Trends in neovascular glaucoma management: Practice patterns of glaucoma and retina specialists in the United States

2019 ◽  
Vol 2 ◽  
pp. 7
Author(s):  
Arthi G. Venkat ◽  
Rishi P. Singh ◽  
Jonathan Eisengart ◽  
Ming Hu ◽  
Amy S. Babiuch
Keyword(s):  
Practice Patterns ◽  
Care Delivery ◽  
Management Practice ◽  
Neovascular Glaucoma ◽  
The United States ◽  
Initial Therapy ◽  
Complex Problem ◽  
Survey Study ◽  
Good Visual Acuity ◽  
Anti Vegf

Purpose: To characterize practice patterns between and within retina and glaucoma subspecialists treating neo- vascular glaucoma (NVG). Methods: Preliminary survey study consisting of 8-questions developed based on actual clinical cases presenting to our institution between June 2014 and June 2016. The survey was administered in the form of clinical vignettes and circulated electronically using Survey Monkey ©. to members of the American Glaucoma Society (AGS) and American Society of Retina Specialists (ASRS). Results: 109 glaucoma and 130 retina specialists initiated the survey. For initial management of patients with good visual acuity (VA) and NVG, retina specialists preferred anti-VEGF therapy (P < 0.01) while glaucoma specialists preferred combined anti-VEGF and tube shunt surgery (P < 0.01). Following initial therapy in patients with good VA, glaucoma specialists preferred surgery (P < 0.01) and retina specialists preferred PRP (P < 0.01). In patients with poor VA, PRP and anti-VEGF were equally favored, with a preference for surgery by glaucoma specialists compared to retina specialists (P < 0.01). Conclusion: NVG is a complex problem within the field of ophthalmology that often requires management by both retina and glaucoma specialists. Agreement between both subspecialties for the use of anti-VEGF agents as first line treatment, either alone or in concert with other therapies was noted. Multiple differences exist in next step in therapy and long-term management. Future consensus panels may mitigate discrepancies in NVG management and work toward development of care paths for more efficient care delivery.

Overview of Current Approaches to Aural Rehabilitation for Adults With Cochlear Implants

2020 ◽  
Vol 5 (5) ◽  
pp. 1175-1187
Author(s):  
Rachel Glade ◽  
Erin Taylor ◽  
Deborah S. Culbertson ◽  
Christin Ray
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Cochlear Implants ◽  
Practice Patterns ◽  
The United States ◽  
Care Providers ◽  
Aural Rehabilitation ◽  
Starting Point ◽  
Clinical Models ◽  
Hearing Health

Purpose This clinical focus article provides an overview of clinical models currently being used for the provision of comprehensive aural rehabilitation (AR) for adults with cochlear implants (CIs) in the Unites States. Method Clinical AR models utilized by hearing health care providers from nine clinics across the United States were discussed with regard to interprofessional AR practice patterns in the adult CI population. The clinical models were presented in the context of existing knowledge and gaps in the literature. Future directions were proposed for optimizing the provision of AR for the adult CI patient population. Findings/Conclusions There is a general agreement that AR is an integral part of hearing health care for adults with CIs. While the provision of AR is feasible in different clinical practice settings, service delivery models are variable across hearing health care professionals and settings. AR may include interprofessional collaboration among surgeons, audiologists, and speech-language pathologists with varying roles based on the characteristics of a particular setting. Despite various existing barriers, the clinical practice patterns identified here provide a starting point toward a more standard approach to comprehensive AR for adults with CIs.

Peritoneal Dialysis Use and Practice Patterns: An International Survey Study

2020 ◽  
Author(s):  
Yeoungjee Cho ◽  
Aminu K. Bello ◽  
Adeera Levin ◽  
Meaghan Lunney ◽  
Mohamed A. Osman ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Practice Patterns ◽  
Survey Study ◽  
International Survey

A survey of Instagram users with asthma to evaluate the acceptability of a planned clinical trial intervention (Preprint)

2020 ◽  
Author(s):  
Kerry Spitzer ◽  
Brent Heineman ◽  
Marcella Jewell ◽  
Michael Moran ◽  
Peter Lindenauer
Keyword(s):  
United States ◽  
Social Media ◽  
Health Care Providers ◽  
College Education ◽  
The United States ◽  
Survey Study ◽  
Care Providers ◽  
Healthy Behaviors ◽  
Social Media Platforms ◽  
Hispanic White

BACKGROUND Asthma is a chronic lung disease that affects nearly 25 million individuals in the United States. There is a need for more research into the potential for health care providers to leverage existing social media platforms to improve healthy behaviors and support individuals living with chronic health conditions. OBJECTIVE In this study, we assess the willingness of Instagram users with poorly controlled asthma to participate in a pilot study that uses Instagram as a means of providing social and informational support. In addition, we explore the potential for adapting photovoice and digital storytelling to social media. METHODS A survey study of Instagram users living with asthma in the United States, between the ages of 18 to 40. RESULTS Over 3 weeks of recruitment, 457 individuals completed the pre-survey screener; 347 were excluded. Of the 110 people who were eligible and agreed to participate in the study, 82 completed the study survey. Respondents mean age was 21(SD = 5.3). Respondents were 56% female (n=46), 65% (n=53) non-Hispanic white, and 72% (n=59) had at least some college education. The majority of respondents (n = 66, 81%) indicated that they would be willing to participate in the study. CONCLUSIONS Among young-adult Instagram users with asthma there is substantial interest in participating in a study that uses Instagram to connect participants with peers and a health coach in order to share information about self-management of asthma and build social connection.

scholarly journals QOLP-03. NEURO-ONCOLOGY PALLIATIVE CARE SURVEY OF PHYSICIANS IN SUB-SAHARAN AFRICA

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii175-ii175
Author(s):  
Ramya Tadipatri ◽  
Amir Azadi ◽  
Madison Cowdrey ◽  
Samuel Fongue ◽  
Paul Smith ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Delivery ◽  
Cultural Beliefs ◽  
Oral Feeding ◽  
Statistical Testing ◽  
Sub Saharan Africa ◽  
Neurological Deficits ◽  
Survey Study ◽  
Prior Training ◽  
Sub Saharan

Abstract BACKGROUND Early access to palliative care is a critical component of treating patients with advanced cancer, particularly for glioblastoma patients who have low rates of survival despite optimal therapies. Additionally, there are unique considerations for primary brain tumor patients given the need for management of headaches, seizures, and focal neurological deficits. METHODS We conducted a survey of 109 physicians in Sub-Saharan Africa in order to determine level of understanding and skill in providing palliative care, types of palliative care therapies provided, role of cultural beliefs, availability of resources, and challenges faced. Demographic data including age, gender, and prior training was collected and analyzed using ANOVA statistical testing. RESULTS Among the participants, 48% felt comfortable in providing palliative care consultations, 62% have not had prior training, 52% believed that palliative care is only appropriate when there is irreversible deterioration, 62% expressed having access to palliative care, 49% do not have access to liquid opioid agents, 50% stated that cultural beliefs held by the patient or family prevented them from receiving, palliative care, and 23% stated that their own beliefs affected palliative care delivery. Older providers (age &gt; 30) had a clearer understanding of palliative care (p = 0.004), were more comfortable providing consultation (p = 0.052), and were more likely to address mental health (p &lt; 0.001). CONCLUSIONS Palliative care delivery to glioblastoma patients in Sub-Saharan Africa is often delayed until late in the disease course. Barriers to adequate palliative care treatment identified in this survey study include lack of training, limited access to liquid opioid agents, and cultural beliefs. Challenges most often identified by participants were pain management and end-of-life communication skills, but also included patient spirituality and psychological support, anxiety and depression, terminal dyspnea, ethics, and intravenous hydration and non-oral feeding.

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