Volume 3, Issue 1 (Spring 2016)
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
Breast Management in Women with Newly Diagnosed Breast Cancer
Nate L. Jones, MDd, Shelley L. Galvin, MAb,c, Ashley Case, MDe
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
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
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
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
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
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.
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.