sex-and gender-based differences in the pathophysiology, quality of care, and patient experiences of disease require sexand gender-specific science to inform the provision of patientcentered, evidence-based care. For example, when compared with men, women with coronary artery disease are less likely to take statins and antiplatelet medications (Johansen, Hefner, & Foraker, 2015), and respond differently to pharmacologic interventions for pain (Bartley & Fillingim, 2013). Acquiring the evidence needed to optimize patient-centered care for women Supported by the Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Enrollment and Retention of Men and Women in Health Services Research and Development Trials

Goldstein

Duan-Porter

Alkon

et al. 2019

Women's Health Issues

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Discharge Information and Support for Patients Discharged from the Emergency Department: Results from a Randomized Controlled Trial

et al. 2019

Self Cite

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BACKGROUND: Little research has been done on primary care-based models to improve health care use after an emergency department (ED) visit. OBJECTIVE: To examine the effectiveness of a primary care-based, nurse telephone support intervention for Veterans treated and released from the ED. DESIGN: Randomized controlled trial with 1:1 assignment to telephone support intervention or usual care arms (ClinicalTrials.gov: NCT01717976). SETTING: Department of Veterans Affairs Health Care System (VAHCS) in Durham, NC. PARTICIPANTS: Five hundred thirteen Veterans who were at high risk for repeat ED visits. INTERVENTION: The telephone support intervention consisted of two core calls in the week following an ED visit. Call content focused on improving the ED to primary care transition, enhancing chronic disease management, and educating Veterans and family members about VHA and community services. MAIN MEASURES: The primary outcome was repeat ED use within 30 days. KEY RESULTS: Observed rates of repeat ED use at 30 days in usual care and intervention groups were 23.1% and 24.9%, respectively (OR = 1.1; 95% CI = 0.7, 1.7; P = 0.6). The intervention group had a higher rate of having at least 1 primary care visit at 30 days (OR = 1.6, 95% CI = 1.1-2.3). At 180 days, the intervention group had a higher rate of usage of a weight management program (OR = 3.5, 95% CI = 1.6-7.5), diabetes/nutrition (OR = 1.8, 95% CI = 1.0-3.0), and home telehealth services (OR = 1.7, 95% CI = 1.0-2.9) compared with usual care. CONCLUSIONS: A brief primary care-based nurse telephone support program after an ED visit did not reduce repeat ED visits within 30 days, despite intervention participants' increased engagement with primary care and some chronic disease management services.

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Exploring differential response to an emergency department-based care transition intervention

Seidenfeld

Stechuchak

Mahanna

et al. 2021

The American Journal of Emergency Medicine

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Discharge information and support for veterans Receiving Outpatient Care in the Emergency Department: Study design and methods

Cited by 6 publications

References 21 publications

Enrollment and Retention of Men and Women in Health Services Research and Development Trials

Enrollment and Retention of Men and Women in Health Services Research and Development Trials

Discharge Information and Support for Patients Discharged from the Emergency Department: Results from a Randomized Controlled Trial

Exploring differential response to an emergency department-based care transition intervention

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