Journal Archives

Volume 3, Issue 2 (Summer 2017)

Editor-in-Chief's Comments

We are proud to announce the latest edition of the MAHEC Online Journal of Research!

MAHEC prioritizes innovation. This value is often manifested in our practice sites exploring and evaluating new ways to deliver optimal care to our patients. This issue houses several interesting articles examining evolving models of care.

First, the MAHEC Ob/Gyn Specialists team presents an evaluation of the CenteringPregnancy™ program and the potential impact this model of care has on birth outcomes. The article provides compelling support for this innovative delivery of care.

Have you noticed more women asking about a home birth? Descieux, et al. describe this growing phenomenon, especially in western NC, and evaluate the literature to determine factors that compel some women to choose a home birth.

Next, Galvin, et al. examine the Family Health Center’s Chronic Pain Management Program to determine if patients who receive care through this model have improved pain self-efficacy scores and more appropriate pain medication regimens. As we all grapple to deal with the opioid epidemic, novel models of care that provide improved patient outcomes are imperative.

Finally, Pior and Johnson evaluate the recent literature surrounding whether it is safe to use ondansetron in early pregnancy. This article is a must read as it highlights the recent data prompting a significant shift in practice for many of our providers caring for women during pregnancy.

We hope you enjoy this edition!

Courtenay Gilmore Wilson, PharmD, CDE, BCPS, BCACP, CPP



Care Utilization and Birth Outcomes among Women Obtaining CenteringPregnancy™ Group Prenatal Care

Kiran Sigmon, MDa, AnnaBeth Parlier, BSb, Katie Descieux, MAb, Kacey R. Scott, MLISc, Shelley L. Galvin, MAa,b

PDF | Abstract

Why Women Choose Home Birth: A Narrative Review

Katie Descieux, MAb, Kathik Kavasseri, MDd, Kacey R. Scott, MLISc, AnnaBeth Parlier, BSb

PDF | Abstract

Patient-centered Self-management of Chronic Pain Improves Patients' Self-efficacy

Shelley L. Galvin, MAa,b, AnnaBeth Parlier, BSb, Elizabeth Flemming, MA, LPCe, Carriedelle Fusco, FNPd

PDF | Abstract

Is Ondansetron Safe in Pregnancy? A Recommendation Based on Literature Review

Jessica Pior, MDd, Travis Johnson, MDd

PDF | Abstract

Author Affiliations

Mountain Area Health Education Center:
aDepartment of Obstetrics and Gynecology; bDivision of Research; cLibrary and Knowledge Services; dDivision of Family Medicine; eRegional Services

Editorial Team

Editor-in-Chief: Courtenay Gilmore Wilson, PharmD, CDE, BCPS, BCACP, CPP
Managing Editor: Joan Colburn, MLIS
Associate Editor: Shelley Galvin, MA

Volume 3, Issue 1 (Spring 2016)

Editor-in-Chief's Comments

Spring time!  Sun shining, flowers blooming, birds chirping and MAHEC research projects! This issue of the MAHEC Online Journal of Research showcases many of the talented research endeavors undertaken by our learners in recent years.  Hopefully this wets your appetite for things to come at the 23rd annual MAHEC Research Day on May 11th. 

We begin this issue with an interesting analysis of the interplay between housing and health. This article assesses self-reported health status, chronic disease burden, and functional status of elderly public housing residents. The results from this study will challenge mainstream assumptions about older adults living in public housing. The resiliency of this patient population will inspire you.

From there, we hear from our OB colleagues on a new technology used to screen for and manage breast cancer. Breast-Specific Gamma Imaging is proving to be very sensitive with fewer false positives than other tests, especially for women with dense breasts.  It seems we may have one more tool to help in the detection and treatment of breast cancer.

Next, Park et al. raise the alarm regarding the prescribing and management of the new direct oral anticoagulants (DOACs). Numerous national organizations, including the Institute of Safe Medication Practices and Joint Commission, have issued concerns about the safe prescribing of these agents. This article provides a baseline assessment of how well we are managing our patients on DOACs. Although I am not surprised by the results, I am very much looking forward to the added level of care that will result from this study.

The following two articles by Warren et al. and Coulson et al. provide insight into the complexities of genetic testing and providing care to our most vulnerable patient, the unborn. Learn about the changing preferences in the types of genetic testing completed as new, less invasive technologies become available and how western North Carolina is doing compared to urban US. 

Parlier et al. then tackle a topic that has been dominating the news lately: safe prescribing of opioid medications for chronic non-cancer pain. This paper assesses MAHEC’s Chronic Pain Management Program to determine if the rates of appropriate prescribing have improved.  How will our data stack up against the new Centers for Disease Control and Prevention guidelines?

Finally, we have a thoughtful commentary on our role as rural providers and the ways we connect with our patients. This special piece highlights the great work of MAHEC’s UNCA Summer Internship Program. After reading this piece, give some thought to how much personal information you share with your patients. How well do they know the person who cares for them? I hope you enjoy our latest edition!

We hope you enjoy this edition!

Courtenay Gilmore Wilson, PharmD, CDE, BCPS, BCACP, CPP

Special Section Editor's Remarks

This special section of the spring issue focuses on the research conducted by a student intern from the MAHEC UNC Asheville summer internship program. This competitive program provides selected students from UNC Asheville the opportunity to shadow MAHEC faculty and residents and participate in projects, which students present at the end of their internship. Hunter Sprinkles was one such intern, who chose a research project that focused on the fascinating relationship between patient trust and provider disclosure.

In this article, Hunter discusses what information patients value knowing about their doctors, and how increased personal disclosure may foster stronger patient-provider trust and positively impact patient compliance and outcomes. His project raises interesting points for reflection in the era of social media and also broaches new, creative ways to engage patients. It is our hope that this summer we can continue to expand our new initiative of publishing intern research projects like Hunter’s to showcase the hard work our interns do at MAHEC, and around the community!

Kacey Ryan Scott, MLIS



Housing and Health: Health Status and Functionality of Older Adults in Public Housing

Megan Dunay, MD, MPHa, Amanda Williams, DOa, Annette Beyea, MD, MPHa, Shelley L. Galvin, MAb,c

PDF | Abstract

Breast Management in Women with Newly Diagnosed Breast Cancer

Nate L. Jones, MDd, Shelley L. Galvin, MAb,c, Ashley Case, MDe

PDF | Abstract

Evaluating Appropriate Dosing of Direct Oral Anticoagulants in a Family Medicine Practice

Irene Park, PharmD, BCACP, CPPf,g, Leah Herity, PharmD Candidateg, Samantha Patton, PharmD Candidateg

PDF | Abstract

Aneuploidy Screening and Invasive Testing in Western North Carolina in the Era of Cell-free Fetal DNA Testing

Jennifer E. Warren, MDc,d, Carol C. Coulson, MDc,d, Rick M. Loftis, MDd, AnnaBeth Parlier, BSb, Shearon F. Roberts, MS, CGCh, Shelley L. Galvin, MAb,c

PDF | Abstract

The Effects of Improved Serum Screening on Prenatal Invasive Testing

Carol C. Coulson, MDc,d, Shelley L. Galvin, MAb,c, Shearon F. Roberts, MS, CGCh, Rick M. Loftis, MDd, Jennifer E. Warren, MDc,d

PDF | Abstract

Appropriate Use of Chronic Pain Medications: A Pre-post Intervention Comparison

Anna Beth Parlier, BSb, Elizabeth Tevepaugh, PharmDg, Carriedelle Fusco, FNP-BCi, Courtenay Gilmore Wilson, PharmDf,g, Shelley L. Galvin, MAb,c

PDF | Abstract

Special Section: University of North Carolina Undergraduate Intern Paper

The Patient-Provider Relationship in a Small Rural Clinic: The Connection Between Provider Self-Disclosure and Patient Trust

Hunter Sprinkles, BA


Author Affiliations

aMAHEC Division of Family Medicine – Geriatrics Fellowship Program; bMAHEC Division of Research; cUniversity of North Carolina School of Medicine, Department of Obstetrics and Gynecology; dMAHEC Department of Obstetrics and Gynecology – Residency Program; eHOPE: A Women’s Cancer Center; fMAHEC, Division of Family Medicine – Pharmacy; gUniversity of North Carolina Eshelman School of Pharmacy; hMission Hospital, Fullerton Genetic Center; iMAHEC Division of Family Medicine.

Editorial Team

Editor-in-Chief: Courtenay Gilmore Wilson, PharmD, CDE, BCPS, BCACP, CPP
Managing Editor: Joan Colburn, MLIS
Associate Editor: Shelley Galvin, MA

The MAHEC Online Journal of Research, published by the Mountain Area Health Education Center, promotes and publishes peer-reviewed, learner research and other scholarly activities that advance the understanding of our patients, evidence-based patient care, and education in obstetrics and gynecology, family medicine, general surgery, psychiatry, pharmacy, hospice and palliative care, geriatrics, and general dentistry.

The MAHEC Online Journal of Research publishes open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License which permits use, distribution and reproduction in any medium, provided the original work is properly cited and the purpose is non-commercial.

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