A5004157694- Palliative Care and End-of-Life Issues
- Heart Failure Treatment and Management
- Health Systems, Economic Evaluations, Quality of Life
- Cardiac Valve Diseases and Treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Pharmaceutical Practices and Patient Outcomes
- Childhood Cancer Survivors' Quality of Life
- Dialysis and Renal Disease Management
- Cardiac Arrest and Resuscitation
- Infective Endocarditis Diagnosis and Management
- Family and Patient Care in Intensive Care Units
- Cardiac Structural Anomalies and Repair
- Geriatric Care and Nursing Homes
- Intensive Care Unit Cognitive Disorders
- Cardiovascular and exercise physiology
- Aortic Disease and Treatment Approaches
- Technology Use by Older Adults
- Grief, Bereavement, and Mental Health
- Religion, Spirituality, and Psychology
- Healthcare Decision-Making and Restraints
- Chronic Disease Management Strategies
- Cardiac pacing and defibrillation studies
- Cardiac and Coronary Surgery Techniques
- Dementia and Cognitive Impairment Research
- Telemedicine and Telehealth Implementation
University of Washington
2019-2025
VA Puget Sound Health Care System
2019-2025
Geriatric Research Education and Clinical Center
2022-2025
University of Washington Medical Center
2024
University of Puget Sound
2022-2024
University of Pennsylvania
2024
The University of Texas Southwestern Medical Center
2024
Emory University Hospital
2016
Auckland City Hospital
2016
Brigham and Women's Hospital
2016
Cardiovascular multidisciplinary heart teams (MDHTs) have evolved significantly over the past decade. These play a central role in treatment of wide array cardiovascular diseases affecting interventional cardiology, cardiac surgery, imaging, advanced failure, adult congenital disease, cardio-oncology, and cardio-obstetrics. To meet specific needs both patients programs, composition function MDHTs had to adapt evolve. Although lessons been learned from cancer care, best practices for...
Guideline-based management of cardiovascular disease often involves prescribing multiple medications, which contributes to polypharmacy and risk for adverse drug events in older adults. Deprescribing is a potential strategy mitigate these risks. We sought characterize compare clinician perspectives regarding deprescribing medications across three specialties. National cross-sectional survey. Ambulatory. Random sample geriatricians, general internists, cardiologists from the American College...
Calcific aortic stenosis can be considered a model for geriatric cardiovascular conditions due to confluence of factors. The remarkable technological development transcatheter valve replacement was studied initially on older adult populations with prohibitive or high-risk surgical replacement. Through these trials, the community has recognized that stratification chronologically adults improved incrementally by invoking concept frailty and other risks. Given complexity aging process,...
Importance For patients hospitalized with acute decompensated heart failure (ADHF), the presence of kidney dysfunction can substantially shape prognosis and treatment options. Yet little is known about lived experiences these medically vulnerable patients. Objective To elicit accounts illness care currently or recently ADHF in order to identify potential opportunities improve care. Design, Setting, Participants This qualitative study was conducted at 3 hospitals within an academic health...
<h3>Importance</h3> Whether the cardiopulmonary resuscitation (CPR) preferences of patients receiving dialysis align with their values and other aspects end-of-life care is not known. <h3>Objective</h3> To describe CPR how these are associated responses to questions about care. <h3>Design, Setting, Participants</h3> Cross-sectional survey study a consecutive sample at 31 nonprofit facilities in 2 US metropolitan areas (Seattle, Washington, Nashville, Tennessee) between April 22, 2015,...
Using positron emission tomography (PET) imaging, we sought to determine whether normal age or exercise training cause changes in the cardiac sympathetic nervous system function male female healthy volunteers. Healthy sedentary participants underwent PET studies before and after 6 months of supervised training. Presynaptic uptake by norepinephrine transporter-1 was measured using imaging [ 11 C]-meta-hydroxyephedrine, a analog, expressed as permeability–surface area product (PS nt...
This cohort study examines differences regarding existential and supportive care needs for patients with kidney disease between individuals of racial ethnic minority groups compared White individuals.
Abstract Background Little is known about policies and practices for patients undergoing Transcatheter Aortic Valve Replacement (TAVR) who have a documented preference Do Not Resuscitate (DNR) status at time of referral. We investigated how across TAVR programs align with goals care presenting DNR status. Methods Between June September 2019, we conducted semi‐structured interviews coordinators from 52/73 invited (71%) in Washington California (TAVR volume > 100/year:34%; 50–99:36%;...
Abstract Patient Priorities Care (PPC) is an effective approach to identifying and aligning ‘what matters’ (i.e., values) with healthcare for patients multimorbidity frailty. VA metrics [i.e., Jen Frailty Index (JFI); Assessment Need (CAN)] predict mortality institutionalization but may not correlate the number complexity of needs veterans multimorbidity. For referred a Geriatric PPC Consultation clinic, recommendations alignment care were guided by veteran-derived health outcome goal....
Background: Bundled payment policies have focused on 30-day readmission rates after AMI, yet these are likely to lengthen over time. Identifying patients with multiple readmissions in the year AMI could help focus transitional care efforts high risk patients. Methods: Data from CRUSADE registry linked Medicare billing data was used examine longitudinal outcomes of 32,776 NSTEMI ≥ 65 years between 2003 and 2006 12-month follow-up. Defining frequent as ≥3 hospitalizations 12 months, we...
Introduction: Whereas individuals aged ≥75 years account for >1/3 of non-ST-segment elevation (NSTE) ACS episodes and the majority deaths due to NSTE in current practice, little is known about their participation clinical trials. Methods: We studied 79,133 patients enrolled 11 phase III trials (GUSTO IIb, PURSUIT, PARAGON-A, PARAGON-B, PRISM, PRISM-PLUS, GUSTO IV-ACS, SYNERGY, EARLY ACS, TRACER, APPRAISE-2) during 5 time periods (1994-97, 1998-01, 2002-05, 2006-10) over 17 years....