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AbstractAimsThe aim of this study was to examine the effectiveness of topical fluorides in prevention of root caries‐related treatment in high caries risk Veterans.MethodsThis retrospective analysis of longitudinal data examined the effectiveness of professionally applied or prescription (Rx) fluoride treatment, in VHA clinics from FY 2009–2018. Professional fluoride treatments included 5% Sodium Fluoride (NaF) varnish (22 600 ppm fluoride), 2% NaF gel/rinse (9050 ppm fluoride), and 1.23% APF gel (12 300 ppm fluoride). The Rx for daily home use was 1.1% NaF paste/gel (5000 ppm fluoride). Outcomes studied were new root caries restorations or extractions and percent of patients with treatment over 1 year. Logistic regressions were adjusted for age, gender, race, ethnicity, chronic medical or psychiatric conditions, number of medication classes, anticholinergic drugs, smoking, baseline root caries treatment, preventive care, and time between first‐last restoration in the index year.ResultsRoot caries at baseline was associated with a high risk for new root caries. Veterans without root caries during the index year who received a fluoride gel/rinse intervention were 32–40% less likely to receive caries‐related treatment for root caries during the follow‐up period. Once Veterans had root caries, fluorides did not exhibit a positive effect.ConclusionIn older adults with high caries risk, early fluoride prevention is key, before root caries requires treatment.

<p><strong>Background</strong>. Poor blood pressure (BP) control and racial disparities therein may be a function of clinical inertia and ineffective communication about BP care.</p><p><strong>Methods. </strong>We compared two different interventions (electronic medical record reminder for BP care (Reminder only [RO]), and clinician training on BP care-related communication skills plus the reminder (Reminder + Training, [R+T]) with usual care in three primary care clinics, examining BP outcomes among 8,866 patients, and provider-patient communication and medication adherence among a subsample of 793.</p><p><strong>Results. </strong>Clinician counseling improved most at R+T. BP improved overall; R+T had a small but significantly greater reduction in diastolic BP (DBP; -1.7 mm Hg). White patients at RO experienced greater overall improvements in BP control. Site and race disparities trends suggested that disparities decreased at R+T, either stayed the same or decreased at Control; and stayed the same or increased at RO. </p><p><strong>Conclusions. </strong>More substantial or racial/ethnically tailored interventions are needed. Ethn Dis. 2016;26(1):27-36; doi: 10.18865/ed.26.1.27</p>

Objectives: Despite numerous interven­tions to address adherence to antihyperten­sive medications, continued high rates of uncontrolled blood pressure (BP) suggest a need to better understand patient factors beyond adherence associated with BP con­trol. We examined how patients' BP-related beliefs, and aspects of life context affect BP control, beyond medication adherence.Methods: We conducted a cross-sectional telephone survey of primary care patients with hypertension between 2010 and 2011 (N=103; 93 had complete data on all variables and were included in the regression analyses). We assessed patient so­ciodemographics (including race/ethnicity), medication adherence, BP-related beliefs, aspects of life context, and used clinical BP assessments.Results: Regression models including sociodemographics, medication adherence, and either beliefs or context consistently predicted BP control. Adding context after beliefs added no predictive value while adding beliefs after context significantly predicted BP control.Conclusion: Including patients' BP beliefs after context had the strongest effects on BP control.Practice Implications: Results suggest that when clinicians must choose a dimen­sion on which to intervene, focusing on beliefs would be the most fruitful approach to effecting change in BP control.Ethn Dis. 2019;29(4):567-576; doi:10.18865/ ed.29.4.567