Intimate Partner Violence and Telemedicine Usage and Satisfaction Early in the COVID-19 Pandemic.

BACKGROUND: COVID-19 has transformed the landscape of telemedicine utilization, shifting from predominantly in-person services to increased virtual encounters. Although telemedicine offers increased accessibility for medical care, many advocates voice concern about utilization and satisfaction with these services among individuals who experience intimate partner violence (IPV) given the unique practical, mental, and physical health challenges many face. OBJECTIVE: The purpose of the present study was to evaluate differences in telemedicine utilization and satisfaction, as well as global health and perceived loneliness, among data-driven patterns of IPV during the early phases of the pandemic. METHODS: In this longitudinal survey study, participants first completed an online survey between May 2019 and February 2020 that assessed social, psychological, and physical functioning, as well as emotional and physical IPV. A follow-up survey sent in May 2020 assessed recent telemedicine use and satisfaction, as well as response to the COVID-19 pandemic. RESULTS: Latent class analysis favored 4 classes of IPV that differed based on severity and features of IPV experienced. Although all 4 classes reported high satisfaction with telemedicine, individuals reporting low IPV had the highest satisfaction with telemedicine and the lowest rates of telemedicine utilization. Individuals who experienced IPV, particularly multiple forms of emotional and physical IPV, reported high physical and social concerns and perceived stress. CONCLUSIONS: Clinicians using telemedicine should be aware of the multiple challenges faced by individuals experiencing IPV and take additional steps to ensure their needs are met in a safe way. These results have potentially important clinical and policy implications.

Factors associated with a positive phosphatidylethanol test during liver transplantation evaluation.

BACKGROUND: Early identification of alcohol use is crucial for informing recommendations of appropriate follow-up treatment pre-liver transplant and optimizing post-liver transplant outcomes. The purpose of the study was to investigate whether there are psychosocial factors associated with a positive PEth test. METHODS: All patients who underwent a routine pre-surgical psychological evaluation for liver transplant listing (all etiologies, including acute liver failure, dual organ, and re-transplantation) at a single health care system in 2020 were included in a retrospective chart review. Data extraction included results from PEth testing and information from the psychological evaluation (i.e., demographic, psychiatric symptoms, and cognitive functioning). RESULTS: There were 158 patients (73.8%) who had a PEth test, of whom 21.5% had a positive result (n = 34). Younger age was associated with a positive PEth (p < .001). ALD status and type of ALD (hepatitis vs. cirrhosis) were also associated with a positive PEth test. Other demographic characteristics and psychiatric symptoms were not associated with a positive PEth result (p > .05). CONCLUSION: Younger age was the only significant demographic variable associated with a positive PEth test. Given the difficulty of predicting who may be using alcohol, it may be useful to use PEth testing for all patients during the pre-liver transplant evaluation and while patients are listed for liver transplant. Early identification of alcohol use through routine PEth testing will help identify patients who are using alcohol and need further treatment for alcohol use to optimize health and post-transplant outcomes.

History of abuse is associated with thoughts of harm among patients with pain after accounting for depressive symptoms.

INTRODUCTION: Screening for depressive symptoms is often the first step to understanding risk for thoughts of harm among patients with pain. Pain characteristics and history of abuse are also associated with thoughts of harm; however, little is known about these associations after accounting for depressive symptoms. This study examined the association between pain characteristics and history of abuse with thoughts of harm among pain patients with moderate to severe and low to mild depressive symptoms. METHODS: We conducted a cross-sectional analysis of patients (n=7510) who presented to a tertiary-care, outpatient pain clinic. RESULTS: Abuse history was significantly associated with increased odds of reporting thoughts of harm for both patients with moderate to severe depressive symptoms as well as low to mild depressive symptoms. Abuse did not modify the association between any of the pain characteristics and thoughts of harm. DISCUSSION: Our results highlight the importance of abuse history in assessing thoughts of harm. Although we are unable to infer causality due to the cross-sectional design, this study highlights the importance of screening for abuse history when assessing for suicidal and homicidal ideation.