A5072981120- Geriatric Care and Nursing Homes
- Pharmaceutical Practices and Patient Outcomes
- Emergency and Acute Care Studies
- Frailty in Older Adults
- Intergenerational Family Dynamics and Caregiving
- Hip and Femur Fractures
- Opioid Use Disorder Treatment
- Patient Satisfaction in Healthcare
- Health disparities and outcomes
- Heart Failure Treatment and Management
- Urinary Tract Infections Management
- Intensive Care Unit Cognitive Disorders
- Potassium and Related Disorders
- Cardiac Arrest and Resuscitation
- Sleep and Work-Related Fatigue
- Homelessness and Social Issues
- COVID-19 Clinical Research Studies
- Respiratory viral infections research
- Antibiotic Use and Resistance
- Health Systems, Economic Evaluations, Quality of Life
- Cardiac, Anesthesia and Surgical Outcomes
- Diabetes Treatment and Management
- Older Adults Driving Studies
- Pain Management and Opioid Use
- Influenza Virus Research Studies
Brown University
2021-2025
Providence College
2020-2024
John Brown University
2024
Rhode Island Department of Health
2024
Rhode Island Hospital
2020
Lifespan
2020
ABSTRACT Purpose Hip fractures in older adults cause severe pain that often necessitates opioid use. However, opioids may trigger falls result subsequent fractures. Studies examining the effects of on are limited by unmeasured confounding between opioid‐treated and untreated persons. To overcome this limitation, we used a self‐controlled case series (SCCS) design to investigate fracture risk during periods use after hip fracture. Methods The retrospective cohort included Medicare...
Although older adults may use potentially driver-impairing (PDI) medications that can produce psychomotor impairment, little is known about changes to PDI medication among from the time before after a motor vehicle crash (MVC). To quantify of and in an MVC. This cohort study used linked Medicare claims police-reported MVC data on 154 096 person-crashes 121 846 drivers. Eligible persons were drivers aged 66 years or older, involved New Jersey May 1, 2007, through December 31, 2017, with...
The high-value pharmacy enterprise (HVPE) framework and constituent best practice consensus statements are presented, the methods used to develop framework's 8 domains described. A panel of leaders an evidence- expert opinion-based approach define core aspirational elements that should be established within contemporary health-system enterprises by calendar year 2025. Eight HVPE were identified: Patient Care Services; Business Ambulatory Specialty Pharmacy Inpatient Operations; Safety...
Studies examining the safety and effectiveness of sodium-glucose cotransporter-2 inhibitors (SGLT2is) versus glucagon-like peptide-1 receptor agonists (GLP-1RAs) among community-dwelling adults may not generalize to nursing home (NH) residents, who are typically older more multimorbid. We compared cardiovascular SGLT2is GLP-1RAs US NH residents. Eligible individuals were aged ≥66 years with type 2 diabetes mellitus initiated an SGLT2i or GLP-1RA in between 2013 2018. Safety outcomes included...
Background Pneumonia and sepsis are among the most common causes of hospitalization in United States often result discharges to a skilled nursing facility (SNF) for rehabilitation. We described timing 30-day unplanned hospital readmission following an index pneumonia or sepsis. Methods findings This national retrospective cohort study included adults ≥65 years who were hospitalized discharged SNF between July 1, 2012 4, 2015. quantified ten diagnoses estimated daily risk first...
In this national cohort of older adults residing long-term in US nursing homes between 2013 and 2017, we calculated period prevalence estimates for antibiotic prescribing, rates days therapy. Among 1 375 062 residents, 66.2% were prescribed at least during the home stay. The most prevalent classes fluoroquinolones, sulfonamides related agents, first-generation cephalosporins. Levofloxacin, ciprofloxacin, sulfamethoxazole-trimethoprim antibiotics. These results can inform stewardship...
Abstract Background Post-acute care (PAC) services after hospitalization for hip fracture are typically provided in skilled nursing facilities (SNFs), inpatient rehabilitation (IRFs), or at home via health (HHC). Little is known about the clinical course following PAC fracture. We examined nationwide burden of adverse outcomes by setting year discharge from Methods This retrospective cohort included Medicare Fee-for-Service beneficiaries > 65 years who received U.S. SNFs, IRFs, HHC...
Tramadol is increasingly used to treat acute postoperative pain among older adults following total hip and knee arthroplasty (THA/TKA). However, tramadol has a complex pharmacology may be no safer than full opioid agonists. We compared the safety of tramadol, oxycodone, hydrocodone opioid-naïve elective THA/TKA. This retrospective cohort included Medicare Fee-for-Service beneficiaries ≥ 65 years with THA/TKA between January 1, 2010 September 30, 2015, 12 months continuous Parts A B...
Abstract Nonbenzodiazepine hypnotics (“Z-drugs”) are prescribed for insomnia but might increase the risk of motor vehicle crash (MVC) among older adults through prolonged drowsiness and delayed reaction times. We estimated effect initiating Z-drug treatment on 12-week MVC in a sequential target trial emulation. After linking New Jersey driver licensing police-reported data to Medicare claims, we emulated new each week (July 1, 2007, October 7, 2017) which fee-for-service beneficiaries were...
To encourage person-centered care, the Centers for Medicare and Medicaid require nursing homes to measure resident preferences using Preferences Assessment Tool (PAT). No known research has examined implications of respondent type (i.e., resident, proxy, staff) on preference importance; therefore, purpose this study was compare importance depending which completed PAT. Participants included 16,111 Veterans discharged community-based skilled facilities after hospitalization heart failure. A...
Pharmacists are well positioned to provide transitions of care (TOC) services patients with heart failure (HF); however, hospitalizations for HF likely exceed the capacity a TOC pharmacist. We developed and validated tool help pharmacists efficiently identify high-risk maximize their potential impact by intervening on at highest risk 30-day all-cause readmission. conducted retrospective cohort study including adults admitted health system between October 1, 2016, 31, 2019. randomly divided...
Abstract Background Medications are one of the most easily modifiable risk factors for motor vehicle crashes (MVCs) among older adults, yet limited information exists on how use potentially driver‐impairing (PDI) medications changes following an MVC. Therefore, we examined number and types PDI medication classes dispensed before after Methods This observational study included Medicare fee‐for‐service beneficiaries aged ≥67 years who were involved in a police‐reported MVC New Jersey as driver...
The comparative safety of sulfonylureas (SUs) in nursing home (NH) residents remains understudied despite widespread use. We compared the effects three SU medications and initial doses on adverse glycemic cardiovascular events among NH residents. This national retrospective cohort study linked Medicare claims with Minimum Data Set 2.0 assessments for long-stay aged ≥65 years between January 2008 September 2010. Exposures were medication initiated (glimepiride, glipizide, or glyburide)...
ObjectivesQuantify how observable characteristics contribute to influenza vaccination disparities among White, Black, and Hispanic nursing home (NH) residents.DesignRetrospective cohort.Setting ParticipantsShort- long-stay U.S. NH residents aged ≥65 years.MethodsWe linked Minimum Data Set (MDS) Medicare data LTCFocUS other facility data. We included with 6-month continuous enrollment in an MDS assessment between October 1, 2013, March 31, 2014. Residents were classified as short-stay (<100...