For most people, medical care comes from more than one health care system, and patients expect a primary doctor to help coordinate care of medical specialists and hospitalizations. But a new study says that most of the time, that is not happening. Researchers at Regenstrief Institute, IUPUI, the U.S. Department of Veterans Affairs, and the Icahn School of Medicine at Mount Sinai found that primary care physicians recognize the need for better coordination and welcome health information exchange event notifications as a means of improving the flow of information to enable better patient care. Currently, the U.S. health care system has a siloed approach, making care coordination among providers challenging and infrequent. This incomplete sharing of clinical information may adversely affect health outcomes, researchers say. Study author and IUPUI professor Brian Dixon and other researchers focused on primary care in the VA system, which is representative of most systems in the U.S. The team reported that primary care doctors in the VA system typically are not notified when their patients were seen at a non-VA emergency department or hospitalized at a non-VA facility, This means physicians are unaware of the need for follow up and often have to wait months before learning of the event from a patient themselves - months during which the patient was not receiving care from the doctor responsible for overseeing their overall health. Primary care team members interviewed by the study authors viewed electronic alerts such as a notification that a patient was seen in the emergency department for chest pains and sent home when it was determined not to be a cardiac event, as both necessary and effective in supporting timely follow-up care, especially for older adults at higher risk of such medical events. The researchers are now working on a quantitative analysis, measuring the actual impact of notifications on follow-up care as well as preventing repeat emergency department visits and rehospitalizations.
In other news, like most adverse events, the pandemic has caused an increase in anxiety. According to the Centers for Disease Control and Prevention, in June 2020 -- a few months into the pandemic -- 13 percent of Americans started using or increasing substance use to cope with their emotions and stress due to the unknowns about the pandemic. And according to a new study by the IU School of Medicine that examined how biological factors impact anxiety disorders, anxiety in females intensifies when there's a specific, life-relevant condition. The team studied male and female rodent models to better understand sex differences in biological responses related to anxiety. Through studying both male and female models, they found that females and males were very different in their response to the most life-relevant aspects related to anxiety. The researchers also gave the rodents diazepam -- a drug used to treat anxiety -- and it greatly reduced anxiety in females, but it had little effect in males. Researcher Thatiane De Oliveira Sergio says anxiety disorders occur twice as often in women than men, and social and cultural factors likely play an important role in the development of anxiety in females. De Oliveira says roles for many women have amplified during the pandemic -- working remotely, teaching children in virtual school, everyday tasks, errands. These life-relevant conditions, she says, could have increased their anxiety. While anxiety in humans is complex, anxiety in animals is based solely on biology. Biological factors play an important role in these types of mood disorders, but it can be hard to untangle the mechanisms that drive anxiety in humans, De Oliveira says. The study is important to help develop more effective and personalized treatments, she says. Knowing that anxiety can manifest from different concerns in males and females, with females particularly attuned to the most life-relevant conditions, is a valuable step towards seeking better treatments, De Oliveira says.