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Novel Telecare Approach Transforms Alcohol Use Screening and Treatment in Primary Care Setting
TOPLINE:
A new telephone-based program implemented in a Federally Qualified Health Center (FQHC) demonstrates effectiveness in reducing unhealthy alcohol use among diverse adult patients screened using the Alcohol Use Disorders Identification Test (AUDIT).
METHODOLOGY:
- Researchers implemented a screening and team-based telephonic program within a large FQHC system in Texas in which adult patients were routinely screened using AUDIT-Consumption (AUDIT-C) questions.
- The team-based, telecare-centered program was designed to follow-up positive screening results with full AUDIT assessments and to provide a two-session brief intervention for all patients. Patients with AUDIT scores ≥ 12 received the brief intervention along with a referral for additional support or an assessment for pharmacotherapy prescription.
- The researchers screened 3959 patients between March 2021 and May 2023, of whom 412 patients with positive results were successfully contacted and had their AUDIT completed (mean age, 46 years; 32% women; 86% Hispanic/Latino; 65% preferred Spanish).
- Of these, 29 patients had full AUDIT scores ranging from 0 to 3, 252 had scores between 4 and 12, and 131 had scores > 12.
- Follow-up AUDIT assessments conducted at 3-6 months were completed for 251 patients (26% women; 90% Hispanic/Latino), and those with AUDIT scores ≥ 12 were offered additional treatment options, including telecare services, in-person appointments with the addiction medicine clinic, and/or pharmacotherapy.
TAKEAWAY:
- Among the patients with an initial AUDIT score > 12, 19 received pharmacotherapy and 13 had at least one appointment with the addiction medicine service.
- For patients who completed the initial and final follow-ups, the mean change in AUDIT score was −4.1 (95% CI, −3.4 to −4.7).
- Spanish-speaking patients demonstrated a greater reduction in AUDIT scores than English-speaking patients.
- The mean reduction in the AUDIT score at the 3- to 6-month follow-up was larger in those with initial AUDIT scores > 12 than in those with initial AUDIT scores ≤ 12 (7.99 vs 2.25).
IN PRACTICE:
“Our intervention was delivered outside of traditional office visits and did not disrupt clinic flow or add burden to the practice’s providers, who already face significant challenges in serving this high-needs population,” the authors wrote. “We believe this program offers a template for delivering evidence-based, equitable preventive care for unhealthy alcohol use in a diverse patient population.”
SOURCE:
The study was led by Michael Pignone, MD, MPH, Department of Medicine, Duke University School of Medicine, Durham, North Carolina. It was published online in the Journal of General Internal Medicine.
LIMITATIONS:
The lack of systematic tracking for the unsuccessful attempts at establishing contact limited the understanding of the variations in screening positivity and the subsequent engagement in the program. Program staffing and constraints in the budget limited the ability to reach all potentially interested participants. The absence of a control group made it difficult to attribute the observed reductions in the AUDIT scores solely to the intervention. The data on follow-up were collected from only 61% participants, raising the possibility that those who were not reached may have had different outcomes than those who were successfully contacted.
DISCLOSURES:
The Cancer Prevention and Research Institute of Texas provided funding for this program. The authors reported no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
TOPLINE:
A new telephone-based program implemented in a Federally Qualified Health Center (FQHC) demonstrates effectiveness in reducing unhealthy alcohol use among diverse adult patients screened using the Alcohol Use Disorders Identification Test (AUDIT).
METHODOLOGY:
- Researchers implemented a screening and team-based telephonic program within a large FQHC system in Texas in which adult patients were routinely screened using AUDIT-Consumption (AUDIT-C) questions.
- The team-based, telecare-centered program was designed to follow-up positive screening results with full AUDIT assessments and to provide a two-session brief intervention for all patients. Patients with AUDIT scores ≥ 12 received the brief intervention along with a referral for additional support or an assessment for pharmacotherapy prescription.
- The researchers screened 3959 patients between March 2021 and May 2023, of whom 412 patients with positive results were successfully contacted and had their AUDIT completed (mean age, 46 years; 32% women; 86% Hispanic/Latino; 65% preferred Spanish).
- Of these, 29 patients had full AUDIT scores ranging from 0 to 3, 252 had scores between 4 and 12, and 131 had scores > 12.
- Follow-up AUDIT assessments conducted at 3-6 months were completed for 251 patients (26% women; 90% Hispanic/Latino), and those with AUDIT scores ≥ 12 were offered additional treatment options, including telecare services, in-person appointments with the addiction medicine clinic, and/or pharmacotherapy.
TAKEAWAY:
- Among the patients with an initial AUDIT score > 12, 19 received pharmacotherapy and 13 had at least one appointment with the addiction medicine service.
- For patients who completed the initial and final follow-ups, the mean change in AUDIT score was −4.1 (95% CI, −3.4 to −4.7).
- Spanish-speaking patients demonstrated a greater reduction in AUDIT scores than English-speaking patients.
- The mean reduction in the AUDIT score at the 3- to 6-month follow-up was larger in those with initial AUDIT scores > 12 than in those with initial AUDIT scores ≤ 12 (7.99 vs 2.25).
IN PRACTICE:
“Our intervention was delivered outside of traditional office visits and did not disrupt clinic flow or add burden to the practice’s providers, who already face significant challenges in serving this high-needs population,” the authors wrote. “We believe this program offers a template for delivering evidence-based, equitable preventive care for unhealthy alcohol use in a diverse patient population.”
SOURCE:
The study was led by Michael Pignone, MD, MPH, Department of Medicine, Duke University School of Medicine, Durham, North Carolina. It was published online in the Journal of General Internal Medicine.
LIMITATIONS:
The lack of systematic tracking for the unsuccessful attempts at establishing contact limited the understanding of the variations in screening positivity and the subsequent engagement in the program. Program staffing and constraints in the budget limited the ability to reach all potentially interested participants. The absence of a control group made it difficult to attribute the observed reductions in the AUDIT scores solely to the intervention. The data on follow-up were collected from only 61% participants, raising the possibility that those who were not reached may have had different outcomes than those who were successfully contacted.
DISCLOSURES:
The Cancer Prevention and Research Institute of Texas provided funding for this program. The authors reported no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
TOPLINE:
A new telephone-based program implemented in a Federally Qualified Health Center (FQHC) demonstrates effectiveness in reducing unhealthy alcohol use among diverse adult patients screened using the Alcohol Use Disorders Identification Test (AUDIT).
METHODOLOGY:
- Researchers implemented a screening and team-based telephonic program within a large FQHC system in Texas in which adult patients were routinely screened using AUDIT-Consumption (AUDIT-C) questions.
- The team-based, telecare-centered program was designed to follow-up positive screening results with full AUDIT assessments and to provide a two-session brief intervention for all patients. Patients with AUDIT scores ≥ 12 received the brief intervention along with a referral for additional support or an assessment for pharmacotherapy prescription.
- The researchers screened 3959 patients between March 2021 and May 2023, of whom 412 patients with positive results were successfully contacted and had their AUDIT completed (mean age, 46 years; 32% women; 86% Hispanic/Latino; 65% preferred Spanish).
- Of these, 29 patients had full AUDIT scores ranging from 0 to 3, 252 had scores between 4 and 12, and 131 had scores > 12.
- Follow-up AUDIT assessments conducted at 3-6 months were completed for 251 patients (26% women; 90% Hispanic/Latino), and those with AUDIT scores ≥ 12 were offered additional treatment options, including telecare services, in-person appointments with the addiction medicine clinic, and/or pharmacotherapy.
TAKEAWAY:
- Among the patients with an initial AUDIT score > 12, 19 received pharmacotherapy and 13 had at least one appointment with the addiction medicine service.
- For patients who completed the initial and final follow-ups, the mean change in AUDIT score was −4.1 (95% CI, −3.4 to −4.7).
- Spanish-speaking patients demonstrated a greater reduction in AUDIT scores than English-speaking patients.
- The mean reduction in the AUDIT score at the 3- to 6-month follow-up was larger in those with initial AUDIT scores > 12 than in those with initial AUDIT scores ≤ 12 (7.99 vs 2.25).
IN PRACTICE:
“Our intervention was delivered outside of traditional office visits and did not disrupt clinic flow or add burden to the practice’s providers, who already face significant challenges in serving this high-needs population,” the authors wrote. “We believe this program offers a template for delivering evidence-based, equitable preventive care for unhealthy alcohol use in a diverse patient population.”
SOURCE:
The study was led by Michael Pignone, MD, MPH, Department of Medicine, Duke University School of Medicine, Durham, North Carolina. It was published online in the Journal of General Internal Medicine.
LIMITATIONS:
The lack of systematic tracking for the unsuccessful attempts at establishing contact limited the understanding of the variations in screening positivity and the subsequent engagement in the program. Program staffing and constraints in the budget limited the ability to reach all potentially interested participants. The absence of a control group made it difficult to attribute the observed reductions in the AUDIT scores solely to the intervention. The data on follow-up were collected from only 61% participants, raising the possibility that those who were not reached may have had different outcomes than those who were successfully contacted.
DISCLOSURES:
The Cancer Prevention and Research Institute of Texas provided funding for this program. The authors reported no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
BCG Vaccine May Protect Against Long COVID Symptoms
TOPLINE:
METHODOLOGY:
- A phase 3 clinical trial initiated in early 2020 investigated the effect of the BCG vaccine injected during active infection on COVID-19 progression in adults with mild or moderate COVID-19. The current study summarizes the 6- and 12-month follow-up data with a focus on long-COVID symptoms.
- Patients who tested positive for severe acute respiratory syndrome coronavirus 2 were randomly assigned to receive either 0.1 mL of intradermal BCG (n = 191) or 0.9% saline placebo (n = 202) within 14 days of symptom onset and were followed up at 7, 14, 21, and 45 days and at 6 and 12 months postinjection.
- Overall, 157 BCG (median age, 40 years; 54.1% women) and 142 placebo (median age, 41 years; 65.5% women) recipients completed the 6-month follow-up, and 97 BCG (median age, 37 years; 49.5% women) and 95 placebo (median age, 40 years; 67.4% women) recipients completed the 12-month follow-up.
- The researchers primarily assessed the effect of the BCG vaccine on the development of the symptoms of long COVID at 6 and 12 months.
TAKEAWAY:
- Hearing problems were less frequent among BCG recipients at 6 months compared with those who received placebo (odds ratio [OR], 0.26; 95% CI, 0.045-1.0; P = .044).
- At 12 months, participants who received the BCG vaccine exhibited fewer issues with sleeping (P = .027), concentration (P = .009), memory (P = .009), and vision (P = .022) along with a lower long-COVID score (one-sided Wilcoxon test, P = .002) than those who received placebo.
- At 6 months, BCG demonstrated a sex-specific paradoxical effect on hair loss, decreasing it in men (P = .031), while causing a slight, though statistically nonsignificant, increase in women.
- Male sex was the strongest predictive factor for long COVID, cognitive dysfunction, and cardiopulmonary scores at both follow-up assessments.
IN PRACTICE:
“[The study] findings suggest that BCG immunotherapy for an existing ailment may be superior to prophylaxis in healthy individuals,” the authors wrote.
SOURCE:
The study was led by Mehrsa Jalalizadeh and Keini Buosi, UroScience, State University of Campinas, Unicamp, São Paulo, Brazil. It was published online on November 19, 2024, in the Journal of Internal Medicine.
LIMITATIONS:
Previous mycobacterial exposure was not tested among the study participants. A notable loss to follow-up, particularly at 12 months, may have introduced bias into the results.
DISCLOSURES:
The study was supported by the Coordination for the Improvement of Higher Education Personnel, Federal Government of Brazil, the General Coordination of the National Immunization Program, Ministry of Health (Brazil), and the National Council for Scientific and Technological Development-Research Productivity. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
TOPLINE:
METHODOLOGY:
- A phase 3 clinical trial initiated in early 2020 investigated the effect of the BCG vaccine injected during active infection on COVID-19 progression in adults with mild or moderate COVID-19. The current study summarizes the 6- and 12-month follow-up data with a focus on long-COVID symptoms.
- Patients who tested positive for severe acute respiratory syndrome coronavirus 2 were randomly assigned to receive either 0.1 mL of intradermal BCG (n = 191) or 0.9% saline placebo (n = 202) within 14 days of symptom onset and were followed up at 7, 14, 21, and 45 days and at 6 and 12 months postinjection.
- Overall, 157 BCG (median age, 40 years; 54.1% women) and 142 placebo (median age, 41 years; 65.5% women) recipients completed the 6-month follow-up, and 97 BCG (median age, 37 years; 49.5% women) and 95 placebo (median age, 40 years; 67.4% women) recipients completed the 12-month follow-up.
- The researchers primarily assessed the effect of the BCG vaccine on the development of the symptoms of long COVID at 6 and 12 months.
TAKEAWAY:
- Hearing problems were less frequent among BCG recipients at 6 months compared with those who received placebo (odds ratio [OR], 0.26; 95% CI, 0.045-1.0; P = .044).
- At 12 months, participants who received the BCG vaccine exhibited fewer issues with sleeping (P = .027), concentration (P = .009), memory (P = .009), and vision (P = .022) along with a lower long-COVID score (one-sided Wilcoxon test, P = .002) than those who received placebo.
- At 6 months, BCG demonstrated a sex-specific paradoxical effect on hair loss, decreasing it in men (P = .031), while causing a slight, though statistically nonsignificant, increase in women.
- Male sex was the strongest predictive factor for long COVID, cognitive dysfunction, and cardiopulmonary scores at both follow-up assessments.
IN PRACTICE:
“[The study] findings suggest that BCG immunotherapy for an existing ailment may be superior to prophylaxis in healthy individuals,” the authors wrote.
SOURCE:
The study was led by Mehrsa Jalalizadeh and Keini Buosi, UroScience, State University of Campinas, Unicamp, São Paulo, Brazil. It was published online on November 19, 2024, in the Journal of Internal Medicine.
LIMITATIONS:
Previous mycobacterial exposure was not tested among the study participants. A notable loss to follow-up, particularly at 12 months, may have introduced bias into the results.
DISCLOSURES:
The study was supported by the Coordination for the Improvement of Higher Education Personnel, Federal Government of Brazil, the General Coordination of the National Immunization Program, Ministry of Health (Brazil), and the National Council for Scientific and Technological Development-Research Productivity. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
TOPLINE:
METHODOLOGY:
- A phase 3 clinical trial initiated in early 2020 investigated the effect of the BCG vaccine injected during active infection on COVID-19 progression in adults with mild or moderate COVID-19. The current study summarizes the 6- and 12-month follow-up data with a focus on long-COVID symptoms.
- Patients who tested positive for severe acute respiratory syndrome coronavirus 2 were randomly assigned to receive either 0.1 mL of intradermal BCG (n = 191) or 0.9% saline placebo (n = 202) within 14 days of symptom onset and were followed up at 7, 14, 21, and 45 days and at 6 and 12 months postinjection.
- Overall, 157 BCG (median age, 40 years; 54.1% women) and 142 placebo (median age, 41 years; 65.5% women) recipients completed the 6-month follow-up, and 97 BCG (median age, 37 years; 49.5% women) and 95 placebo (median age, 40 years; 67.4% women) recipients completed the 12-month follow-up.
- The researchers primarily assessed the effect of the BCG vaccine on the development of the symptoms of long COVID at 6 and 12 months.
TAKEAWAY:
- Hearing problems were less frequent among BCG recipients at 6 months compared with those who received placebo (odds ratio [OR], 0.26; 95% CI, 0.045-1.0; P = .044).
- At 12 months, participants who received the BCG vaccine exhibited fewer issues with sleeping (P = .027), concentration (P = .009), memory (P = .009), and vision (P = .022) along with a lower long-COVID score (one-sided Wilcoxon test, P = .002) than those who received placebo.
- At 6 months, BCG demonstrated a sex-specific paradoxical effect on hair loss, decreasing it in men (P = .031), while causing a slight, though statistically nonsignificant, increase in women.
- Male sex was the strongest predictive factor for long COVID, cognitive dysfunction, and cardiopulmonary scores at both follow-up assessments.
IN PRACTICE:
“[The study] findings suggest that BCG immunotherapy for an existing ailment may be superior to prophylaxis in healthy individuals,” the authors wrote.
SOURCE:
The study was led by Mehrsa Jalalizadeh and Keini Buosi, UroScience, State University of Campinas, Unicamp, São Paulo, Brazil. It was published online on November 19, 2024, in the Journal of Internal Medicine.
LIMITATIONS:
Previous mycobacterial exposure was not tested among the study participants. A notable loss to follow-up, particularly at 12 months, may have introduced bias into the results.
DISCLOSURES:
The study was supported by the Coordination for the Improvement of Higher Education Personnel, Federal Government of Brazil, the General Coordination of the National Immunization Program, Ministry of Health (Brazil), and the National Council for Scientific and Technological Development-Research Productivity. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
Study Finds Isotretinoin Effective for Acne in Transgender Patients on Hormone Rx
TOPLINE:
, but more information is needed on dosing and barriers to treatment.
METHODOLOGY:
- Acne can be a side effect of masculinizing hormone therapy for transmasculine individuals. While isotretinoin is an effective treatment option for acne, its effectiveness and safety in transgender and gender-diverse individuals are not well understood.
- This retrospective case series included 55 patients (mean age, 25.4 years) undergoing masculinizing hormone therapy at four medical centers, who were prescribed isotretinoin for acne associated with treatment.
- Isotretinoin treatment was started a median of 22.1 months after hormone therapy was initiated and continued for a median of 6 months with a median cumulative dose of 132.7 mg/kg.
- Researchers assessed acne improvement, clearance, recurrence, adverse effects, and reasons for treatment discontinuation.
TAKEAWAY:
- Overall, 48 patients (87.3%) experienced improvement, and 26 (47.3%) achieved clearance during treatment. A higher proportion of patients experienced improvement (97% vs 72.7%) and achieved clearance (63.6% vs 22.7%) with cumulative doses of ≥ 120 mg/kg than those who received cumulative doses < 120 mg/kg.
- The risk for recurrence was 20% (in four patients) among 20 patients who achieved clearance and had any subsequent health care encounters, with a mean follow-up time of 734.3 days.
- Common adverse effects included dryness (80%), joint pain (14.5%), and headaches (10.9%). Other adverse effects included nose bleeds (9.1%) and depression (5.5%).
- Of the 22 patients with a cumulative dose < 120 mg/kg, 14 (63.6%) were lost to follow-up; among those not lost to follow-up, 2 patients discontinued treatment because of transfer of care, 1 because of adverse effects, and 1 because of gender-affirming surgery, with concerns about wound healing.
IN PRACTICE:
“Although isotretinoin appears to be an effective treatment option for acne among individuals undergoing masculinizing hormone therapy, further efforts are needed to understand optimal dosing and treatment barriers to improve outcomes in transgender and gender-diverse individuals receiving testosterone,” the authors concluded.
SOURCE:
The study, led by James Choe, BS, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, was published online in JAMA Dermatology.
LIMITATIONS:
The study population was limited to four centers, and variability in clinician- and patient-reported acne outcomes and missing information could affect the reliability of data. Because of the small sample size, the association of masculinizing hormone therapy regimens with outcomes could not be evaluated.
DISCLOSURES:
One author is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Three authors reported receiving grants or personal fees from various sources. The other authors declared no conflicts of interest.
A version of this article first appeared on Medscape.com.
TOPLINE:
, but more information is needed on dosing and barriers to treatment.
METHODOLOGY:
- Acne can be a side effect of masculinizing hormone therapy for transmasculine individuals. While isotretinoin is an effective treatment option for acne, its effectiveness and safety in transgender and gender-diverse individuals are not well understood.
- This retrospective case series included 55 patients (mean age, 25.4 years) undergoing masculinizing hormone therapy at four medical centers, who were prescribed isotretinoin for acne associated with treatment.
- Isotretinoin treatment was started a median of 22.1 months after hormone therapy was initiated and continued for a median of 6 months with a median cumulative dose of 132.7 mg/kg.
- Researchers assessed acne improvement, clearance, recurrence, adverse effects, and reasons for treatment discontinuation.
TAKEAWAY:
- Overall, 48 patients (87.3%) experienced improvement, and 26 (47.3%) achieved clearance during treatment. A higher proportion of patients experienced improvement (97% vs 72.7%) and achieved clearance (63.6% vs 22.7%) with cumulative doses of ≥ 120 mg/kg than those who received cumulative doses < 120 mg/kg.
- The risk for recurrence was 20% (in four patients) among 20 patients who achieved clearance and had any subsequent health care encounters, with a mean follow-up time of 734.3 days.
- Common adverse effects included dryness (80%), joint pain (14.5%), and headaches (10.9%). Other adverse effects included nose bleeds (9.1%) and depression (5.5%).
- Of the 22 patients with a cumulative dose < 120 mg/kg, 14 (63.6%) were lost to follow-up; among those not lost to follow-up, 2 patients discontinued treatment because of transfer of care, 1 because of adverse effects, and 1 because of gender-affirming surgery, with concerns about wound healing.
IN PRACTICE:
“Although isotretinoin appears to be an effective treatment option for acne among individuals undergoing masculinizing hormone therapy, further efforts are needed to understand optimal dosing and treatment barriers to improve outcomes in transgender and gender-diverse individuals receiving testosterone,” the authors concluded.
SOURCE:
The study, led by James Choe, BS, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, was published online in JAMA Dermatology.
LIMITATIONS:
The study population was limited to four centers, and variability in clinician- and patient-reported acne outcomes and missing information could affect the reliability of data. Because of the small sample size, the association of masculinizing hormone therapy regimens with outcomes could not be evaluated.
DISCLOSURES:
One author is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Three authors reported receiving grants or personal fees from various sources. The other authors declared no conflicts of interest.
A version of this article first appeared on Medscape.com.
TOPLINE:
, but more information is needed on dosing and barriers to treatment.
METHODOLOGY:
- Acne can be a side effect of masculinizing hormone therapy for transmasculine individuals. While isotretinoin is an effective treatment option for acne, its effectiveness and safety in transgender and gender-diverse individuals are not well understood.
- This retrospective case series included 55 patients (mean age, 25.4 years) undergoing masculinizing hormone therapy at four medical centers, who were prescribed isotretinoin for acne associated with treatment.
- Isotretinoin treatment was started a median of 22.1 months after hormone therapy was initiated and continued for a median of 6 months with a median cumulative dose of 132.7 mg/kg.
- Researchers assessed acne improvement, clearance, recurrence, adverse effects, and reasons for treatment discontinuation.
TAKEAWAY:
- Overall, 48 patients (87.3%) experienced improvement, and 26 (47.3%) achieved clearance during treatment. A higher proportion of patients experienced improvement (97% vs 72.7%) and achieved clearance (63.6% vs 22.7%) with cumulative doses of ≥ 120 mg/kg than those who received cumulative doses < 120 mg/kg.
- The risk for recurrence was 20% (in four patients) among 20 patients who achieved clearance and had any subsequent health care encounters, with a mean follow-up time of 734.3 days.
- Common adverse effects included dryness (80%), joint pain (14.5%), and headaches (10.9%). Other adverse effects included nose bleeds (9.1%) and depression (5.5%).
- Of the 22 patients with a cumulative dose < 120 mg/kg, 14 (63.6%) were lost to follow-up; among those not lost to follow-up, 2 patients discontinued treatment because of transfer of care, 1 because of adverse effects, and 1 because of gender-affirming surgery, with concerns about wound healing.
IN PRACTICE:
“Although isotretinoin appears to be an effective treatment option for acne among individuals undergoing masculinizing hormone therapy, further efforts are needed to understand optimal dosing and treatment barriers to improve outcomes in transgender and gender-diverse individuals receiving testosterone,” the authors concluded.
SOURCE:
The study, led by James Choe, BS, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, was published online in JAMA Dermatology.
LIMITATIONS:
The study population was limited to four centers, and variability in clinician- and patient-reported acne outcomes and missing information could affect the reliability of data. Because of the small sample size, the association of masculinizing hormone therapy regimens with outcomes could not be evaluated.
DISCLOSURES:
One author is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Three authors reported receiving grants or personal fees from various sources. The other authors declared no conflicts of interest.
A version of this article first appeared on Medscape.com.
SCD: Delaying Transition to Adult Care Poses Risks
TOPLINE:
METHODOLOGY:
- Guidelines have recommended that young adults with SCD transfer from pediatric care within 6 months, but many transfers take longer — sometimes up to a year.
- Researchers evaluated the impact of prolonged transition gaps on health outcomes in 183 young adults who completed pediatric care between 2012 and 2018 and were transitioned to an adult care program. Patients were followed for 2-8 years from their first adult care visit.
TAKEAWAY:
- Approximately 88% of patients transferred to adult health care within 6 months, with a median transfer gap of 1.4 months. At 2 years of adult care, patients with a transition gap of 6 months or longer were 89% (relative risk, 1.89) more likely to have an inpatient visit and 75% (RR, 1.75) more likely to have ED visits.
- Those with transfer gaps of 6 months or longer had twice the rate of inpatient visits (rate ratio, 2.01) at 8 years of follow-up, compared with those who transitioned within 2 months.
- However, fewer adult care outpatient visits were seen (5.1 vs 6.7 visits per year) for young adults transferred in 6 or more months versus those within 6 months.
IN PRACTICE:
According to the authors, “longer delays in establishing adult health care following pediatric care were associated with greater acute health care resource utilization and fewer health care maintenance (ie, outpatient) SCD visits. These findings emphasize the importance of swift transfer from pediatric to adult care among young adults with SCD.”
SOURCE:
The study was led by Kristen E. Howell, of the Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, Texas, and was published online in Blood Advances.
LIMITATIONS:
Data was available only for patients within a specific health care system, limiting the generalizability of the findings. Involving only one pediatric and two adult programs could impact findings. Insurance loss or changes due to low income were not accounted for.
DISCLOSURES:
The study was funded by U1EMC19331 and the American Lebanese Syrian Associated Charities. The authors declared no relevant conflicts of interest.
TOPLINE:
METHODOLOGY:
- Guidelines have recommended that young adults with SCD transfer from pediatric care within 6 months, but many transfers take longer — sometimes up to a year.
- Researchers evaluated the impact of prolonged transition gaps on health outcomes in 183 young adults who completed pediatric care between 2012 and 2018 and were transitioned to an adult care program. Patients were followed for 2-8 years from their first adult care visit.
TAKEAWAY:
- Approximately 88% of patients transferred to adult health care within 6 months, with a median transfer gap of 1.4 months. At 2 years of adult care, patients with a transition gap of 6 months or longer were 89% (relative risk, 1.89) more likely to have an inpatient visit and 75% (RR, 1.75) more likely to have ED visits.
- Those with transfer gaps of 6 months or longer had twice the rate of inpatient visits (rate ratio, 2.01) at 8 years of follow-up, compared with those who transitioned within 2 months.
- However, fewer adult care outpatient visits were seen (5.1 vs 6.7 visits per year) for young adults transferred in 6 or more months versus those within 6 months.
IN PRACTICE:
According to the authors, “longer delays in establishing adult health care following pediatric care were associated with greater acute health care resource utilization and fewer health care maintenance (ie, outpatient) SCD visits. These findings emphasize the importance of swift transfer from pediatric to adult care among young adults with SCD.”
SOURCE:
The study was led by Kristen E. Howell, of the Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, Texas, and was published online in Blood Advances.
LIMITATIONS:
Data was available only for patients within a specific health care system, limiting the generalizability of the findings. Involving only one pediatric and two adult programs could impact findings. Insurance loss or changes due to low income were not accounted for.
DISCLOSURES:
The study was funded by U1EMC19331 and the American Lebanese Syrian Associated Charities. The authors declared no relevant conflicts of interest.
TOPLINE:
METHODOLOGY:
- Guidelines have recommended that young adults with SCD transfer from pediatric care within 6 months, but many transfers take longer — sometimes up to a year.
- Researchers evaluated the impact of prolonged transition gaps on health outcomes in 183 young adults who completed pediatric care between 2012 and 2018 and were transitioned to an adult care program. Patients were followed for 2-8 years from their first adult care visit.
TAKEAWAY:
- Approximately 88% of patients transferred to adult health care within 6 months, with a median transfer gap of 1.4 months. At 2 years of adult care, patients with a transition gap of 6 months or longer were 89% (relative risk, 1.89) more likely to have an inpatient visit and 75% (RR, 1.75) more likely to have ED visits.
- Those with transfer gaps of 6 months or longer had twice the rate of inpatient visits (rate ratio, 2.01) at 8 years of follow-up, compared with those who transitioned within 2 months.
- However, fewer adult care outpatient visits were seen (5.1 vs 6.7 visits per year) for young adults transferred in 6 or more months versus those within 6 months.
IN PRACTICE:
According to the authors, “longer delays in establishing adult health care following pediatric care were associated with greater acute health care resource utilization and fewer health care maintenance (ie, outpatient) SCD visits. These findings emphasize the importance of swift transfer from pediatric to adult care among young adults with SCD.”
SOURCE:
The study was led by Kristen E. Howell, of the Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, Texas, and was published online in Blood Advances.
LIMITATIONS:
Data was available only for patients within a specific health care system, limiting the generalizability of the findings. Involving only one pediatric and two adult programs could impact findings. Insurance loss or changes due to low income were not accounted for.
DISCLOSURES:
The study was funded by U1EMC19331 and the American Lebanese Syrian Associated Charities. The authors declared no relevant conflicts of interest.