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Identifying Research Priorities in Adult Day Centers to Support Evidence-Based Care of Vulnerable Older Adults

Sadarangani, Tina; Zagorski, William; Parker, Lauren; Missaelides, Lydia
Adult day centers (ADCs) are essential community resources that allow frail older adults to remain in their communities. Research demonstrates that ADC staff have the capacity to leverage their culturally and socially congruent relationships with clients and caregivers, to deliver evidence-based interventions that improve health outcomes. Yet, they remain a largely overlooked neighborhood resource for older adults with complex health care needs. The National Adult Day Services Association (NADSA) created a multistakeholder work group to identify priority areas for research to enhance the quality of services offered in ADCs and the delivery of evidence-based practices to clients. This perspective piece, which presents the workgroup's findings in the form of key research priorities, is intended as practical guide for researchers seeking to align their research questions with the needs of ADCs and those they serve. In addition to identifying areas of further exploration, we discuss current studies being undertaken within the ADC setting.
PMID: 33775968
ISSN: 1557-055x
CID: 4862272

Working Upstream in Advance Care Planning in Pandemic Palliative Care

Zaurova, Milana; Krouss, Mona; Israilov, Sigal; Hart, Louis; Jalon, Hillary; Conley, Georgia; Luong, Khoi; Wei, Eric K; Smeltz, Robert; Frankenthaler, Michael; Nichols, Jeffrey; Cohen, Susan; Suleman, Natasha; Ivanyuk, Marina; Shulman, Pavel; Tala, Osbely; Parker, Lauren; Castor, Tita; Pearlstein, Nicole; Kavanagh, Elizabeth; Cho, Hyung J
PMID: 32706629
ISSN: 2326-5108
CID: 4534282

Recommendations for follow up interval after colonoscopy with inadequate bowel preparation: An analysis from the gi quality improvement consortium (GIQuIC) [Meeting Abstract]

Greenwald, D A; Eisen, G; Bernstein, B B; Pochapin, M B; Schmitt, C M; Holub, J L; Lucas, Williams J; Essex, E; Parker, L
Background: Inadequate bowel preparation is estimated to occur in as many as 25% of colonoscopies, and can lead to adverse outcomes including prolonged examination times, missed lesions of up to 42-48% and an increased rate of complications. Adequacy of bowel preparation is recognized as an important metric when assessing quality of colonoscopy. National guidelines state that when bowel preparation for colonoscopy is considered inadequate, repeat examination should occur within one year. Our aim was to evaluate the timing of recommendation for repeat colonoscopy when inadequate bowel prep was reported using GIQuIC, the GI Quality Improvement Consortium, a large, national clinical gastroenterology data registry. Methods: We performed an analysis of all screening and surveillance colonoscopies among adults age 18-89 reported in GIQuIC during the period from 2010-2017. A standardized data collection tool captured information about bowel preparation quality. GIQuIC prospectively collects patient and procedural information on colonoscopies from over 450 sites across the US. We examined data on colonoscopy where bowel preparation was deemed to be inadequate and then evaluated recommendations for interval follow up. Results: A total of 3,773,519 colonoscopies were analyzed for this study, recorded in the registry between 2010-2017. Inadequate bowel preparation was reported in 201,804 (5.3%). Of these, 127,854 were found on examinations where the indication was screening and 74,220 where the indication was surveillance. The recommendation for follow up interval to be less than one year was made in 25.1% when all examinations were assessed. The rate was 25.6% when only looking at screening exams and 24.2% for surveillance exams. (Table 1) When assessed per physician, data was available for 3582 physicians, and mean performance to recommend follow up in less than one year when poor preparation was noted was 34.2%; median performance was 27.3%. When follow up other than within 1 year was recommended, the recommendation was for none (4.9%), 2 years (5.2%), 3 years (26.7%), 5 years (37.9%), 10 years (11.2%), and other (14.2%) (Table 2) Conclusions: The recommendation for repeat screening or surveillance colonoscopy in less than one year when the index colonoscopy has an inadequate bowel prep is a quality measure in gastroenterology. This study, using data from GIQuIC, demonstrates poor compliance with these guideline recommendations. Given the consequences of poor bowel prep in colonoscopy, including possible missed lesions, repeat examination is recommended soon after the initial procedure, and certainly within one year. Adherence to these guidelines as demonstrated here is low, and this suggests the need to understand factors behind this low adherence, as well as increased education and increased adherence to colorectal cancer screening and surveillance guidelines
EMBASE:622899149
ISSN: 1097-6779
CID: 3193372

Influence of electronic health records and in-office weight management support resources on childhood obesity care

Adhikari, Payal D; Parker, Lauren A; Binns, Helen J; Ariza, Adolfo J
PMID: 21576184
ISSN: 1938-2707
CID: 2118342