The Georgia Academy Annual Research Poster Competition was held during the Annual Meeting and Scientific Assembly November 7-10 in Atlanta. Posters were displayed outside of Salon E-G of the Evergreen Marriott Conference Resort in Stone Mountain for all attendees to view, and were evaluated by Dr. Rhonda Walton, Dr. Catherine James Peters, and AAFP Representative Dr. Leonard Reeves. Pre-med, medical students, residents and practicing physicians from throughout the state participated in the competition.
Results were as follows:
Pre-Med Category Winner:
1st Place – “Say What?” Patient Health Literacy as a Determinant of Effective Physician-Patient
Communication in a Community Clinic
Author/Presenter: Taylor Bennett, Clark Hall, Kathryn McGraw
Advisor/Coordinator/Contributor: Catherine Apaloo, MD, FACP; Zahraa Rabeeah, MD
Abstract:
Effective communication is a key element in patient care. Health literacy can affect understanding and subsequent adherence to the treatment plan. Miscommunication is thought to be the root cause of medical errors and malpractice cases. In this study, we evaluated patient health literacy and physician communication style to protect patient safety using a descriptive cross-sectional at Piedmont Athens Regional Community Care Clinic (PARMC). Questionnaires were given to patients and doctors to evaluate health literacy, communication style, autonomy, and shared decision capacity before and after the visit. Analysis was done using IBM SPSS Statistics. Study population consisted of 51 percent male and 49 percent female. 83 percent of surveyed patients stated that they asked a lot of questions, yet only 50 percent were unable to read labels or follow hand out instructions. Patients older than 50 years old asked more questions than younger patients [p=0.02]. Females were more likely to understand labels [p =0.03]. 66 percent of participants had difficulty navigating insurance plans. Our studies show that low health literacy is a major contributor to non-adherence and loss of follow-up. Future plans to improve physician-patient communication will include a score sheet for each physician implemented every 3 months designating patient feedback and advice for areas of improvement. Communication workshops targeted towards health literacy will be conducted every 6 months in order to improve physicians’ attention to health literacy and to provide safer care.
Medical Student Category Winner
Reducing Non-Essential Emergency Department Visits Among Mercy Health Center Patients
Authors/Presenters: Jakob Feeney, Silki Modi, Nzota Nsona, E’Lexus Okafor, Kyle Royalty,
Harini Vakamudi, Eden Woubshet
Advisor/Coordinator/Contributor:
Abstract
Purpose. Approximately 20 percent of U.S. adults seek emergency department (ED) care each year, and at least 30% of these visits are non-urgent. Inappropriate ED use leads to unnecessary testing, treatment, and larger downstream healthcare costs for patients/providers. Interviews with patients/providers suggest a knowledge gap pertaining to proper ED use. This study aims to use patient education on appropriate ED use to decrease financial burdens on hospitals and improve long-term patient care.
Methods. Bilingual informative television slides and posters were displayed highlighting appropriate ED use and Mercy Health Center’s services. Surveys were administered eliciting patient comprehension of the posters. Mock phone calls to Mercy tested ability to schedule acute care appointments. Viability of a triage hotline was assessed for afterhours care recommendations.
Results. Surveys were completed by 40 patients. About 78 percent of patients reported increased willingness to call Mercy for an acute appointment, and 40 percent learned new information from the poster. Phone calls to Mercy highlighted barriers for making acute appointments, including scheduling unavailability during evenings and inconsistent callbacks. The initiation/use of triage hotlines was not currently a feasible option.
Conclusions. This study identified several factors to increase patient utilization of Mercy. Mercy’s scheduling can be improved by modifying voicemail protocol. Patient receptiveness to informational posters warrants converting them into brochures for distribution. This study reinforces using an educational, lifestyle medicine approach to increase patient understanding of symptoms and availability of medical resources which decreases inappropriate ED use, hospital financial burdens, and poor patient care.
Resident Category Winner
Implementation of Multi-Disciplinary Teams to Provide Comprehensive Care for Type 2 Diabetes Population in a Primary Care Clinic Setting
Author/Presenter: Afua Akhi-Gbade, MD
Advisor/Coordinator/Contributor: Miranda Moore, PhD; Susana A. Alfonso, MD, MHCM; Yawen Wang, MPH
Practicing Physician/Fellow Category Winner
Evaluate the Effectiveness of the American Heart Association (AHA) Check. Change. Control Hypertension Management Program in patients with uncontrolled Hypertension at Grady East Point Health Center.
Author(s): Dolapo Babalola, MD
Advisor/Coordinator/Contributor: Denise Bell-Carter, MD, Esther Iwotor, DNP, Carli Barbo, MS, Mark Mooney, MPH, Unique Waker, MPH, Nike Agbe, PharmD
Abstract
Evaluate the Effectiveness of the American Heart Association (AHA) Check. Change. Control Hypertension Management Program in patients with uncontrolled Hypertension at Grady East Point Health Center.
Background
It is well documented the cardiovascular risk doubles with uncontrolled blood pressure for systolic and diastolic greater than baseline of 120/80. Data analysis reveals 60 percent of patients at Grady East Point Clinic (GEP) have uncontrolled Hypertension. This leads to macrovascular disorders complications from longstanding hypertension to include coronary artery disease, myocardial infarction, stroke, congestive heart failure, and peripheral vascular disease. These patient outcomes lead to increased healthcare bill and overall poor health.
Hypothesis
The Hypothesis is will the Evidence based American Heart Association (AHA) Check. Change. Control Hypertension Management Program reveal at least 70 percent of the patients seen at Grady East Point recruited with uncontrolled blood pressure of greater than 140/90 will have a BP of less than 140/90 or a 10 mmHg decrease in systolic blood pressure by the proposed four months multidisciplinary intervention involving physicians, community personnel, nutritionist and pharmacist.
Method
Setting:
- The study will be conducted at Grady East Point (GEP) ambulatory clinic in the East Point Community. GEP is a Grady’s Neighborhood Health Centers which offers primary care and more for men and women of all ages. Providers offer complete care for all parts of your body and for most diseases. Referrals are made if there is a need to see a specialist.
- The population density in East Point is 1319 percent higher than Georgia. The median age in East Point is 4 percent lower than Georgia. In East Point 15.43 percent of the population is Caucasian. In East Point 75.64 percent of the population is African American.
Design study
The procedure for the study is as follows;
- There will be a Retrospective chart review of patients with uncontrolled Hypertension seen at Grady East Point Health Center between January to November 2017
- 50 Adult patients’ ages 18-75 seen and treated at Grady East Point Health Center with uncontrolled hypertension greater than 140/90 will be recruited and consented by the physician champions to voluntarily participate in the study to monitor their blood pressure by using the AHA Check. Change. Control Hypertension Management Program.
- The Intervention period will run for 4 months with patients participating in the following activities;
- Twice a month blood pressure check measured at either Grady East Point Health Center or the YMCA facility. This will take 15 – 30 minutes each time.
- Once a month blood pressure check via remote monitoring using the free blood pressure cuff monitor provided to patients to record their blood pressure on a log sheet which will be submitted to the physician champions to review the blood pressure and make treatment plan.
- Once a month nutritional seminar held at either Grady East Point Health Center or the YMCA facility to discuss the impact of nutrition, low sodium, low fat, and portion control on hypertension goals. The sessions will be one hour long.
- Post-Intervention retrospective chart review will be done in July 2018 and results will be compared to patients’ baseline blood pressure.
Results/Discussion
Table 1: Bivariate association between Final BP Meet Goal and covariates
| Variable | Final BP Meet Goal | |||
| Yes | No | |||
| N (%) | N (%) | P-value* | ||
| Class Taken | 1 or 2 | 6 (85.7) | 1 (14.3) | 0.585 |
| 3 or 4 | 6 (66.7) | 3 (33.3) | ||
| Age | < 60 | 6 (85.7) | 1 (14.3) | 0.585 |
| >=60 | 6 (66.7) | 3 (33.3) | ||
| Gender | Male | 2 (100) | 0 (0) | 1 |
| Female | 10 (71.4) | 4 (28.6) | ||
| Smoking Status | Yes | 1 (50.0) | 1 (50.0) | 0.45 |
| No | 11 (78.6) | 3 (21.4) | ||
| Alcohol Consumption | Yes | 2 (100) | 0 (0) | 1 |
| No | 10 (71.4) | 4 (28.6) | ||
| *Fisher’s exact tests were used to calculate p-values. | ||||
| Table 2: Association between Final BP Meet Goal and Number of Class Taken adjusted
for Age using logisitc regression model |
||||||||||
| Variable | aOR (95%CI) | P-value | ||||||||
| Class Taken | 1 or 2 | ref | ||||||||
| 3 or 4 | 0.399 (0.016, 4.734) | 0.488 | ||||||||
| Age | < 60 | 2.509 (0.211, 61.279) | 0.488 | |||||||
| >=60 | ref | |||||||||
| aOR=adjusted odds ratio, 95 percent CI= 95% confidence interval | ||||||||||
The aOR for ‘Class Taken 3 or 4’ is 0.399, which means patients who attended 3 or 4 classes were about 60% less likely to meet the BP control goal compared to those who had 1 or 2 classes, but the result was not statistically significant (p=0.488). Intuitively, people who had more classes were supposed to be more likely to meet the goal. Two major explanations are;
(1) The sample size is too small to represent the true situation. Table 1 reveals 4 patients whose blood pressure didn’t meet the goal, but three of them actually attended all the four classes.
(2) Some confounding factors may play a part in the relationship between ‘Number of Class Taken’ and ‘Whether BP meet goal’. For example, baseline severity of hypertension may confound the association. People with severe hypertension or worse baseline health condition might be more interested and adhering to these classes, but it is also more difficult for them to meet the goal compared to people with much better health condition.
Conclusion
The purpose of this research is for GEP patients to improve and maintain a healthy heart as well as creating a Healthier Community by overcoming barriers by using a multidisciplinary approach with involves the following;
- Checking their blood pressure with routine self-monitor and clinic appointments
- Changing their blood pressure with healthy lifestyle habits: exercise and food
- Controlling their blood pressure with the YMCA Community programs
Congratulations to the GAFP 2018 Research Poster Winners! We wish them continued success in their research efforts!