2024
Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study. Journal Of Palliative Medicine 2024 PMID: 39515377, DOI: 10.1089/jpm.2024.0182.Peer-Reviewed Original ResearchSpecialist palliative careVeterans Affairs Medical CenterEnd of lifeCare qualityInpatient hospiceEnd of life outcomesUse of hospiceInpatient hospice careMedical CenterMultilevel logistic regressionFamilies of patientsAffairs Medical CenterHospice carePalliative careRetrospective cohort studyAdvanced heart failureBlack adultsHospiceCohort studyFacility rateLogistic regressionStudy outcomesObservational studyCareHeart failureFactors Associated With Influenza Vaccination in a National Veteran Cohort
Chen A, Farmer M, Han L, Runels T, Bade B, Crothers K, Bastian L, Bazan I, Bean-Mayberry B, Brandt C, Akgün K. Factors Associated With Influenza Vaccination in a National Veteran Cohort. AJPM Focus 2024, 4: 100290. PMID: 39611140, PMCID: PMC11602634, DOI: 10.1016/j.focus.2024.100290.Peer-Reviewed Original ResearchOdds of vaccinationInfluenza vaccineFemale veteransAmerican Indian/Alaskan Native raceFactors associated with influenza vaccinationReceipt of influenza vaccinationDocumenting influenza vaccinationReduced oddsRetrospective cohort studyElectronic health record dataMale veteransHealth record dataAmbulatory care utilizationInfluenza seasonRuralMale sexWhite male veteransWhite veteransAssociated with raceCohort studyBlack veteransBlack raceEthnic groupsRacial disparitiesInfluenzaKeeping Race and Diversity Relevant in Medical Education.
Baugh A, Akgün K, Rusk A, Adelson V, Afolabi F, Crowder S, Ferreira J, Gurubhagavatula I, Lovinsky-Desir S, Lawrence K, Myers L, Niranjan S, Schotland H, Sheares B, Sullivan D, Wisnivesky J, Sweet S. Keeping Race and Diversity Relevant in Medical Education. Annals Of The American Thoracic Society 2024, 21: 1365-1371. PMID: 39078251, PMCID: PMC11451892, DOI: 10.1513/annalsats.202403-322ps.Peer-Reviewed Original ResearchAdapting the Tools of Our Trade Shared Decision-Making Aids for Lung Cancer Screening in People With HIV
Bade B, Akgün K. Adapting the Tools of Our Trade Shared Decision-Making Aids for Lung Cancer Screening in People With HIV. CHEST Pulmonary 2024, 2: 100048. DOI: 10.1016/j.chpulm.2024.100048.Peer-Reviewed Original ResearchRisk of Serious Adverse Gastrointestinal Events with Potassium Binders in Hospitalized Patients: A National Study
Holleck J, Han L, Skanderson M, Bastian L, Gunderson C, Brandt C, Perkal M, Chang J, Akgün K. Risk of Serious Adverse Gastrointestinal Events with Potassium Binders in Hospitalized Patients: A National Study. Journal Of General Internal Medicine 2024, 1-7. PMID: 39103605, DOI: 10.1007/s11606-024-08979-1.Peer-Reviewed Original ResearchAdjusted odds ratiosSodium zirconium cyclosilicateU.S. Department of Veterans Affairs healthcare systemDepartment of Veterans Affairs healthcare systemVA Corporate Data WarehouseVeterans Affairs Healthcare SystemCorporate Data WarehousePotassium bindersHospitalized patientsGI eventsHealthcare systemOdds ratioAdverse GI eventsSodium polystyrene sulfonateNational studyPotassium-binding drugsComparative riskAdverse gastrointestinal eventsGI adverse eventsTreatment of hyperkalemiaZirconium cyclosilicateGastrointestinal eventsPatiromerAdverse eventsClinician Insights into Effective Components, Delivery Characteristics, and Implementation Strategies of Ambulatory Palliative Care for People with Heart Failure: A Qualitative Analysis
Feder S, Iannone L, Lendvai D, Zhan Y, Akgün K, Ersek M, Luhrs C, Allen L, Bekelman D, Goldstein N, Kavalieratos D. Clinician Insights into Effective Components, Delivery Characteristics, and Implementation Strategies of Ambulatory Palliative Care for People with Heart Failure: A Qualitative Analysis. Journal Of Cardiac Failure 2024 PMID: 39098653, DOI: 10.1016/j.cardfail.2024.07.009.Peer-Reviewed Original ResearchSpecialist palliative careVeterans Affairs Medical CenterCardiology cliniciansPalliative careImplementation strategiesDelivery characteristicsDiscussion of goals of careSpecialist palliative care cliniciansAmbulatory palliative careGoals of careGuideline-directed careQualitative descriptive studyAffairs Medical CenterSemi-structured interviewsCare deliveryAdvanced practiceLeadership supportVA systemReferral proceduresDescriptive studyAmbulatory settingClinicians insightCareHeart failureMedical CenterVariation in Uptake of Specialist Palliative Care Among People with Advanced Heart Failure Across VA Medical Centers
Zhan Y, Han L, Abel E, Akgun K, Redeker N, Feder S. Variation in Uptake of Specialist Palliative Care Among People with Advanced Heart Failure Across VA Medical Centers. Journal Of Pain And Symptom Management 2024, 67: e551-e552. DOI: 10.1016/j.jpainsymman.2024.02.339.Peer-Reviewed Original ResearchSpecialist palliative careVA Medical CenterDepartment of Veterans AffairsPalliative careVeterans AffairsRandom intercept multilevel logistic regressionPalliative care deliveryDelivery characteristicsMedical CenterMultilevel logistic regressionCare deliveryICD-9/10 codesAdvanced heart failureRetrospective cohort studyHealth careModifiable factorsCareTeam staffingCohort studyHeart failureLogistic regressionImplementation effortsIdentified factorsICD-9/10Study findingsDo Pulmonary Function Measures Added to the Veterans Aging Index Improve All-cause Mortality Prediction?
Abdo M, Cheung K, Brandt C, Crothers K, Justice A, Akgun K. Do Pulmonary Function Measures Added to the Veterans Aging Index Improve All-cause Mortality Prediction? 2024, a1464-a1464. DOI: 10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a1464.Peer-Reviewed Original ResearchChaos and Confusion: Antipsychotic Use in the ICU Within the Veterans Healthcare System During the COVID Pandemic
Murphy I, Akgun K, Burk M, Jiang R, Bryan K, Morneau K, Sutherland A, Rightnour E, Rosen A, Zavala S, Franck A, Davids B, Lee J, Wong M, Providence S, Schmitt T, Exline T, Guilbeault T, Drumright K, Klenosky B, Pisani M, Witcher P. Chaos and Confusion: Antipsychotic Use in the ICU Within the Veterans Healthcare System During the COVID Pandemic. 2024, a2717-a2717. DOI: 10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a2717.Peer-Reviewed Original ResearchHow Much Is Too Much? An Assessment of Intensive Care Unit Sedative Use Across the Veterans Healthcare System During the COVID-19 Pandemic
Murphy I, Akgun K, Burk M, Jiang R, Bryan K, Sutherland A, Morneau K, Rightnour E, Providence S, Zavala S, Rosen A, Franck A, Wong M, Davids B, Lee J, Schmitt T, Exline T, Guilbeault T, Drumright K, Klenosky B, Pisani M, Witcher P. How Much Is Too Much? An Assessment of Intensive Care Unit Sedative Use Across the Veterans Healthcare System During the COVID-19 Pandemic. 2024, a5032-a5032. DOI: 10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a5032.Peer-Reviewed Original ResearchVariation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Variation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs. Journal Of Pain And Symptom Management 2024, 68: 22-31.e1. PMID: 38561132, PMCID: PMC11168897, DOI: 10.1016/j.jpainsymman.2024.03.022.Peer-Reviewed Original ResearchOutpatient specialist palliative careSpecialist palliative careVeterans Affairs Medical CenterPalliative careSpecialist palliative care consultationRandom intercept multilevel logistic regressionDepartment of Veterans AffairsMultilevel logistic regressionAffairs Medical CenterClinical practice guidelinesICD-9/10 codesAdvanced heart failureRetrospective cohort studyVeterans AffairsOutpatient palliativeOutpatient deliveryPractice guidelinesCohort studyLogistic regressionCardiology involvementDelivery characteristicsAssociated factorsMedical CenterIdentified factorsICD-9/10Postoperative Outcomes Associated with the Timing of Surgery After SARS-CoV-2 Infection
Leeds I, Park L, Akgun K, Weintrob A, Justice A, King J. Postoperative Outcomes Associated with the Timing of Surgery After SARS-CoV-2 Infection. Annals Of Surgery 2024, 280: 241-247. PMID: 38323413, PMCID: PMC11236522, DOI: 10.1097/sla.0000000000006227.Peer-Reviewed Original ResearchIncreased 90-day mortalitySARS-CoV-2 infectionDays of infectionPostoperative outcomesSARS-CoV-2Increased post-operative mortalityPositive testRetrospective cohort of patientsUS Veterans Health Administration facilitiesVeterans Health Administration facilitiesPost-operative mortalityMultivariate modelTime of surgeryAdverse surgical outcomesCohort of patientsMultivariate logistic regression modelSurgical procedure groupsSARS-CoV-2 positive testDeferred surgeryPrimary endpointSurgery intervalSurgical outcomesSurgical cohortUninfected patientsASA 4
2023
USING MULTI-LEVEL MODELING TO EXAMINE RACIAL DISPARITIES IN PALLIATIVE CARE AMONG OLDER ADULTS WITH HEART FAILURE
Han L, Abel E, Zhan Y, Akgün K, Feder S. USING MULTI-LEVEL MODELING TO EXAMINE RACIAL DISPARITIES IN PALLIATIVE CARE AMONG OLDER ADULTS WITH HEART FAILURE. Innovation In Aging 2023, 7: 1149-1150. PMCID: PMC10736640, DOI: 10.1093/geroni/igad104.3689.Peer-Reviewed Original ResearchAdvanced heart failureVeterans Affairs Medical CenterSpecialist palliative careHeart failureOlder adultsWhite raceGuideline-concordant careICD-9/10 codesService delivery characteristicsAHF cohortSPC servicesPalliative careBlack raceMedical CenterLogistic regressionSocioeconomic disparitiesFacility characteristicsRacial disparitiesPersistent disparitiesAdultsRandom interceptDelivery characteristicsConventional logistic regressionCareEquitable access1312. Incidence and Microbiology of Prosthetic Joint Infection According to Time Following Total Knee Arthroplasty: A Retrospective Cohort Study Among US Veterans
Weinstein E, Re V, Stephens-Shields A, Newcomb C, Silibovsky R, Nelson C, O’Donnell J, Glaser L, Hsieh E, Hanberg J, Akgün K, Tate J, King J. 1312. Incidence and Microbiology of Prosthetic Joint Infection According to Time Following Total Knee Arthroplasty: A Retrospective Cohort Study Among US Veterans. Open Forum Infectious Diseases 2023, 10: ofad500.1151. PMCID: PMC10678406, DOI: 10.1093/ofid/ofad500.1151.Peer-Reviewed Original ResearchLate prosthetic joint infectionsPrimary total knee arthroplastyProsthetic joint infectionTotal knee arthroplastyIncidence rate ratiosElective primary total knee arthroplastyJoint infectionKnee arthroplastyIncidence rateChi-squared testGram-negative organismsCumulative incidenceConfidence intervalsIncidence of PJIMicrobiology dataEarly prosthetic joint infectionKaplan-Meier failure curvesCulture-negative prosthetic joint infectionPrimary TKA surgeryRetrospective cohort studyKaplan-Meier methodPearson's chi-squared testGrant/research supportOverall study periodIncident hospitalization1313. Determinants of Prosthetic Joint Infection According to Time Following Total Knee Arthroplasty: A Retrospective Cohort Study Among US Veterans
Weinstein E, Re V, Stephens-Shields A, Newcomb C, Silibovsky R, Nelson C, O’Donnell J, Glaser L, Hsieh E, Hanberg J, Akgün K, Tate J, King J. 1313. Determinants of Prosthetic Joint Infection According to Time Following Total Knee Arthroplasty: A Retrospective Cohort Study Among US Veterans. Open Forum Infectious Diseases 2023, 10: ofad500.1152. PMCID: PMC10679182, DOI: 10.1093/ofid/ofad500.1152.Peer-Reviewed Original ResearchPrimary total knee arthroplastyProsthetic joint infectionIncidence rate ratiosTotal knee arthroplastyAutoimmune inflammatory arthritisYear of TKAEarly prosthetic joint infectionLate prosthetic joint infectionsVA Surgical Quality Improvement ProgramPeri-operative factorsVeterans Health AdministrationJoint infectionKnee arthroplastyHCV infectionInflammatory arthritisAlcohol use disorderOperative timeRate ratioUse disordersElective primary total knee arthroplastySurgical Quality Improvement ProgramSkin/soft tissueRetrospective cohort studyConfidence intervalsQuality Improvement ProgramEasing Suffering for ICU Patients and Their Families: Evidence and Opportunities for Primary and Specialty Palliative Care in the ICU
Doherty C, Feder S, Gillespie-Heyman S, Akgün K. Easing Suffering for ICU Patients and Their Families: Evidence and Opportunities for Primary and Specialty Palliative Care in the ICU. Journal Of Intensive Care Medicine 2023, 39: 715-732. PMID: 37822226, DOI: 10.1177/08850666231204305.Peer-Reviewed Original ResearchSurrogate decision makersPalliative needsCritical illnessICU patientsPalliative medicineIntensive care unit admissionChronic critical illnessPalliative medicine teamsPost-ICU disabilitySpecialty palliative careCare unit admissionTransitions of careImprovement of patientsAdvanced practice nursesFamily-centered carePerson-centred careUnit admissionICU carePalliative supportPalliative carePractice nursesPalliative principlesMedicine teamPatientsICUIncidence, Microbiological Studies, and Factors Associated With Prosthetic Joint Infection After Total Knee Arthroplasty
Weinstein E, Stephens-Shields A, Newcomb C, Silibovsky R, Nelson C, O’Donnell J, Glaser L, Hsieh E, Hanberg J, Tate J, Akgün K, King J, Re V. Incidence, Microbiological Studies, and Factors Associated With Prosthetic Joint Infection After Total Knee Arthroplasty. JAMA Network Open 2023, 6: e2340457. PMID: 37906194, PMCID: PMC10618849, DOI: 10.1001/jamanetworkopen.2023.40457.Peer-Reviewed Original ResearchConceptsPrimary total knee arthroplastyProsthetic joint infectionTotal knee arthroplastyIncidence rate ratiosLate prosthetic joint infectionsPostoperative periodIncidence rateCohort studyOverall cohortJoint infectionKnee arthroplastyVeterans Affairs Surgical Quality Improvement Program dataElective primary total knee arthroplastyEarly prosthetic joint infectionHepatitis C virus infectionQuality Improvement Program dataVeterans Affairs Corporate Data WarehouseAutoimmune inflammatory arthritisPostoperative antibiotic useC virus infectionRisk factor modificationChronic kidney diseasePeripheral artery diseaseLate postoperative periodYears of careSEDATION STEWARDSHIP: DEVELOPMENT OF A NATIONAL MEDICATION USE EVALUATION FOR ASSESSMENT OF INTENSIVE CARE UNIT SEDATION PRACTICES DURING THE COVID-19 PANDEMIC
MURPHY I, BRYAN K, BURK M, CUNNINGHAM F, BUKOWSKI K, WONG M, PROVIDENCE S, EXLINE T, RIGHTNOUR E, MORNEAU K, RICE S, WITCHER P, SCHMITT T, LEE J, DAVIDS B, KLENOSKY B, ROSEN A, ZAVALA S, SUTHERLAND A, RATLIFF L, AKGUN K. SEDATION STEWARDSHIP: DEVELOPMENT OF A NATIONAL MEDICATION USE EVALUATION FOR ASSESSMENT OF INTENSIVE CARE UNIT SEDATION PRACTICES DURING THE COVID-19 PANDEMIC. CHEST Journal 2023, 164: a3781-a3782. DOI: 10.1016/j.chest.2023.07.2460.Peer-Reviewed Original ResearchAccess to Medically Necessary Reproductive Care for Individuals with Pulmonary Hypertension
Sonntag E, Akgün K, Bag R, Rosensweig E, Bernardo R, Burnetti C, Chybowski A, de Jesus Perez V, Diwan J, Guthrie K, Halscott T, Lahm T, Vaught J, Ventetuolo C, Hemnes A. Access to Medically Necessary Reproductive Care for Individuals with Pulmonary Hypertension. American Journal Of Respiratory And Critical Care Medicine 2023, 208: 234-237. PMID: 37311249, PMCID: PMC10395720, DOI: 10.1164/rccm.202302-0230vp.Peer-Reviewed Original ResearchDesign and methods of a randomized trial testing "Advancing care for COPD in people living with HIV by implementing evidence-based management through proactive E-consults (ACHIEVE)"
Ives J, Bagchi S, Soo S, Barrow C, Akgün K, Erlandson K, Goetz M, Griffith M, Gross R, Hulgan T, Moanna A, Soo Hoo G, Weintrob A, Wongtrakool C, Adams S, Sayre G, Helfrich C, Au D, Crothers K. Design and methods of a randomized trial testing "Advancing care for COPD in people living with HIV by implementing evidence-based management through proactive E-consults (ACHIEVE)". Contemporary Clinical Trials 2023, 132: 107303. PMID: 37481201, PMCID: PMC10528346, DOI: 10.1016/j.cct.2023.107303.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseE-consultsEvidence-based managementElectronic health recordsCOPD managementVeterans Affairs Medical CenterCommon comorbid diseasesObstructive pulmonary diseaseChronic disease comorbiditiesEvidence-based careEvidence-based recommendationsComorbid diseasesPulmonary diseaseHIV populationInappropriate therapyBlood InstituteNational HeartACHIEVE trialMedical CenterClinical providersDisease comorbiditiesHIVPWHTrial testingCare