Browsing by Author "Drouin, Michelle"

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    The association of COMT genotype with buproprion treatment response in the treatment of major depressive disorder
    (Wiley, 2020-05-27) Fawver, Jay; Flanagan, Mindy; Smith, Thomas; Drouin, Michelle; Mirro, Michael; BioHealth Informatics, School of Informatics and Computing
    Background Pharmacodynamics and pharmacogenetics are being explored in pharmacological treatment response for major depressive disorder (MDD). Interactions between genotype and treatment response may be dose dependent. In this study, we examined whether MDD patients with Met/Met, Met/Val, and Val/Val COMT genotypes differed in their response to bupropion in terms of depression scores. Methods This study utilized a convenience sample of 241 adult outpatients (≥18 years) who met DSM‐5 criteria for MDD and had visits at a Midwest psychopharmacology clinic between February 2016 and January 2017. Exclusion criteria included various comorbid medical, neurological, and psychiatric conditions and current use of benzodiazepines or narcotics. Participants completed genetic testing and the 9 question patient‐rated Patient Health Questionnaire (PHQ‐9) at each clinic visit (M = 3.8 visits, SD = 1.5) and were prescribed bupropion or another antidepressant drug. All participants were adherent to pharmacotherapy treatment recommendations for >2 months following genetic testing. Results Participants were mostly Caucasian (85.9%) outpatients (154 female and 87 male) who were 44.5 years old, on average (SD = 17.9). For Val carriers, high bupropion doses resulted in significantly lower PHQ‐9 scores than no bupropion (t(868) = 5.04, p < .001) or low dose bupropion (t(868) = 3.29, p = .001). Val carriers differed significantly from Met/Met patients in response to high dose bupropion (t(868) = −2.03, p = .04), but not to low dose bupropion. Conclusion High‐dose bupropion is beneficial for MDD patients with Met/Val or Val/Val COMT genotypes, but not for patients with Met/Met genotype. Prospective studies are necessary to replicate this pharmacodynamic relationship between bupropion and COMT genotypes and explore economic and clinical outcomes.
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    ‘Back-burner relationships’ are more common than you’d think
    (The Conversation US, Inc., 2018-02-09) Dibble, Jayson; Drouin, Michelle; Psychology, School of Science
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    Clinician use of data elements from cardiovascular implantable electronic devices in clinical practice
    (Elsevier, 2023-01-20) Daley, Carly; Coupe, Amanda; Allmandinger, Tina; Shirazi, Jonathan; Wagner, Shauna; Drouin, Michelle; Ahmed, Ryan; Toscos, Tammy; Mirro, Michael; BioHealth Informatics, School of Informatics and Computing
    Background: Cardiovascular implantable electronic devices (CIEDs) capture an abundance of data for clinicians to review and integrate into the clinical decision-making process. The multitude of data from different device types and vendors presents challenges for viewing and using the data in clinical practice. Efforts are needed to improve CIED reports by focusing on key data elements used by clinicians. Objective: The purpose of this study was to uncover the extent to which clinicians use the specific types of data elements from CIED reports in clinical practice and explore clinicians' perceptions of CIED reports. Methods: A brief, web-based, cross-sectional survey study was deployed using snowball sampling from March 2020 through September 2020 to clinicians who are involved in the care of patients with CIEDs. Results: Among 317 clinicians, the majority specialized in electrophysiology (EP) (80.1%), were from North America (88.6%), and were white (82.2%). Over half (55.3%) were physicians. Arrhythmia episodes and ventricular therapies rated the highest among 15 categories of data presented, and nocturnal or resting heart rate and heart rate variability were rated the lowest. As anticipated, clinicians specializing in EP reported using the data significantly more than other specialties across nearly all categories. A subset of respondents offered general comments describing preferences and challenges related to reviewing reports. Conclusion: CIED reports contain an abundance of information that is important to clinicians; however, some data are used more frequently than others, and reports could be streamlined for users to improve access to key information and facilitate more efficient clinical decision making.
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    Involving patients as key stakeholders in the design of cardiovascular implantable electronic device data dashboards: Implications for patient care
    (Elsevier, 2020-05-11) Daley, Carly; Ghahari, Romisa Rohani; Drouin, Michelle; Ahmed, Ryan; Wagner, Shauna; Reining, Lauren; Coupe, Amanda; Toscos, Tammy; Mirro, Michael; BioHealth Informatics, School of Informatics and Computing
    Background: Data from remote monitoring (RM) of cardiovascular implantable electronic devices (CIEDs) currently are not accessible to patients despite demand. The typical RM report contains multiple pages of data for trained technicians to read and interpret and requires a patient-centered approach to be curated to meet individual user needs. Objective: The purpose of this study was to understand which RM data elements are important to patients and to gain design insights for displaying meaningful data in a digital dashboard. Methods: Adults with implantable cardioverter-defibrillators (ICDs) and pacemakers (PMs) participated in this 2-phase, user-centered design study. Phase 1 included a card-sorting activity to prioritize device data elements. Phase 2 included one-on-one design sessions to gather insights and feedback about a visual display (labels and icons). Results: Twenty-nine adults (mean age 71.8 ± 11.6 years; 51.7% female; 89.7% white) participated. Priority data elements for both ICD and PM groups in phase 1 (n = 19) were related to cardiac episodes, device activity, and impedance values. Recommended replacement time for battery was high priority for the PM group but not the ICD group. Phase 2 (n = 10) revealed that patients would like descriptive, nontechnical terms to depict the data and icons that are intuitive and informative. Conclusion: This user-centered design study demonstrated that patients with ICDs and PMs were able to prioritize specific data from a comprehensive list of data elements that they had never seen before. This work contributes to the goal of sharing RM data with patients in a way that optimizes the RM feature of CIEDs for improving patient outcomes and clinical care.
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    Predictors of Mortality in Adults With Calcium Channel Blocker Toxicity Receiving Extracorporeal Membrane Oxygenation Support: An Extracorporeal Life Support Organization Registry Analysis
    (Wolters Kluwer, 2025) Subramanian, Rakeshkumar; Roebuck, Amelia; Joshi, Hariom; Drouin, Michelle; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    Calcium channel blocker (CCB) toxicity presents a significant mortality risk, highlighting the need for effective treatment strategies such as extracorporeal membrane oxygenation (ECMO). This study analyzes Extracorporeal Life Support Organization (ELSO) registry data to determine the mortality rate in adults treated with ECMO for CCB toxicity and identifies clinical predictors of mortality. A retrospective analysis of the ELSO registry from January 2016 to April 2023 was conducted, focusing on adults diagnosed with CCB toxicity (ICD-10 T46.1) who received ECMO. Data collected included patient demographics, ECMO details (mode, duration, type), pre-ECMO clinical indicators (pH, lactate levels, cardiac arrest incidence), and in-hospital mortality. The analysis employed descriptive statistics to profile the patient population, with independent t-tests and chi-square tests comparing survivors to nonsurvivors. Logistic regression identified mortality predictors, integrating multiple imputations to remedy missing data, thus ensuring the analysis's integrity. The mortality rate for ECMO-treated CCB toxicity was 40.6%. Severe acidosis and the need for pre-ECMO renal replacement therapy were identified as key predictors of mortality. Further research is needed to determine if early ECMO initiation before a significant pH drop improves outcomes.
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    "Technoference" and Implications for Mothers' and Fathers' Couple and Coparenting Relationship Quality
    (Elsevier, 2018-03) McDaniel, Brandon T.; Galovan, Adam M.; Cravens, Jaclyn D.; Drouin, Michelle; Psychology, School of Science
    Technology devices are widely used today, creating opportunities to connect and communicate with distant others while also potentially disrupting communication and interactions between those who are physically present (i.e., technoference or phubbing). These disruptions in couple and coparenting relationships have the potential to negatively impact relationship outcomes. In this two-part study of 182 married/cohabiting couples from the Daily Family Life Project and 239 couples from the Couple Well-Being Project, we examined the role of technoference in couple and coparenting relationship quality and potential gender differences utilizing dyadic data. We found that greater technoference related to greater conflict over technology use, and greater conflict predicted lower relationship satisfaction and poorer perceptions of coparenting quality (Study 1). Using a more diverse sample (Study 2), we again found support for the main pathways tested in our first study, suggesting that results found in Study 1 and in previous work are not artifacts of sampling. As satisfaction, support, and agreement among relationship partners and parents are often critical to relationship health and family cohesion, it is important for couples and families to evaluate, monitor, and be willing to adapt their technology usage patterns so that these patterns do not cause conflict and possibly relationship deterioration over time