A5031974487- Renal Transplantation Outcomes and Treatments
- Organ Donation and Transplantation
- Organ Transplantation Techniques and Outcomes
- Liver Disease and Transplantation
- Renal and Vascular Pathologies
- Liver Disease Diagnosis and Treatment
- Emergency and Acute Care Studies
- Neurological Complications and Syndromes
- Healthcare Policy and Management
- Healthcare Systems and Technology
- Pharmacological Effects and Toxicity Studies
- Interprofessional Education and Collaboration
- Dialysis and Renal Disease Management
- Geriatric Care and Nursing Homes
- Pregnancy and Medication Impact
- Stroke Rehabilitation and Recovery
- Primary Care and Health Outcomes
- Transplantation: Methods and Outcomes
- Drug-Induced Hepatotoxicity and Protection
- Telemedicine and Telehealth Implementation
- Hepatitis C virus research
- Palliative Care and End-of-Life Issues
- Nausea and vomiting management
- Clinical Nutrition and Gastroenterology
- Patient Dignity and Privacy
Medical University of South Carolina
2016-2025
Health Resources and Services Administration
2023
Patient-Centered Outcomes Research Institute
2023
National Institute of Diabetes and Digestive and Kidney Diseases
2023
Beth Israel Deaconess Medical Center
2023
University of South Carolina
2023
National Hospital for Neurology and Neurosurgery
2019
University College London
2019
College of Charleston
2018
Wenzhou Medical University
2017
Low tacrolimus concentrations have been associated with higher risk of acute rejection, particularly within African American (AA) kidney transplant recipients; little is known about intrapatient variabilities impact on racial disparities.Ten year, single-center, longitudinal cohort study recipients. Intrapatient variability was assessed using the coefficient variation (CV) measured between 1 month posttransplant and clinical event, a comparable period in those without events. Pediatrics,...
We sought proof of concept a Big Data Solution incorporating longitudinal structured and unstructured patient-level data from electronic health records (EHR) to predict graft loss (GL) mortality. For quality improvement initiative, GL mortality prediction models were constructed using baseline follow-up (0-90 days posttransplant; for 1-year models; up 1 year 3-year models) on adult solitary kidney transplant recipients transplanted during 2007-2015 as follows: Model 1: United Network Organ...
Telehealth may improve access to care for populations in rural communities. However, little is known about the effectiveness of telehealth programs designed children.To examine associations a school-based program Williamsburg county (South Carolina) with all-cause emergency department (ED) visits made by children enrolled Medicaid.This Medicaid claims data analysis was conducted and 4 surrounding counties South Carolina included aged 3 17 years who were living any 5 from January 2012...
Background and objectives Medication safety events are predominant contributors to suboptimal graft outcomes in kidney transplant recipients. The goal of this study was examine the efficacy improving medication through a pharmacist-led, mobile health–based intervention. Design, setting, participants, & measurements This 12-month, single-center, prospective, parallel, two-arm, single-blind, randomized controlled trial. Adult recipients 6–36 months post-transplant were eligible....
This was an economic analysis of a 12-month, parallel arm, randomized controlled trial in adult kidney recipients 6 to 36 months posttransplant (NCT03247322). All participants received usual care, while the intervention arm supplemental clinical pharmacist-led medication therapy monitoring and management, via smartphone-enabled mHealth app, integrated with risk-based televisits. Hospitalization charges were captured from study institution accounts payable non-study hospitalization estimated...
Abstract Purpose Nonadherence is a leading cause of death-censored allograft loss in kidney transplant recipients. Strong associations have tied tacrolimus intrapatient variability (IPV) to degree nonadherence and high IPV clinical endpoints such as rejection loss. dynamic, complex problem best targeted by multidimensional interventions, including mobile health (mHealth) technologies. Methods This was secondary planned analysis 12-month, parallel, 2-arm, semiblind, 1:1 randomized controlled...
A small but significant number of patients make frequent emergency department (ED) visits to multiple EDs within a region. We have unique health information exchange (HIE) that includes every ED encounter in all hospital systems our Using HIE we were able characterize users region, regardless visited or payer class. The objective study was use data from an region who are (FEDUs).We constructed database cohort adult (18 years old older) with regional for 1-year period beginning April 2012....
Moral distress affects workplace environment, burnout, employee retention, and patient safety. Palliative care is frequently involved in complex for patients that may cause moral among staff. The goal of this study was to measure change nurses after implementation a policy allows consult palliative care. Before the change, data were gathered via email using Distress Scale-Revised. scale redistributed 6 months policy. Pre post Scale-Revised results analyzed. Qualitative thematic analyses...
The Organ Procurement and Transplantation Network (OPTN) approved changes to the US kidney allocation system in 2019. potential effects of this policy change using transplant rates normalized end-stage disease (ESKD) incidence have not been investigated.
Assessment of interprofessional education (IPE) frequently focuses on students' learning outcomes including changes in knowledge, skills, and/or attitudes. While a foundational the values and information their chosen profession is critical, follows continuum from formal to practice. The increases significance complexity as becomes more relationship based dependent upon ability navigate complex interactions with patients, families, communities, co-workers, others. Integrating IPE into...
Identifying kidney transplant patients at highest risk for graft loss prior to may allow effective interventions improve 5 years survival.We performed a 10 retrospective cohort study of adult recipients (n = 1747). We acquired data from electronic health records, United Network Organ Sharing, social determinants health, natural language processing extraction, and real-time capture dynamically evolving clinical obtained within 1 year transplant; which we developed survival model.Total 1439...
Background. The goal of this study was to increase organ donor registrations at the Department Motorized Vehicles (DMV) via utilization a sustainable, low-cost, African American-centric donation educational video. Results from previous studies provided framework generate 10-minute video that featured registered donors, deceased families, and transplant recipients. Methods. presented an interrupted time series design (repeating on 2 mo, off mo) televisions placed in 6 regional DMVs. During...
Abstract Reducing acute care utilization is a means of improving long‐term patient outcomes. We sought to assess high inpatient (IP) admission and standalone emergency department (ED) within 9‐month period post‐kidney transplantation identify mutable factors reduce utilization. In this ten‐year retrospective study, 1599 adult kidney transplant recipients were identified. A previous transplant, graft loss, or death 3 months post‐transplantation excluded 319 patients. Comprehensive resource...
Abstract This was a single‐center, randomized controlled trial assessing the impact of 3‐month (10‐16 weeks) conversion to everolimus with low‐exposure tacrolimus, as compared remaining on full exposure tacrolimus mycophenolate (NCT 02096107). Adult kidney transplant recipients functioning graft were eligible for participation. Goal troughs in intervention arm 2‐5 ng/mL and 3‐8 everolimus, maintained at 5‐12 control arm; 60 (30 each arm) well matched baseline; mean age 51 years 57%...
<b><i>Background:</i></b> Several studies have been performed to evaluate surrogate markers of long-term allograft function in renal transplant recipients. These include serum creatinine, estimated glomerular filtration rate (eGFR), slope eGFR, and more recently eGFR variability. The aim this study was measure while assessing the variability if high occurring at any time post-transplant predictive poorer outcomes a large cohort kidney...
Background: High tacrolimus intrapatient variability (tac IPV) is associated with poor outcomes in kidney transplantation, including rejection, donor-specific antibodies, and graft loss. A common cause of high tac IPV related to patient nonadherence, but this yet be conclusively demonstrated. Methods: This was a longitudinal cohort study comprising adult recipients, who received transplants between 2015 2017, follow-ups through February 2020. The goal identify the most etiologies levels...
Abstract African American (AA) organ donation registration rates fall short of national objectives. The goal the present study was to utilize data acquired from a quantitative telephone survey provide information for future Department Motorized Vehicles (DMV) intervention increase AA donor at DMV. AAs (n = 20 177) that had visited an Alabama DMV office within 3‐month period were recruited via direct mailing participate in phone survey. Data 155 respondents participated analyzed. Of those...
Abstract Medication non‐adherence is common after transplant and a major contributor to graft loss. The objective of this pilot study was obtain preliminary safety adherence data complete once‐daily immunosuppression regimen Extended‐release‐tacrolimus (LCP‐tac), everolimus, prednisone vs LCP‐tac, mycophenolate Twice daily (BID), through randomized controlled 40 patients (20 in each arm). At 3 ± 2 months post‐transplant, were receive LCP‐tac everolimus once or BID (control arm) for 6 months;...
Introduction: The optimal treatment for end-stage kidney disease is renal transplant. However, only 1 in 5 (21.5%) patients nationwide receiving dialysis are on a transplant waitlist. Factors associated with not initiating evaluation complex and include patient specific factors such as knowledge self-efficacy. Research Question: Can center-based educational video intervention increase patients’ knowledge, self-efficacy, evaluations initiated? Design: Dialysis who had yet completed were...
<sec> <title>BACKGROUND</title> The outcome disparities for African American recipients of kidney transplant is a public health issue that has plagued the field since its inception. Based on national data, have nearly twice risk graft loss at 5 years after transplant, when compared with White recipients. Evidence demonstrates medication nonadherence and high tacrolimus variability substantially impact outcomes racial disparities, most notably late (>2 years) transplant. Nonadherence...