No abstract

The National Spinal Cord Injury Statistical Center estimates 294,000 people in the US live with a spinal cord injury (SCI), with approximately 17,810 new cases each year. Although the physical outcomes associated with SCI have been widely studied, the psychological consequences of sustaining a SCI remain largely unexplored. Scant research has focused on posttraumatic stress disorder (PTSD) in this population, despite prevalence estimates suggesting that up to 60% of individuals with SCI experience PTSD post-injury, compared to only 7% of the general US population. Fortunately, prolonged exposure therapy (PE) is a well-researched and highly effective treatment for PTSD. However, no trauma focused exposure-based therapy for PTSD (e.g. PE) has not yet been tested in a SCI population. Thus, we aim to conduct the first test of an evidence-based intervention for PTSD among patients with SCI. Adults with SCI and PTSD ( N = 60) will be randomly assigned to either: (1) 12-sessions of PE (2–3 sessions per week) or (2) a treatment as usual (TAU) control group who will receive the standard inpatient rehabilitation care for SCI patients. Primary outcomes will be assessed at 0, 6, 10, and 32 weeks.

No abstract

No abstract

No abstract

No abstract

Intro: Respiratory inhalers deliver the mainstay treatments to control and relieve symptoms for individuals with COPD. While these medications are highly efficacious, their real-world effectiveness is limited by poor adherence and/or inhaler technique. Through a partnership with a national insurance company's value based insurance design (VBID) program for patients with COPD we piloted a direct-to-patient 'virtual teach-to-goal' (V-TTG) educational intervention conjunction with pharmacist-based phone calls to determine feasibility and acceptability. Methods: We aimed to enroll n=10 patients with COPD in this pilot study. The intervention consisted of an email with information about how to access the educational modules and one conversation with pharmacists. Pharmacists conducted a brief qualitative interview with patients at the end of their conversation. We obtained adherence to the module using the module platform analytics. This program received quality improvement determination at the University of Chicago. Results: Ten patients were enrolled in October 2020. Of the 10 patients, 9 (90%) completed the pharmacist call, 8 (80%) completed the module, and 8 (80%) completed the post-intervention survey. One of the two that did not complete the module started but did not complete due to it being "too much trouble" and so did not have survey feedback and the other one did not start the module or talk with the pharmacist. Of those completing the module (8/10), 6 used their smartphone and 2 used a computer. The majority of patients thought the module was easy to use (6/8) and would recommend this intervention to a friend (6/8); all patients thought the video demonstration provided value (8/8). The value patients noted included that it is helpful to "have a refresher" (n=2), learned something new (n=4): "learned to wait between sprays if needed twice (n=1)," "learned about spacer (n=2)," and learned I was breathing in too quickly (n=2)," the video length was appropriate (short): "all that people can retain," gained confidence (n=1): "I am more confident in using my inhaler now." In addition to positive feedback, patients had constructive feedback including text was small when using a smart phone (n=2), could not return to change an answer (n=1), and a question was confusing (n=1). Discussion: A direct to consumer/patient inhaler training module was both feasible and acceptable among the majority of patients enrolled in a pilot VBID intervention. Larger studies are needed to determine whether widespread uptake could impact patient outcomes and healthcare utilization.