A5070056940- Blood Pressure and Hypertension Studies
- Health Systems, Economic Evaluations, Quality of Life
- Geriatric Care and Nursing Homes
- Pressure Ulcer Prevention and Management
- Pharmaceutical Practices and Patient Outcomes
- Dementia and Cognitive Impairment Research
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Atrial Fibrillation Management and Outcomes
- Frailty in Older Adults
- Chronic Disease Management Strategies
- Patient Satisfaction in Healthcare
- Wound Healing and Treatments
- Venous Thromboembolism Diagnosis and Management
- Epilepsy research and treatment
- Cardiovascular Syncope and Autonomic Disorders
- Pharmacological Effects and Toxicity Studies
- Machine Learning in Healthcare
- Diabetic Foot Ulcer Assessment and Management
- Medication Adherence and Compliance
- Clinical practice guidelines implementation
- Diagnosis and Treatment of Venous Diseases
- Diabetes Management and Education
- Palliative Care and End-of-Life Issues
- Hormonal and reproductive studies
University of Massachusetts Lowell
2019-2025
Boston University
2013-2025
Bedford VA Research Corporation
2014-2024
VA New England Healthcare System
2005-2023
University of Massachusetts Amherst
2023
University of Nebraska Medical Center
2005-2023
Christie's
2005-2023
University of Lübeck
2023
Englewood Hospital and Medical Center
2023
Rutgers, The State University of New Jersey
2023
<h3>Importance</h3> The appropriate treatment target for systolic blood pressure (SBP) in older patients with hypertension remains uncertain. <h3>Objective</h3> To evaluate the effects of intensive (<120 mm Hg) compared standard (<140 SBP targets persons aged 75 years or but without diabetes. <h3>Design, Setting, and Participants</h3> A multicenter, randomized clinical trial who participated Systolic Blood Pressure Intervention Trial (SPRINT). Recruitment began on October 20, 2010,...
Many patients with hypertension have inadequate control of their blood pressure. Improving the treatment requires an understanding ways in which physicians manage this condition and a means assessing efficacy care.
Primary care physicians may not be aggressive enough with the management of hypertension. The purpose this study was to identify barriers primary physicians' willingness increase intensity treatment among patients uncontrolled hypertension.Descriptive survey study. We sampled patient visits in a large midwestern health system treating were asked complete about visit copy office notes attached (patient visits, n = 270; response rate, 86%).Pharmacologic therapy initiated or changed at only 38%...
Background: High blood pressure is an important public health concern because it highly prevalent and a risk factor for adverse outcomes, including coronary heart disease, stroke, decompensated failure, chronic kidney decline in cognitive function. Observational studies show progressive increase associated with above 115/75 mm Hg. Prior research has shown that reducing elevated systolic lowers the of subsequent clinical complications from cardiovascular disease. However, optimal to reduce...
Emerging evidence indicates that patients with mental health conditions (MHCs) may receive less intensive medical care. Diabetes serves as a useful condition in which to test for MHC-related disparities We examined whether quality measures diabetes care are worse or without MHCs.This national, cross-sectional study included 313 586 noninstitutionalized Veterans Health Administration (identified from diagnostic codes and prescriptions) whose facility transmitted laboratory data central...
Abstract Aim This paper discusses the critical determinants of pressure ulcer development and proposes a new conceptual framework. Background Recent work to develop validate evidence‐based risk assessment framework was undertaken. formed part Pressure UlceR Programme Of re SE arch ( RP ‐ PG ‐0407‐10056), funded by National Institute for Health Research. The foundation component incorporated systematic review consensus study that highlighted need propose Design Discussion Paper. Data Sources...
The European Pressure Ulcer Advisory Panel, the Pan Pacific Injury Alliance, and National Panel are updating 'Prevention Treatment of Ulcers: Clinical Practice Guideline' (CPG) in 2019. aim this contribution is to summarize discuss guideline development protocol for 2019 update.A governance group determines monitors all steps CPG development. An international survey consumers will be undertaken establish consumer needs interests. Systematic evidence searches relevant electronic databases...
The previously published results of the Systolic Blood Pressure Intervention Trial showed that among participants with hypertension and an increased cardiovascular risk, but without diabetes, rates events were lower those who assigned to a target systolic blood pressure less than 120 mm Hg (intensive treatment) 140 (standard treatment). Whether such intensive treatment affected patient-reported outcomes was uncertain; from trial are reported here.We randomly 9361 blood-pressure or Hg....
The purpose of this study was to identify prospectively risk factors for pressure sores and compare these results with a cross‐sectional analysis in the same population. Medical records on all admissions chronic care hospital over 13‐month period were reviewed. Data potential abstracted from initial history, physical examination, nursing assessment, laboratory studies. Pressure sore status admission at three weeks determined standardized form completed patients sore. performed by comparing...
Angioedema is a rare but potentially serious complication of angiotensin-converting enzyme inhibitor (ACE) use. We conducted study to estimate incidence ACE-related angioedema and explore its determinants in large racially diverse patient population. used linked medical pharmacy records identify all patients the US Veterans Affairs Health Care System from April 1999 through December 2000 who received first prescriptions for antihypertensive medications. studied 195 192 ACE initiators 399 889...
Concerns about administrative data on race/ethnicity have led some researchers to consider self-reported as superior.1–5 However, few studies examined the differential impact of source data, that is, observed or selfreported, study outcomes. We investigated whether differences in reporting different results with regard use one therapeutic dental procedure, root canal therapy.
To determine the relationship between blood pressure (BP) and all-cause mortality in subjects aged 80 older with hypertension.Retrospective cohort study 5 years of follow-up.Ten Veterans AFFAIRS (VA) sites.Four thousand seventy-one ambulatory patients hypertension.The outcome measure was likelihood survival during follow-up period. Vital status obtained from VA Social Security files. Variables collected for adjustment Cox regression models were baseline BP, medications, demographics,...
The Systolic Blood Pressure Intervention Trial (SPRINT) is testing whether a lower systolic blood pressure (BP) target of 120mm Hg leads to reduction in cardiovascular morbidity and mortality among hypertensive, nondiabetic adults. Because there may be detrimental effects intensive BP control, particularly older, frail adults, we sought characterize frailty within SPRINT address ongoing questions about the ability large-scale trials enroll representative samples noninstitutionalized,...
The authors estimated the validity of algorithms for identification mental health conditions (MHCs) in administrative data 133 068 diabetic patients who used Veterans Health Administration (VHA) nationally 1998 and responded to 1999 Large Survey Veteran Enrollees. They compared various MHCs from International Classification Diseases, 9th Revision (ICD-9) codes with self-reported depression, posttraumatic stress disorder, or schizophrenia survey. Positive predictive value (PPV) negative (NPV)...
Background— Oral anticoagulation is safer and more effective when patients receive high-quality care. However, there have been no prior efforts to measure quality of oral care or risk adjust it ensure credible comparisons. Our objective was profile site performance in the Veterans Health Administration (VA) using risk-adjusted percent time therapeutic range (TTR). Methods Results— We included 124 551 who received outpatient from 100 VA sites for indications other than valvular heart disease...
OBJECTIVES: To test the accuracy of a brief cognitive assessment nursing home (NH) residents and to determine whether facility nurses can reliably perform this assessment. DESIGN: Cross‐sectional, independent screening tests with NH residents. SETTING: Six Department Veteran Affairs facilities. PARTICIPANTS: Three hundred seventy‐four from six regionally distributed NHs. MEASUREMENTS: instruments: Brief Interview Mental Status (BIMS), created for study; Minimum Data Set (MDS) 2.0 Cognitive...
We examined the quality of adult epilepsy care using Quality Indicators in Epilepsy Treatment (QUIET) measure, and variations based on source care. identified 311 individuals with diagnosis between 2004 2007 a tertiary medical center New England. abstracted charts to identify extent which participants received indicator (QI) concordant for individual QI's proportion recommended processes completed different aspects over two year period. Finally, we compared those receiving only primary care,...