A5022609876- Antibiotic Use and Resistance
- Patient Satisfaction in Healthcare
- Healthcare Systems and Technology
- Electronic Health Records Systems
- Primary Care and Health Outcomes
- Pneumonia and Respiratory Infections
- Health Systems, Economic Evaluations, Quality of Life
- Pharmaceutical Practices and Patient Outcomes
- Healthcare Policy and Management
- Respiratory and Cough-Related Research
- Healthcare cost, quality, practices
- Streptococcal Infections and Treatments
- Emergency and Acute Care Studies
- Pharmaceutical studies and practices
- COVID-19 and Mental Health
- Patient-Provider Communication in Healthcare
- Otolaryngology and Infectious Diseases
- Biomedical Text Mining and Ontologies
- Clinical Reasoning and Diagnostic Skills
- Health disparities and outcomes
- Mobile Health and mHealth Applications
- Asthma and respiratory diseases
- Health Promotion and Cardiovascular Prevention
- Antimicrobial Resistance in Staphylococcus
- Innovations in Medical Education
Northwestern University
2017-2025
Purdue University West Lafayette
2024
University of Southern California
2024
Linde (United States)
2024
University of Westminster
2022
Sanofi (France)
2022
Lundbeck (Italy)
2022
Pfizer (United Kingdom)
2022
Weatherford College
2022
Institute of Public Health Zadar
2022
<h3>Importance</h3> The National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% 2020, but the extent is unknown. <h3>Objective</h3> To estimate rates oral prescribing age and diagnosis, estimated portions that may be in adults children United States. <h3>Design, Setting, Participants</h3> Using 2010-2011 Ambulatory Medical Care Survey Hospital Survey, annual numbers population-adjusted with 95% confidence...
<h3>Importance</h3> Interventions based on behavioral science might reduce inappropriate antibiotic prescribing. <h3>Objective</h3> To assess effects of interventions and rates (not guideline-concordant) prescribing during ambulatory visits for acute respiratory tract infections. <h3>Design, Setting, Participants</h3> Cluster randomized clinical trial conducted among 47 primary care practices in Boston Los Angeles. Participants were 248 enrolled clinicians to receive 0, 1, 2, or 3 18 months....
The evolving outbreak of coronavirus disease 2019 (COVID-19) is requiring social distancing and other measures to protect public health. However, messaging has been inconsistent unclear.
<h3>Background</h3> Electronic health records (EHRs) have been proposed as a sustainable solution for improving the quality of medical care. We assessed association between EHR use, implemented, and ambulatory care in nationally representative survey. <h3>Methods</h3> performed retrospective, cross-sectional analysis visits 2003 2004 National Ambulatory Medical Care Survey. examined use throughout United States with 17 indicators. Performance on indicators was defined percentage applicable...
<b>Objective</b> To determine the diagnostic and triage accuracy of online symptom checkers (tools that use computer algorithms to help patients with self diagnosis or triage). <b>Design</b> Audit study. <b>Setting</b> Publicly available, free checkers. <b>Participants</b> 23 were in English provided advice across a range conditions. 45 standardized patient vignettes compiled equally divided into three categories urgency: emergent care required (for example, pulmonary embolism), non-emergent...
"Nudges" that influence decision making through subtle cognitive mechanisms have been shown to be highly effective in a wide range of applications, but there few experiments improve clinical practice.To investigate the use behavioral "nudge" based on principle public commitment encouraging judicious antibiotics for acute respiratory infections (ARIs).Randomized trial 5 outpatient primary care clinics. A total 954 adults had ARI visits during study timeframe: 449 patients were treated by...
Clinicians make many patient care decisions each day. The cumulative cognitive demand of these may erode clinicians’ abilities to resist making potentially inappropriate choices. Psychologists, who refer the erosion self-control after repeated as decision fatigue,1,2 have found evidence that it affects nonmedical professionals. For example, court sessions wear on, judges are more likely deny parole, “easier” or “safer” option.3
The sickest, most expensive, and fastest growing segment of the US population are seniors 65 years older. 1 Digital health technology has been advocated as a solution to improve care quality, cost, safety.However, little is known about digital use among seniors.Methods | Partners HealthCare Human Research Committee exempted this study from review.The National Health Aging Trends Study (NHATS) an annual in-home, computerassisted, longitudinal, nationally representative survey...
To assess the appropriateness of outpatient antibiotic prescribing for privately insured children and non-elderly adults in US using a comprehensive classification scheme diagnosis codes ICD-10-CM (international diseases-clinical modification, 10th revision), which replaced ICD-9-CM on 1 October 2015.
Judicious use of antibiotics can slow the spread antimicrobial resistance. However, overall patterns antibiotic among ambulatory patients are not well understood.To study outpatient in United States, focusing on broad-spectrum antibiotics.Cross-sectional survey three 2-year periods (1991-1992, 1994-1995, and 1998-1999).The National Ambulatory Medical Care Survey, a nationally representative sample community-based visits.Patients visiting clinics.Rates (azithromycin clarithromycin,...
4][5][6][7][8][9] Group A -hemolytic streptococci is the only common cause of sore throat warranting antibiotic treatment. 10deally, proportion patients with receiving an would approximate or perhaps slightly exceed prevalence GABHS in those throat.However, 76% adults and 71% children diagnosed pharyngitis 1992 were treated antibiotic. 11,12Therefore, represents 5.6 million annual prescriptions responsible for 9% all antibiotics used adults, over half which are likely unnecessary. 11ompared...
ContextOf children with sore throat, 15% to 36% have pharyngitis caused by group A β-hemolytic streptococci (GABHS). Performance of a GABHS test prior antibiotic prescribing is recommended for throat. Penicillin, amoxicillin, erythromycin, and first-generation cephalosporins are the antibiotics treatment throat due GABHS.ObjectivesTo measure rates testing evaluate association between throat.Design, Setting, ParticipantsAnalysis visits aged 3 17 years office-based physicians, hospital...
Acute bronchitis is a cough-predominant acute respiratory illness of less than 3 weeks' duration.For more 40 years, trials have shown that antibiotics are not effective for bronchitis. 1 Despite this, between 1980 and 1999, the rate antibiotic prescribing was 60% 80% in United States. 2 During past 15 Centers Disease Control Prevention (CDC) has led efforts to decrease 3,4 Since 2005, Healthcare Effectiveness Data Information Set (HEDIS) measure stated should be zero. 5 To estimate...
Pneumococcal pneumonia is concentrated among the elderly. Using a decision analytic model, we projected future incidence of pneumococcal and associated healthcare utilization costs accounting for an aging US population. Between 2004 2040, as population increases by 38%, hospitalizations will increase 96% (from 401 000 to 790 000), because growth fastest in older age groups experiencing highest rates disease. Absent intervention, total cost $2.5 billion annually, demand services pneumonia,...
Widening socioeconomic disparities in mortality the United States are largely explained by slower declines tobacco use among smokers of low status (SES) than those higher SES, which points to need for targeted cessation interventions. Documentation smoking electronic health records (EHRs) provides tools systems proactively offer treatment socioeconomically disadvantaged smokers.To evaluate a proactive strategy that addresses sociocontextual mediators low-SES smokers.This prospective,...
Receipt of primary care is associated with better health. 1,2espite the benefits care, Americans' receipt changes in over time, and differences according to sociodemographic clinical characteristics are not well known.Female 52 (51-52) 82 (81-83) 18 (17-19) 51 80 (79-81) 20 (19-21) 1 [Reference] Male 48 (48-49) 72 (70-73) 28 (27-30) 49 70 (68-71) 30 (29-32) 0.59 (0.57-0.60)Race/ethnicity Non-Latino white 71 (69-72) 64 (62-66) 79 (78-81) 21 (19-22) Latino 12 (11-13) 58 (55-61) 42 (39-45) 16...
This study examines assesses inappropriate antibiotic prescribing 12 months after stopping a randomized clinical trial of behavioral intervention intended to reduce the rate for acute respiratory infections.
Clinicians prescribe antibiotics to over 65% of adults with acute bronchitis despite guidelines stating that are not indicated. To identify and understand primary care clinician perceptions about antibiotic prescribing for bronchitis, we conducted semi-structured interviews 13 clinicians in Boston, Massachusetts used thematic content analysis. All the participants agreed indicated felt other than themselves were responsible overprescribing. Barriers guideline adherence included 6 themes: (1)...
Widespread deficits in the quality of US health care were described over a decade ago. Since then, local, regional, and national efforts have sought to improve patient experience, but there is incomplete information about whether such been successful.To measure changes outpatient experience United States from 2002 2013.We analyzed temporal trends 2013 using measures constructed Medical Expenditure Panel Survey (MEPS), nationally representative annual survey population that collects data...
The US health care system is typically organized around hospitals and specialty care. value of primary remains unclear debated.To determine whether an association exists between receipt high-value services, low-value patient experience.This a nationally representative analysis noninstitutionalized adults 18 years or older who participated in the Medical Expenditure Panel Survey. Propensity score-weighted quality experience were compared 49 286 with 21 133 without from 2012 to 2014. Temporal...