A5085017781- Parkinson's Disease Mechanisms and Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Neurological disorders and treatments
- Epilepsy research and treatment
- Intracerebral and Subarachnoid Hemorrhage Research
- Pharmacological Effects and Toxicity Studies
- Pharmaceutical Practices and Patient Outcomes
- Dysphagia Assessment and Management
- Chronic Disease Management Strategies
- Attention Deficit Hyperactivity Disorder
- Genetic Neurodegenerative Diseases
- Botulinum Toxin and Related Neurological Disorders
- Dementia and Cognitive Impairment Research
- Schizophrenia research and treatment
- Restless Legs Syndrome Research
- Ophthalmology and Visual Impairment Studies
- Medication Adherence and Compliance
- Cerebral Palsy and Movement Disorders
- Acute Ischemic Stroke Management
- Assistive Technology in Communication and Mobility
- Telemedicine and Telehealth Implementation
- Atrial Fibrillation Management and Outcomes
- Ginkgo biloba and Cashew Applications
- Stroke Rehabilitation and Recovery
- Opioid Use Disorder Treatment
University of Pennsylvania
2016-2025
National Patient Safety Foundation
2023-2025
Philadelphia VA Medical Center
2021-2025
California University of Pennsylvania
2021-2024
University of Iowa
2024
Rutgers, The State University of New Jersey
2024
Health Economics and Outcomes Research (United Kingdom)
2023
Icahn School of Medicine at Mount Sinai
2020-2022
University of Vermont Medical Center
2022
Williston State College
2021
Estimates of the prevalence Parkinson's disease in North America have varied widely and many estimates are based on small numbers cases from regional subpopulations. We sought to estimate by combining data a multi-study sampling strategy diverse geographic regions and/or sources. Five separate cohort studies California (2), Minnesota (1), Hawaii USA Ontario, Canada (1) estimated PD health-care records (3), active ascertainment through facilities, large group, neurology practices longitudinal...
<i>Background:</i> Parkinson disease is a common neurodegenerative disease. The racial, sex, age, and geographic distributions of in the US are unknown. <i>Methods:</i> We performed serial cross-sectional study Medicare beneficiaries aged 65 older from years 1995, 2000–2005. Using over 450,000 cases per year, we calculated prevalence annual incidence by race, county. Spatial analysis investigated distribution <i>Results:</i> Age-standardized (per 100,000)...
<h3>Objective:</h3> To investigate the utilization of neurologist providers in treatment patients with Parkinson disease (PD) United States and determine whether is associated improved clinical outcomes. <h3>Methods:</h3> This was a retrospective observational cohort study Medicare beneficiaries PD year 2002. Multilevel logistic regression used to which patient characteristics predicted care between 2002 2005 compare age, race, sex, comorbidity-adjusted annual risk skilled nursing facility...
To determine whether providing remote neurologic care into the homes of people with Parkinson disease (PD) is feasible, beneficial, and valuable.
Abstract Parkinson disease (PD) is the second most common age-related neurodegenerative condition diagnosed in North America. We recently demonstrated, using multiple epidemiological data sources, that prevalence of PD diagnoses was greater than previously reported and currently used for clinical, research, policy decision-making. Prior incidence estimates have varied, unclear reasons. There a need improved incidence, not only care delivery planning future but also increasing our...
To determine the relative contributions of individual pathologic protein deposits associated with dementia in patients Parkinson disease (PD).
<h3>Objective</h3>To determine the life expectancy of patients with Parkinson disease (PD) in United States and identify demographic, geographic, clinical factors that influence survival.<h3>Design</h3>Retrospective cohort study 138 000 Medicare beneficiaries incident PD who were identified 2002 followed up through 2008.<h3>Main Outcome Measures</h3>Confounder-adjusted 6-year risk death as influenced by 3 groups factors: (1) race, sex, age at diagnosis; (2) geography environmental factors;...
Parkinson disease associated with farming and exposure to agricultural chemicals has been reported in numerous studies; little is known about risk factors for those living urban areas. The authors investigated the relation between copper, lead, or manganese emissions incidence United States, studying 29 million Medicare beneficiaries year 2003. was determined by using who had not changed residence since 1995. Over 35,000 nonmobile incident cases, diagnosed a neurologist, were identified...
<h3>Objective</h3> To characterize continuous EEG (cEEG) use patterns in the critically ill and to determine association with hospitalization outcomes for specific diagnoses. <h3>Methods</h3> We performed a retrospective cross-sectional study National Inpatient Sample data from 2004 2013. sampled hospitalized adult patients who received intensive care then compared underwent cEEG those did not. considered diagnostic subgroups of seizure/status epilepticus, subarachnoid or intracerebral...
To identify sociodemographic, clinical, and physician/practice factors associated with deep brain stimulation (DBS). DBS is a proven surgical therapy for Parkinson disease (PD), but recommended only patients excellent health, results in significant out-of-pocket costs, requires substantial physician involvement.
To examine long-term care facility (LTCF or nursing home) use and end-of-life for individuals with Parkinson disease (PD).In this nationwide retrospective cohort study, we compared LTCF hospice utilization among Medicare beneficiaries diagnosed PD by demographic, clinical, physician characteristics. We also examined the impact of outpatient neurologist institutionalized patients on care.We identified 469,055 who received benefits in 2002. Nearly 25% (more than 100,000 total) resided an LTCF....
To explore rural-urban differences and trends in tissue plasminogen activator (tPA) utilization among acute ischemic stroke (AIS) patients examine the association between primary center (PSC) growth geographic disparity tPA use.We used hospital discharge data from National Inpatient Sample (NIS) 2000 to 2010 indicators of describe temporal disparities AIS care during PSC growth. The Gini coefficient was quantify inequity use at state level (from 0% 100% maximum potential inequity) use.Of...
To compare access to caregiving between men and women with Parkinson disease (PD).This was a cross-sectional longitudinal study among participants PD enrolled in the National Foundation Parkinson's Outcomes Project from 2009 2014 at 21 international sites. The primary outcome measures were presence of caregiver baseline visit, burden as measured by Multidimensional Caregiver Strain Index (MCSI) baseline, time first paid caregiver.A total 7,209 (63% men, 37% women) evaluated. Men had mean age...
Background Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on burden are limited in subpopulations, such as individuals Parkinson disease (PD). The objective this study was to determine whether associated outcomes a PD inpatient population. Methods Using Cerner Health Facts® database, we retrospectively examined medication use, diagnoses, hospital...
It is widely cited that dementia occurs in up to 80% of patients with Parkinson disease (PD), but studies reporting such high rates were published over two decades ago, had relatively small samples, and other limitations. We aimed determine long-term risk PD using data from large, ongoing, prospective, observational studies.
To investigate the impact of neurologist care on Parkinson disease (PD)-related hospitalizations. Recent data indicate that treatment in PD may be associated with improved survival, yet is underutilized. Factors contributing to this survival remain unknown, but due part optimal or avoidance disease-related complications.This was a retrospective cohort study Medicare beneficiaries diagnosed 2002 and still living 2006. Hospitalization for PD-related (neurodegenerative disease, psychosis,...
Background and Introduction: Delivering care through telemedicine directly into the patient's home is increasingly feasible, valuable, beneficial. However, qualitative data on how patients' physicians' perceive these virtual house calls are lacking. We conducted a analysis of perceptions visits for Parkinson's disease to (1) determine patients physicians (2) identify components contributing positive negative perceptions.Qualitative survey were collected from during 12-month randomized...
Abstract We performed a population‐based case–control study of United States Medicare beneficiaries age 60–90 in 2009 with prescription data (48,295 incident Parkinson disease cases and 52,324 controls) to examine the risk relation use immunosuppressants. Inosine monophosphate dehydrogenase inhibitors (relative = 0.64; 95% confidence interval 0.51–0.79) corticosteroids 0.80; 0.77–0.83) were both associated lower disease. Inverse associations for remained after applying 12‐month exposure lag....
To examine rehabilitation therapy utilization for Parkinson disease (PD).
Objective A recent study observed a 2‐fold greater risk of Parkinson disease (PD) in relation to the β2‐adrenoreceptor antagonist propranolol and markedly lower PD for agonist salbutamol. We examined whether confounding by clinical indication these medications, that is, tremor smoking‐related pulmonary conditions, explained associations. Methods In large, population‐based case–control United States Medicare beneficiaries 2009 with diagnosis codes, procedure prescription data (48,295 incident...
To use administrative medical claims data to identify patients with incident Parkinson disease (PD) prior diagnosis.Using a population-based case-control study of PD in 2009 among Medicare beneficiaries aged 66-90 years (89,790 cases, 118,095 controls) and the elastic net algorithm, we developed cross-validated model for predicting using only demographic 2004-2009 data. We then compared this more basic models containing diagnosis codes constipation, taste/smell disturbance, REM sleep...
State-level variations in disease, healthcare utilization, and spending influence planning at federal state levels should be examined to understand national disparities health outcomes. This descriptive study state-level Parkinson disease (PD) prevalence, patient characteristics, Medicare spending, out-of-pocket costs, service utilization using data on 27.5 million beneficiaries the US 2014. We found that 45.8% (n = 179,496) of diagnosed with PD were women; 26.1% 102,205) aged 85+. The...
Abstract An estimated 90% of people living with Parkinson’s disease (PD) in the US are covered by Medicare health insurance. How these beneficiaries use and engage care system is important to understand face a rapidly growing PD population. Here, we analyzed utilization patterns those diagnosis enrolled 2019. By our estimates, number 685,116 or 1.2% total Compared overall population, 56.3% male (vs 45.6%), 77.9% over age 70 57.1%), 14.7% color 20.7%), 16.0% rural residents 17.5%). Our...
Background:Delivering specialty care remotely directly into people's homes can enhance access for and improve the healthcare of individuals with chronic conditions. However, evidence supporting this approach is limited.Materials Methods:Connect.Parkinson a randomized comparative effectiveness study that compares usual Parkinson's disease in community augmented by virtual house calls specialist from 1 18 centers nationally. Individuals intervention arm receive four visits over year via...