Anuj Aggarwal

All Publications

• Current state of the pain medicine match: perspective and an eye to the future. Regional anesthesia and pain medicine Aggarwal, A. K., Barad, M., Chai, N. C., Furnish, T., Mishra, P., Kohan, L., Moeschler, S., Reddy, R. D., Yalamuru, B. 2024

  Abstract

  The National Resident Matching Program (NRMP) for pain medicine fellowships marked its 10th anniversary in 2023, coinciding with growing discussions within the Association of Pain Program Directors (APPD) regarding the program's future in the context of a recent decline of applicants into pain medicine. This letter explores the rationale behind reassessing the NRMP's utility for pain medicine, examining historical and current trends, and considering the implications of withdrawing from the match. Despite a recent decline in applicants and an increase in unfilled positions, the APPD advocates for continued participation in the match. The match ensures equitable and stable recruitment, preventing the chaotic pre-match environment of competitive, early offers. Data from similar specialties highlight the pitfalls of non-match systems, such as increased applicant pressure and reduced program visibility. The APPD supports maintaining the NRMP match while implementing reforms like preference signaling to address evolving challenges. The APPD aims to preserve the match's benefits and ensure a stable future for pain medicine fellowship recruitment.

  View details for DOI 10.1136/rapm-2024-105770

  View details for PubMedID 39231574

• Review of Ultrasound-Guided Procedures in the Management of Chronic Pain. Anesthesiology clinics Aggarwal, A. K., Ottestad, E., Pfaff, K. E., Huai-Yu Li, A., Xu, L., Derby, R., Hecht, D., Hah, J., Pritzlaff, S., Prabhakar, N., Krane, E., D'Souza, G., Hoydonckx, Y. 2023; 41 (2): 395-470

  Abstract

  This article summarizes clinical expert recommendations and findings for the application of ultrasound-guided procedures in chronic pain management. Data on analgesic outcomes and adverse effects were collected and analyzed and are reported in this narrative review. Ultrasound guidance offers opportunities for the treatment of pain, with focus in this article on greater occipital nerve, trigeminal nerves, sphenopalatine ganglion, stellate ganglion, suprascapular nerve, median nerve, radial nerve, ulnar nerve, transverse abdominal plane block, quadratus lumborum, rectus sheath, anterior cutaneous abdominal nerves, pectoralis and serratus plane, erector spinae plane, illioinguinal/iliohypogastric/genitofemoral nerve, lateral femoral cutaneous nerve, genicular nerve, and foot and ankle nerves.

  View details for DOI 10.1016/j.anclin.2023.02.003

  View details for PubMedID 37245950

• Emerging Field of Biased Opioid Agonists. Anesthesiology clinics Aggarwal, A. K. 2023; 41 (2): 317-328

  Abstract

  Advances in opioid pharmacology promise to bring a "better opioid." Biased opioid agonists, designed to recruit G protein over β-arrestin signaling, may provide analgesia without adverse effects of traditional opioids. Oliceridine, the first biased opioid agonist, was approved in 2020. In vitro and in vivo data present a complicated picture, with decreased gastrointestinal and respiratory adverse effects but similar abuse potential. Advances in pharmacology will result in new opioids brought to market. However, lessons learned from the past implore appropriate safeguards to patient safety and critical evaluation of the data and science behind new drugs.

  View details for DOI 10.1016/j.anclin.2023.02.001

  View details for PubMedID 37245944

• Pain Medicine Education in the United States: Success, Threats, and Opportunities. Anesthesiology clinics Aggarwal, A. K., Kohan, L., Moeschler, S., Rathmell, J., Moon, J. S., Barad, M. 2023; 41 (2): 329-339

  Abstract

  The year 2022 marked the 30th anniversary of the first Accreditation Council for Graduate Medical Education (ACGME) accreditation of pain medicine training programs. Before this, the education of pain medicine practitioners was through primarily an apprenticeship model. Since accreditation, pain medicine education has grown under the national leadership of pain medicine physicians and educational experts from the ACGME, exemplified by the release of Pain Milestones 2.0 in 2022. The rapid growth of knowledge in pain medicine, along with its multidisciplinary nature, poses challenges of fragmentation, standardization of curriculum, and adaptation to societal needs. However, these same challenges present opportunities for pain medicine educators to shape the future of the specialty.

  View details for DOI 10.1016/j.anclin.2023.03.004

  View details for PubMedID 37245945

• Pain Medicine Milestones 2.0: A Step into the Future. Pain medicine (Malden, Mass.) Aggarwal, A., Barad, M., Braza, D. W., McKenzie-Brown, A. M., Lee, D., Mayer, R. S., Przkora, R., Kohan, L., Koka, A., Szabova, A. 2023

  Abstract

  OBJECTIVE: To describe the process of revising the Pain Medicine Milestones 1.0 and implementing changes into the Pain Medicine Milestones 2.0 along with implications for pain medicine trainees.BACKGROUND: Competency-based medical education has been implemented in graduate medical education, including pain medicine. Milestones 1.0, introduced by the Accreditation Council for Graduate Medical Education (ACGME), has been used to assess learners in six competencies and respective sub-competencies. Recognizing areas for improvement in Milestones 1.0, the ACGME initiated the process of Milestones 2.0 and a working group was created to execute this task for pain medicine. The working group discussed revisions; consensus was sought when changes were introduced. Final milestones were agreed upon and made available for public comment prior to publication.RESULTS: Redundant sub-competencies were either merged or eliminated, reducing the number of sub-competencies. A maximum of three rows representing skill, knowledge, behavior and attitude were included for each sub-competency. Harmonized Milestones, aligning with other specialties in a predetermined ACGME framework, were adopted and modified to meet the needs of pain medicine. A supplemental guide was developed to assist educators in implementation of Milestones 2.0 and assessment of trainees.CONCLUSIONS: The intent of the Milestones 2.0 was to create an improved tool that is comprehensive, easier to utilize, and of increased value for pain medicine training programs. It is expected that implementation of Milestones 2.0 will streamline pain medicine trainee assessments by educators and prepare trainees for the future practice of pain medicine while serving to be the foundation of an iterative process to match the evolution of the specialty.

  View details for DOI 10.1093/pm/pnad014

  View details for PubMedID 36786406

• Anesthesiologists With Advanced Degrees in Education: Qualitative Study of a Changing Paradigm. JMIR medical education Aggarwal, A., Hess, O., Lockman, J. L., Smith, L., Stevens, M., Bruce, J., Caruso, T. 2022; 8 (2): e38050

  Abstract

  Anesthesiology education has undergone profound changes over the past century, from a pure clinical apprenticeship to novel comprehensive curricula based on andragogic learning theories. Combined with institutional and regulatory requirements, these new curricula have propagated professionalization of the clinician-educator role. A significant number of clinician-educator anesthesiologists, often with support from department chairs, pursue formal health professions education (HPE) training, yet there are no published data demonstrating the benefits or costs of these degrees to educational leaders.This study aims to collect the experiences of anesthesiologists who have pursued HPE degrees to understand the advantages and costs of HPE degrees to anesthesiologists.Investigators performed a qualitative study of anesthesiologists with HPE degrees working at academic medical centers. Interviews were thematically analyzed via an iterative process. They were coded using a team-based approach, and representative themes and exemplary quotations were identified.Seven anesthesiologists were interviewed, representing diverse geographic regions, subspecialties, and medical institutions. Analyses of interview transcripts resulted in the following 6 core themes: outcomes, extrinsic motivators, intrinsic motivators, investment, experience, and recommendations. The interviewees noted the advantages of HPE training for those wishing to pursue leadership or scholarship in medical education; however, they also noted the costs and investment of time in addition to preexisting commitments. The interviewees also highlighted the issues faculty and chairs might consider for the optimal timing of HPE training.There are numerous professional and personal benefits to pursuing HPE degrees for faculty interested in education leadership or scholarship. Making an informed decision to pursue HPE training can be challenging when considering the competing pressures of clinical work and personal obligations. The experiences of the interviewed anesthesiologists offer direction to future anesthesiologists and chairs in their decision-making process of whether and when to pursue HPE training.

  View details for DOI 10.2196/38050

  View details for PubMedID 35771619

• Anesthesiologists with Advanced Degrees in Education: A Qualitative Study of a Changing Paradigm Hess, O. M., Daniel, D., Aggarwal, A., Lockman, J., Smith, L. E., Stevens, M., Bruce, J., Caruso, T. LIPPINCOTT WILLIAMS & WILKINS. 2022: 388-389

  View details for Web of Science ID 000840283000149

• Considerations in Permanent Implantation of Peripheral Nerve Stimulation (PNS) for Chronic Neuropathic Pain: An International Cross Sectional Survey of Implanters. Pain practice : the official journal of World Institute of Pain Li, A. H., Gulati, A., Leong, M. S., Aggarwal, A. K., Salmasi, V., Spinner, D., Ottestad, E. 2022

  Abstract

  INTRODUCTION: Novel minimally invasive short-term and long-term peripheral nerve stimulation (PNS) systems have revolutionized targeted treatment of chronic neuropathic pain. We present an international survey of PNS-implanting pain physicians to assess what factors they consider when offering permanent PNS.METHODS: This cross-sectional study consisted of a survey (Qualtrics) that was distributed to PNS-implanting physicians in a device supplier's entire email database on November 13, 2020, with 3 weeks of response time. Physicians' contact information in the form of their email addresses had been previously collected by the supplier upon device distribution with permission to use survey responses for research.RESULTS: Of 2,032 database physicians, 40 physicians representing 37 institutions responded to the survey. The most common application of PNS was mononeuropathic pain (57%). The most frequently targeted nerve was the suprascapular nerve (29%). 14% of physicians reported 81-100% of their implants were dual-lead. The representative physicians ranged broadly in their most frequently-targeted nerves. Although mononeuropathic pain was the most common indication for PNS, there was still varied response regarding other indications such as CRPS and post-surgical chronic pain.CONCLUSION: In context of a low response rate, identifying such factors can help update the prevailing treatment algorithm for interventional therapies, assist pain physicians in better identifying which patients are the best candidates for PNS, and inform future clinical trial design on PNS efficacy.

  View details for DOI 10.1111/papr.13105

  View details for PubMedID 35178863

• Management of Postoperative Pain in Patients Following Spine Surgery: A Narrative Review. International journal of general medicine Prabhakar, N. K., Chadwick, A. L., Nwaneshiudu, C., Aggarwal, A., Salmasi, V., Lii, T. R., Hah, J. M. 2022; 15: 4535-4549

  Abstract

  Perioperative pain management is a unique challenge in patients undergoing spine surgery due to the increased incidence of both pre-existing chronic pain conditions and chronic postsurgical pain. Peri-operative planning and counseling in spine surgery should involve an interdisciplinary approach that includes consideration of patient-level risk factors, as well as pharmacologic and non-pharmacologic pain management techniques. Consideration of psychological factors and patient focused education as an adjunct to these measures is paramount in developing a personalized perioperative pain management plan. Understanding the currently available body of knowledge surrounding perioperative opioid management, management of opioid use disorder, regional/neuraxial anesthetic techniques, ketamine/lidocaine infusions, non-opioid oral analgesics, and behavioral interventions can be useful in developing a comprehensive, multi-modal treatment plan among patients undergoing spine surgery. Although many of these techniques have proved efficacious in the immediate postoperative period, long-term follow-up is needed to define the impact of such approaches on persistent pain and opioid use. Future techniques involving the use of precision medicine may help identify phenotypic and physiologic characteristics that can identify patients that are most at risk of developing persistent postoperative pain after spine surgery.

  View details for DOI 10.2147/IJGM.S292698

  View details for PubMedID 35528286

• Characterization of chronic overlapping pain conditions in patients with chronic migraine: A CHOIR study. Headache Barad, M. J., Sturgeon, J. A., Hong, J., Aggarwal, A. K., Mackey, S. C. 2021

  Abstract

  OBJECTIVE: Chronic overlapping pain conditions (COPCs) represent a co-aggregation of widespread pain disorders. We characterized differences in physical and psychosocial functioning in patients with chronic migraine (CM) and those with CM and COPCs.BACKGROUND: Patients with CM and COPCs have been identified as a distinct subgroup of patients with CM, and these patients may be vulnerable to greater symptom severity and burden.METHODS: Data were extracted from Collaborative Health Outcomes Information Registry (an open-source learning health-care system), completed at the patients' first visit at a large tertiary care pain management center and electronic medical records. In 1601 patients with CM, the number of non-cephalic areas of pain endorsed on a body map was used to examine the differences in pain, physical and psychosocial function, adverse life experience, and health-care utilization.RESULTS: Patients endorsing more body map regions reported significantly worse symptoms and function across all domains. Scored on a t-score metric (mean = 50, SD = 10), endorsement of one additional body map region corresponded with a 0.69-point increase in pain interference (95% CI = 0.55, 0.82; p<0.001; Cohen's f=0.328), 1.15-point increase in fatigue (95% CI = 0.97, 1.32; p<0.001; Cohen's f=0.432), and 1.21-point decrease in physical function (95% CI = -1.39, -1.03; p<0.001; Cohen's f=0.560). Patients with more widespread pain reported approximately 5% more physician visits (95% CI = 0.03, 0.07; p<0.001), and patients reporting adverse life events prior to age 17 endorsed 22% more body map regions (95% CI = 0.11, 0.32; p<0.001).CONCLUSIONS: Patients with CM and other overlapping pain conditions as noted on the body map report significantly worse pain-related physical function, psychosocial functioning, increased health-care utilization, and greater association with adverse life experiences, compared with those with localized CM. This study provides further evidence that patients with CM and co-occurring pain conditions are a distinct subgroup of CM and can be easily identified through patient-reported outcome measures.

  View details for DOI 10.1111/head.14129

  View details for PubMedID 34184263

• Evidence for Continuing Buprenorphine in the Perioperative Period. The Clinical journal of pain Li, A. H., Schmiesing, C., Aggarwal, A. K. 2020

  Abstract

  OBJECTIVES: Given there are conflicting recommendations for the perioperative management of buprenorphine, we conducted a retrospective cohort study of our surgery patients on buprenorphine whose baseline dose had been preoperatively continued, tapered or discontinued.METHODS: With IRB approval, we reviewed charts from January 1, 2013 to June 30, 2016 of patients on buprenorphine who had received elective surgery at Stanford Healthcare. Our primary outcome of interest was the change in pain score, defined as mean postoperative pain score - preoperative pain score. We also collected data on patients' tapering procedure and any postoperative non-buprenorphine opioid requirements.RESULTS: Out of approximately 1200 patients on buprenorphine, 121 had surgery of which 50 were admitted and included in the study. Perioperative continuation of transdermal buprenorphine resulted in a lower change in pain score postoperatively (0.606±0.878) than discontinuation (4.83±1.23, P=0.012). Among sublingual patients, there was no difference in the change in pain score between those who were tapered to a non-zero dose versus discontinued (P=0.55). Continuation of sublingual buprenorphine resulted in fewer non-buprenorphine scheduled opioid prescriptions than its taper or discontinuation (P=0.028). Finally, tapers were performed with great variability in the tapering team and rate of taper.DISCUSSION: Based on our findings, we implemented a policy at our institution for the continuation of perioperative buprenorphine whenever possible. Our work reveals crucial targets for the education of perioperative healthcare providers and the importance of coordination amongst all perioperative services and providers.

  View details for DOI 10.1097/AJP.0000000000000858

  View details for PubMedID 32520814

• Comparison of intravenous lidocaine versus epidural anesthesia for traumatic rib fracture pain: a retrospective cohort study. Regional anesthesia and pain medicine Lii, T. R., Aggarwal, A. K. 2020

  Abstract

  BACKGROUND: Effective analgesia is essential in managing traumatic rib fractures. Intravenous lidocaine (IVL) is effective in treating perioperative pain, acute pain in the emergency department, cancer pain in hospice, and outpatient chronic neuropathic pain. Our study examined the associations between IVL versus epidural analgesia (EA) and pain for the treatment of acute rib fracture in the inpatient setting.METHODS: We performed a retrospective study involving adults admitted to an academic level I trauma center from June 1, 2011 to June 1, 2016 with consults to the pain service for acute rib fracture pain. Eighty-nine patients were included in the final analysis (54 IVL and 35 EA patients). Both groups had usual access to opioid medications. The primary outcome was absolute change in numeric pain scores during 0-24 and 24-48hours after initiating IVL or EA, compared with baseline. Secondary outcomes include opioid consumption, incentive spirometry, supplemental oxygens, pneumonia, endotracheal intubation and length of hospital stay.RESULTS: Numeric pain scores differed at baseline (mean 5.6 for IVL vs 4.5 for EA, p=0.01), while age, injury severity, and number of fractured ribs were similar. IVL and EA were associated with similar reductions in numeric pain scores within 0-24 and 24-48hours (mean -2.9 for IVL vs -2.3 for EA during both periods, p=0.19and p=0.17 respectively) . There was greater non-neuraxial opioid consumption with IVL compared with EA (98.6 vs 22.3 mg morphine equivalents (MME) at 0-24hours, p=0.0005; 105.6 vs 18.9 MME at 24-48hours, p<0.0001). When epidural opioids were analyzed, the EA group was exposed to higher total MME at 0-24hours (655.2 vs 98.6 MME, p<0.0001) and 24-48hours (586 vs 105.6 MME, p=0.0001), suggesting an opioid sparing effect of IVL.CONCLUSION: Our results suggest that IVL is similar to EA in numeric pain score reduction, and that IVL may have an opioid sparing effect when taking neuraxial opioids into account. IVL may be an effective alternative to epidurals for the treatment of rib fracture pain. It should be considered for patients who have contraindications to epidurals or are unable to receive an epidural in a timely manner.

  View details for DOI 10.1136/rapm-2019-101120

  View details for PubMedID 32503863

• INTRAVENOUS LIDOCAINE INFUSION FOR MANAGEMENT OF PAIN IN THE INTENSIVE CARE UNIT Jung, S., Ottestad, E., Aggarwal, A., Flood, P., Nikitenko, V. LIPPINCOTT WILLIAMS & WILKINS. 2020

  View details for Web of Science ID 000530000201415

• Qualitative Assessment of Clerkship Students' Perspectives of the Topics of Pain and Addiction in their Preclinical Curriculum. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry Raber, I., Ball, A., Papac, J., Aggarwal, A., Sussman, R., Basaviah, P., Newmark, J., Lembke, A. 2018; 42 (5): 664-667

  Abstract

  A majority of physicians feel poorly trained in the treatment of chronic pain and addiction. As such, it is critical that medical students receive appropriate education in both pain management and addiction. The purpose of this study was to assess the pre-clinical curriculum in pain medicine and addiction from the perspective of students after they had completed their pre-clinical training and to assess what they perceived as the strengths and weaknesses of their training.The authors conducted focused interviews among clinical medical students who had completed at least 6 months of clerkships. The interviews targeted the students' retrospective opinions about the pre-clinical curriculum and their preparedness for clinical encounters with either pain or addiction-related issues during their rotations. Coders thematically analyzed the de-identified interview transcripts, with consensus reached through discussion and code modification.Themes that emerged through the focused interviews included: fragmented curricular structure (and insufficient time) for pain and addiction medicine, not enough specific treatment strategies for pain or addiction, especially for complex clinical scenarios, and lack of a trained work-force to provide guidance in the management of pain and addiction.This study demonstrated the feasibility of gathering student perspectives to inform changes to improve the pre-clinical curriculum in pain and addiction medicine. Students identified multiple areas for improvement at the pre-clerkship level, which have informed updates to the curriculum. More research is needed to determine if curricular changes based on student feedback lead to improved learning outcomes.

  View details for DOI 10.1007/s40596-018-0927-1

  View details for PubMedID 29704194

• Perioperative Considerations for the Patient with Opioid Use Disorder on Buprenorphine, Methadone, or Naltrexone Maintenance Therapy. Anesthesiology clinics Harrison, T. K., Kornfeld, H., Aggarwal, A. K., Lembke, A. 2018; 36 (3): 345–59

  Abstract

  As part of a national effort to combat the current US opioid epidemic, use of currently Food and Drug Administration-approved drugs for the treatment of opioid use disorder/opioid addiction (buprenorphine, methadone, and naltrexone) is on the rise. To provide optimal pain control and minimize the risk of relapse and overdose, providers need to have an in-depth understanding of how to manage these medications in the perioperative setting. This article reviews key principles and discusses perioperative considerations for patients with opioid use disorder on buprenorphine, methadone, or naltrexone.

  View details for PubMedID 30092933

• Qualitative Assessment of Clerkship Students' Perspectives of the Topics of Pain and Addiction in their Preclinical Curriculum Academic Psychiatry Raber, I., Ball, A., Papac, J., Aggarwal, A., Sussman, R., Basaviah, P., Newmark, J., Lembke, A. 2018: 664–67

  Abstract

  A majority of physicians feel poorly trained in the treatment of chronic pain and addiction. As such, it is critical that medical students receive appropriate education in both pain management and addiction. The purpose of this study was to assess the pre-clinical curriculum in pain medicine and addiction from the perspective of students after they had completed their pre-clinical training and to assess what they perceived as the strengths and weaknesses of their training.The authors conducted focused interviews among clinical medical students who had completed at least 6 months of clerkships. The interviews targeted the students' retrospective opinions about the pre-clinical curriculum and their preparedness for clinical encounters with either pain or addiction-related issues during their rotations. Coders thematically analyzed the de-identified interview transcripts, with consensus reached through discussion and code modification.Themes that emerged through the focused interviews included: fragmented curricular structure (and insufficient time) for pain and addiction medicine, not enough specific treatment strategies for pain or addiction, especially for complex clinical scenarios, and lack of a trained work-force to provide guidance in the management of pain and addiction.This study demonstrated the feasibility of gathering student perspectives to inform changes to improve the pre-clinical curriculum in pain and addiction medicine. Students identified multiple areas for improvement at the pre-clerkship level, which have informed updates to the curriculum. More research is needed to determine if curricular changes based on student feedback lead to improved learning outcomes.

  View details for DOI 10.1007/s40596-018-0927-1

• Ehlers Danlos, POTS, and Occult Cerebrospinal Fluid Leak: A Case Report Journal of Anesthesia Pain Medicine Aggarwal, A. K., Carroll, I. 2017; 2 (1)
• Subpleural Cystic Lung Disease In Severe H1n1 Influenza-Induced Acute Respiratory Distress Syndrome (ards) Matusov, Y., Aggarwal, A., Sager, J. S. AMER THORACIC SOC. 2016

  View details for Web of Science ID 000390749601034

• Effect of General Anesthesia in Infancy on Long-Term Recognition Memory in Humans and Rats NEUROPSYCHOPHARMACOLOGY Stratmann, G., Lee, J., Sall, J. W., Lee, B. H., Alvi, R. S., Shih, J., Rowe, A. M., Ramage, T. M., Chang, F. L., Alexander, T. G., Lempert, D. K., Lin, N., Siu, K. H., Elphick, S. A., Wong, A., Schnair, C. I., Vu, A. F., Chan, J. T., Zai, H., Wong, M. K., Anthony, A. M., Barbour, K. C., Ben-Tzur, D., Kazarian, N. E., Lee, J. Y., Shen, J. R., Liu, E., Behniwal, G. S., Lammers, C. R., Quinones, Z., Aggarwal, A., Cedars, E., Yonelinas, A. P., Ghetti, S. 2014; 39 (10): 2275-2287

  Abstract

  Anesthesia in infancy impairs performance in recognition memory tasks in mammalian animals, but it is unknown if this occurs in humans. Successful recognition can be based on stimulus familiarity or recollection of event details. Several brain structures involved in recollection are affected by anesthesia-induced neurodegeneration in animals. Therefore, we hypothesized that anesthesia in infancy impairs recollection later in life in humans and rats. Twenty eight children ages 6-11 who had undergone a procedure requiring general anesthesia before age 1 were compared with 28 age- and gender-matched children who had not undergone anesthesia. Recollection and familiarity were assessed in an object recognition memory test using receiver operator characteristic analysis. In addition, IQ and Child Behavior Checklist scores were assessed. In parallel, thirty three 7-day-old rats were randomized to receive anesthesia or sham anesthesia. Over 10 months, recollection and familiarity were assessed using an odor recognition test. We found that anesthetized children had significantly lower recollection scores and were impaired at recollecting associative information compared with controls. Familiarity, IQ, and Child Behavior Checklist scores were not different between groups. In rats, anesthetized subjects had significantly lower recollection scores than controls while familiarity was unaffected. Rats that had undergone tissue injury during anesthesia had similar recollection indices as rats that had been anesthetized without tissue injury. These findings suggest that general anesthesia in infancy impairs recollection later in life in humans and rats. In rats, this effect is independent of underlying disease or tissue injury.

  View details for DOI 10.1038/npp.2014.134

  View details for Web of Science ID 000340308400002

  View details for PubMedID 24910347

• Demographic Factors Affect Willingness to Register as an Organ Donor More Than a Personal Relationship with a Transplant Candidate DIGESTIVE DISEASES AND SCIENCES Regalia, K., Zheng, P., Sillau, S., Aggarwal, A., Bellevue, O., Fix, O. K., Prinz, J., Dunn, S., Biggins, S. W. 2014; 59 (7): 1386-1391

  Abstract

  Transplant candidate caregivers (TCCs) are an under-utilized but potentially devoted pool of advocates who themselves may be recruited to register for deceased organ donation.The purpose of this study was to assess and compare recruitment barriers to deceased donor registration efforts in TCCs and health fair attendees (HFAs).A 42-item questionnaire assessing willingness to register as an organ donor and perceptions and knowledge about organ donation was administered to 452 participants (174 in Denver, 278 in San Francisco). Logistic regression, stratified by study site, was used to assess associations between explanatory variables and willingness to register as an organ donor.In Denver, 83 % of TCCs versus 68 % of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were female gender [odds ratio (OR) 2.4], Caucasian race (OR 2.3), college graduate (OR 11.1), married (OR 2.4) and higher positive perception of organ donation (OR 1.2), each p < 0.05. In San Francisco, 58 % of TCCs versus 70 % of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were Caucasian race (OR 3.5), college graduate (OR 2.2), married (OR 1.9), higher knowledge (OR 1.6) and higher positive perception of organ donation (OR 1.2), each p < 0.05. In both locales, Caucasians were more likely to have positive perceptions about organ donation and were more willing to register.Demographic characteristics, not personal connection to a transplant candidate, explain willingness to register as an organ donor.

  View details for DOI 10.1007/s10620-014-3053-2

  View details for Web of Science ID 000338344500011

  View details for PubMedID 24519521

  View details for PubMedCentralID PMC4071122

• Mental Illness Among Us: A New Curriculum to Reduce Mental Illness Stigma Among Medical Students ACADEMIC PSYCHIATRY Aggarwal, A. K., Thompson, M., Falik, R., Shaw, A., O'Sullivan, P., Lowenstein, D. H. 2013; 37 (6): 385–91

  Abstract

  Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled "Mental Illness Among Us (MIAU)," would reduce stigma of mental illness.In 2010 and 2011, students completed voluntary pre- and post-MIAU surveys measuring attitudes regarding mental illness in relation to MIAU. Also, in 2011, the authors categorized topics mentioned in student responses to an open-ended, free-response question on the course final examination.Of 298 enrolled students, 250 submitted surveys that were matched pre- and post-intervention. Participants in the curriculum showed a significant difference in Social Distance, indicating an increased willingness to interact with individuals with mental illness, and a significant difference in the Mental Illness: Clinicians' Attitudes (MICA) score representing a stronger agreement with positive statements regarding mental illness. The non-participants' scores showed no changes in measures from pre- to post. Respondents most frequently reported that the neuroscience course prepared them to be a physician because it taught about compassion and the importance of treating the whole patient.The results indicate that participation in MIAU leads to a decrease in stigmatization of mental illness and a greater sense of compassion among UCSF medical students. This finding is consistent with previous research suggesting social and cognitive congruence among peers and peer-teachers can result in meaningful learning experiences. MIAU may represent a sustainable model to supplement current systems to promote well-being of medical trainees.

  View details for DOI 10.1007/BF03340074

  View details for Web of Science ID 000326561500004

  View details for PubMedID 24185285