This abstract supplement includes findings presented through oral or poster presentations at the 51st annual Scientific Day event held on May 21, 2025. Scientific Day provides both an in-person and virtual forum for the sharing of research, quality improvement, and case studies conducted by Illinois- and Wisconsin-based faculty, fellows, residents, and other health professionals associated with Advocate Health.
Purpose: Myocardial infarction (MI) remains to be associated with a high risk of recurrent cardiovascular events and disease burden. This study assessed patient perspectives on the burden of disease and treatment in the first year post-MI.
Methods: Data were collected via a self-administered online questionnaire posted on the Carenity patient platform in the United States (10/30/2022-12/30/2022). Only patients who had an MI in the prior year were eligible for inclusion.
Results: A total of 151 patients completed the survey. The majority were men (69%), median age was 50 years, and 38% had an MI within the previous 90 days. Overall, post-MI complications were reported in 44% of the patients, including depression (23%), recurrent MI (7%), and stroke (7%). Follow-up care was provided by general/clinical cardiologists (67%), interventional cardiologists (38%), and general healthcare providers (59%). Most patients (80%) reported involvement in treatment decisions. The number of prescribed medications was considered the main contributor to post-MI treatment burden; approximately 42% of the patients found it tedious remembering to take their medications. The most commonly quoted post-MI treatment goal was recurrent MI risk reduction. Additionally, 73% of the patients considered improving quality of life to be a key goal. Overall, the patients' emotional well-being, physical well-being, and personal life were particularly impacted by MI. "Stress/anxiety/fear" was the most frequently reported emotion immediately post-MI, and one-third conveyed MI's negative impact on their employment status. MI impacted household finances in 74% of patients, with 38% losing income.
Conclusions: MI places a substantial burden on patients. Understanding patient experiences post-MI may enhance patient-centered care.
Purpose: Patients undergoing lower extremity amputation often desire to take an active part in decision-making. The primary aim of this study was to explore patients' experiences of the care trajectory and information provided after a new care program was introduced. The secondary aim was to explore patients' perspectives of their involvement and participation in shared decision-making throughout the care process. The care program features new educational material, recommendations for the sagittal surgical technique, and information about a rigid removable dressing, early liner treatment, and a multidisciplinary team follow up three weeks after amputation.
Methods: Fifteen participants who underwent transtibial amputation were included in the study and were interviewed two to three months post-surgery. Purposeful sampling was used, and data were analyzed with content analysis.
Results: Three themes were identified: (1) the emotionally mixed experience of becoming a person with an amputation, (2) the need to be seen during the amputation process, and (3) the importance of being involved in care. Participants wanted to take a more active role in the decision-making process, and our multidisciplinary team follow up was an excellent example of shared decision-making. Printed information was appreciated, but the most crucial aspect was oral communication, given the gravity of the subject. Participants experienced a lack of continuity throughout the care trajectory.
Conclusions: Individualized oral information and interaction with dedicated healthcare professionals are essential for participants undergoing transtibial amputation. Implementing a multidisciplinary team consultation pre-amputation may enhance patient involvement and promote shared decision-making.
Purpose: To gain insight into the self-management and support needs of patients experiencing persistent symptoms consistent with hypothyroidism, despite thyroid laboratory values within the normal range.
Methods: A qualitative study using the phenomenological approach was conducted. Semi-structured interviews including 19 patients diagnosed with persistent symptoms consistent with hypothyroidism, despite receiving adequate replacement therapy, were performed. Respondents were recruited using purposive sampling via Schildklier Organisatie Nederland (Dutch Thyroid Organization) (www.schildklier.nl). After transcription and coding, a thematic analysis was performed.
Results: All respondents reported that the persistent symptoms reduced their quality of life. The patients' main focus was on finding the cause of these symptoms and balancing activities in their personal, social, and professional lives. The most frequently mentioned support need was for physicians to pay more attention to patients' symptoms. Respondents expected that this would mainly improve their mental quality of life.
Conclusions: Giving greater attention to persistent symptoms consistent with hypothyroidism in medical guidelines and (continuing) education might make general practitioners and internists more aware of these symptoms. This might help them better understand the impact of the persistent symptoms on quality of life and the support needs of patients, thereby improving the conversation between patients and physicians. This may reduce the perceived gap between patients' needs and what physicians (are able to) provide, which might support self-management of these persistent symptoms.
Purpose: We performed interviews with patients and caregivers to explore whole-person, whole-regimen information needs at times of routine outpatient medication changes. We categorized information needs in this relatively unstudied context and identified which needs were commonly recognized as insufficiently met.
Methods: We explored the content of the semi-structured interviews, which involved nine patients and two caregivers of pediatric patients, all of whom experienced a recent medication change in the outpatient setting of a large urban academic healthcare system. We used inductive thematic analysis to organize information needs into categories to identify key information gaps.
Results: We identified five categories of patient information needs: (1) medication self-administration, (2) clinical reasoning informing the medication change, (3) pre-medication change expectations, (4) post-medication change behaviors, and (5) patient role and responsibilities in safe medication management. Through these categories, we highlighted five themes from which participants frequently described receiving insufficient information: (1) medication history, (2) anticipatory guidance about possible adverse effects, (3) self-monitoring and self-managing instructions, (4) safe information seeking, and (5) safe disposal of surplus medications.
Conclusions: Our findings illustrate patient information needs at times of ambulatory medication changes and identify vulnerabilities where these needs may be insufficiently met. Providing tailored information at times of ambulatory medication changes might support patient engagement with medication safety practices and ultimately reduce patient harm associated with adverse medication events. Further research is needed to confirm these gaps in larger studies and examine this question within special populations, including pediatric caregivers and patients with limited English proficiency.
Purpose: Involving community members in the process of translating scientific evidence into health messaging and interventions can lead to improved health outcomes and more patient-centered healthcare. Community Translation (CT) is one methodology for fostering collaboration between researchers and community members, and it has been shown to result in locally relevant, acceptable solutions to health challenges. There has been very little research on the direct effects that participation may have on community members who become involved in CT. Understanding the mechanisms of CT and its outcomes on participating community members is essential to maximizing the potential of CT. To address this gap, the present study explores processes theorized to be important to the effectiveness of CT.
Methods: Utilizing self-report survey and brief open response data from community partners (N=8) involved in a CT to adapt a family-inclusive lifestyle intervention in the rural Mountain West, we sought to describe change in theorized mechanisms - knowledge, attitudes, and partnership dynamics - and intermediate effectiveness outcomes.
Results: The results indicate that perceived knowledge, attitudes, partnership dynamics, and intermediate effectiveness outcomes all tended to increase across the CT, with intermediate effectiveness outcomes such as group impact, perceived benefits, belonging, and cultural relevance showing the largest changes.
Conclusions: The findings provide preliminary support for the logic model and theoretical basis outlined by the developers of CT, as well as insights for ways to optimize this powerful community-based participatory research methodology.
The Health Care Systems Research Network (HCSRN) comprises 19 learning health systems with integrated care delivery and embedded research units. The network's annual conference serves as a forum for research teams from member institutions to disseminate project findings, explore scientific collaborations, and share insights about population-based research practices that can measurably improve health and health care for all. The theme of this year's conference was "Optimizing Collaborations to Advance Health in a Dynamic Research Landscape." Abstracts presented at HCSRN 2025 are published in this issue supplement of the Journal of Patient-Centered Research and Reviews, the journal of record for HCSRN's annual conference proceedings.
Purpose: Atrial fibrillation (AF), the most common arrhythmia in older adults, is often treated with cryoballoon ablation (CBA) or laser balloon ablation (LBA) when refractory to medication. We used real-world patient data to investigate differences in arrhythmia-free survival, procedure and fluoroscopy times, and complications between these techniques.
Methods: In this single-center, retrospective study of 178 patients with symptomatic paroxysmal AF referred for first-time pulmonary vein isolation (PVI), 103 underwent CBA, and 75 underwent LBA. Recurrence was defined as any atrial arrhythmia of >30 seconds' duration after a three-month blanking period. Complications at 30 days were recorded. Kaplan-Meier analysis was used to estimate arrhythmia-free survival at one year for both groups. Categorical variables were expressed as n (%) and continuous variables as mean±standard deviation or median (Q1, Q3).
Results: Baseline characteristics were similar between groups, with exception to left atrial volume index (CBA 32.2±10.9 ml/m2; LBA 36.0±11.0 ml/m2, p=0.047). History of stroke was higher in CBA (13.6% vs 2.7%; p=0.012), as was coronary artery disease (35.0% vs 14.7%, p=0.002). Median fluoroscopy and procedure times (min) were significantly shorter in LBA (24.2 vs 31.6, p=0.004; 141.0 vs 210.0, p<0.0001, respectively). One-year arrhythmia-free survival rates were similar (CBA 79.1% vs LBA 78.7%, p=0.934), as were total complication rates (21.4% vs 16.0%, p=0.289), including rates of transient ischemic attack/stroke and vascular complications.
Conclusions: In patients with paroxysmal AF undergoing PVI, CBA and LBA were equally efficacious at one year and demonstrated acceptably low complication rates. LBA was associated with reduced procedure time and fluoroscopy exposure.
Long-COVID is a complicated, post-viral syndrome involving multiple body systems and can present with neuropsychiatric symptoms. Little has been reported about the neuropsychiatric symptoms of long-COVID, and validated treatments do not yet exist. There is prior evidence that mindfulness-based strategies have been helpful for those with chronic illnesses; shown significant decreases in anxiety, stress, and depression; and enhanced quality of life. In this study, we report on the utility of a mindfulness-based intervention on levels of anxiety and depression in a long-COVID population. Our hospital system founded both a "Covid Recovery Clinic" (CRC) and a "Post-COVID Resilience Program" (PCRP). The PCRP consisted of a six-week virtual group therapy protocol that focused on mindfulness-based practices. Before and after the therapy intervention, participants answered questionnaires to capture depressive and anxiety symptoms. Pre- and post-questionnaire scores do not show a significant improvement in depressive or anxiety symptoms, although the study was limited by a small sample size. Further research is needed to investigate whether similar programs with a larger sample size can improve the mental health status of patients suffering from long-COVID.
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