Journal of general internal medicine
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Hepatitis C virus (HCV) infections and injection drug use have concurrently increased in the last decade. Evidence supports simultaneously treating chronic HCV and opioid use disorder (OUD) with medication. Kentucky is a hard-hit state for both conditions that has undertaken policy and practice efforts to increase access to both types of medications. ⋯ Gaps in HCV treatment among Kentucky Medicaid recipients with OUD were pervasive. Despite evidence supporting HCV-OUD co-treatment, patients receiving MOUD were significantly less likely to receive curative HCV treatment.
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Perceived discrimination and medical mistrust are barriers to care that impact both individual and population health. ⋯ Perceived discrimination in healthcare and medical mistrust are prevalent at the national scale, with racial and ethnic groups of color bearing the brunt. System-wide efforts are needed to improve health equity for marginalized patient populations.
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Healthy lifestyle behaviors play a significant role in promoting cardiovascular health. Primary care clinicians (PCCs) are tasked with promoting cardiovascular health through the assessment of lifestyle behaviors and the use of behavior change counseling. ⋯ Our framework proposes that this digital communication bundle contains the following features: assess and analyze an individual's cardiovascular health status; communicate personalized information in a health-literacy-friendly, visual format; assess behavioral components of change (e.g., motivation) that can inform the PCC's approach in guiding behavior change; provide PCCs with brief, behavior change counseling prompts that are grounded in motivational interviewing; and assess and address potential structural, socioeconomic, and environmental barriers, thereby fostering resilience in patients' lifestyle change efforts. We highlight the available research to support the need for such a tool and its potential ability to guide PCCs while also promoting behavior change in a patient-centered manner.
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Medical student exposure to role-modeling of high-value care (HVC) behaviors may shape professional identity formation and future HVC practices. ⋯ HVC role-modeling, as observed by medical students, is not consistently demonstrated across clinical rotations. Attendings generally model more HVC than residents and general surgery models less HVC compared to other specialties. Future studies should strive to identify factors which promote or inhibit HVC modeling.