A5051612526- Pharmaceutical Practices and Patient Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Medication Adherence and Compliance
- Chronic Disease Management Strategies
- Cardiac pacing and defibrillation studies
- Blood Pressure and Hypertension Studies
- Dementia and Cognitive Impairment Research
- Intensive Care Unit Cognitive Disorders
- Healthcare cost, quality, practices
- Palliative Care and End-of-Life Issues
- Frailty in Older Adults
- Heart Failure Treatment and Management
- Cardiac, Anesthesia and Surgical Outcomes
- Pharmaceutical studies and practices
- Patient-Provider Communication in Healthcare
- Electronic Health Records Systems
- Geriatric Care and Nursing Homes
- Healthcare Systems and Technology
- Healthcare Decision-Making and Restraints
- Health Policy Implementation Science
- Clinical practice guidelines implementation
- Patient Satisfaction in Healthcare
- Lipoproteins and Cardiovascular Health
- Cardiac Arrhythmias and Treatments
- Mobile Health and mHealth Applications
Johns Hopkins Medicine
2015-2025
Johns Hopkins University
2015-2025
Johns Hopkins Bayview Medical Center
2024
University of Illinois Chicago
2019
Illinois College
2019
The University of Sydney
2019
University of Colorado Anschutz Medical Campus
2016
Denver Health Medical Center
2016
Yale University
2016
Outcomes Research Consortium
2016
Caring for older adults with multiple chronic conditions (MCCs) is challenging. The American Geriatrics Society (AGS) previously developed AGS Guiding Principles the Care of Older Adults With Multimorbidity using a systematic review literature and consensus. objective current work was to translate these principles into framework Actions accompanying Action Steps decision making clinicians who provide both primary specialty care people MCCs. A group geriatricians, cardiologists, generalists:...
Individuals with dementia or mild cognitive impairment frequently have multiple chronic conditions (defined as ≥2 medical conditions) and take medications, increasing their risk for adverse outcomes. Deprescribing (reducing stopping medications which potential harms outweigh benefits) may decrease of
Successful deprescribing for people with dementia (PWD) depends on communication about medication-related priorities between PWD, care partners and clinicians. The objective of this study was to gain in-depth knowledge how elicitation PWD partner during a intervention shaped discussions pharmacists medications. Qualitative analysis audio-recorded interactions patient-care dyads in pilot pharmacist-led primary care. Patients ≥ 65 years taking 7 medications were recruited from an integrated...
ABSTRACT The risk of atherosclerotic cardiovascular disease increases with advancing age. Elevated LDL‐cholesterol and non‐HDL‐cholesterol levels remain predictive incident events among individuals older than 75 years. Risk prediction is less certain because most current calculators lack specificity in those years do not adjust for co‐morbidities, functional status, frailty, cognition which significantly impact prognosis this age group. Data on the benefits risks lowering statins patients...
<h3>Importance</h3> How clinicians communicate about deprescribing, the structured process of reducing or stopping unnecessary, potentially harmful, goal-discordant medicines, may be associated with extent to which older adults are willing do it. <h3>Objective</h3> To examine adults' preferences regarding different rationales a clinician use explain why patient should stop an unnecessary harmful medication. <h3>Design, Setting, and Participants</h3> This cross-sectional survey study was...
As people age, they are more likely to have an increasing number of medical diagnoses and medications, as well healthcare providers who care for those conditions. Health professionals caring older adults understand that issues not the sole factors in phenomenon this "care complexity." Socioeconomic, cognitive, functional, organizational play a significant role. Care complexity also affects family caregivers, providers, systems therefore society at large. The American Geriatrics Society (AGS)...
To advance care for persons with Alzheimer's disease and related dementias (ADRD), real-world health system effectiveness research must actively engage those affected to understand what works, whom, in setting, how long-an agenda central learning (LHS) principles. This perspective discusses emerging payment models, quality improvement initiatives, population strategies present opportunities embed best practice principles of ADRD within the LHS. We discuss stakeholder engagement an LHS when...
Background— Geriatric conditions may influence outcomes among patients receiving implantable cardioverter-defibrillators (ICDs). We sought to determine the prevalence of frailty and dementia older adults primary prevention ICDs impact multimorbidity on mortality within 1 year ICD implantation. Methods Results— The cohort included 83 792 Medicare from National Cardiovascular Data Registry who underwent first implantation between 2006 2009. These data were merged with analytic files frailty,...
Abstract INTRODUCTION Care partners are at the forefront of dementia care, yet little is known about patient portal use in context diagnosis. METHODS We conducted an observational cohort study date/time‐stamped for a 5‐year period (October 3, 2017–October 2, 2022) academic health system. The consisted 3170 patients ages 65+ with diagnosed 2+ visits within 24 months. Message authorship was determined by manual review 970 threads involving 3065 messages 279 patients. RESULTS Most (71.20%)...
<h3>Purpose:</h3> Patients with dementia experience high rates of polypharmacy, potentially inappropriate medication use, and adverse drug events. There is little guidance for clinicians on how to optimize prescribing this population. Our objective was investigate clinician-perceived barriers facilitators optimizing people dementia. <h3>Methods:</h3> Qualitative study involving semistructured interviews primary care specialist in urban, suburban, rural settings. Transcripts were analyzed...
Ideas and Opinions5 February 2019Caring for Patients With Multiple Chronic ConditionsCorrection(s) this article:CorrectionsMar 2019Correction: Caring ConditionsFREEMary E. Tinetti, MD, Ariel R. Green, MPH, Jennifer Ouellet, Michael W. Rich, Cynthia Boyd, MPHMary MDYale School of Medicine Yale Public Health, New Haven, Connecticut (M.E.T., J.O.), MPHJohns Hopkins University Medicine, Baltimore, Maryland (A.R.G., C.B.), MDWashington St. Louis, Missouri (M.W.R.), C.B.)Author, Article,...
People living with dementia (PLWD) have complex medication regimens, exposing them to increased risk of harm. Pragmatic deprescribing strategies that align patient-care partner goals are needed.
ABSTRACT Purpose Accurately identifying medication discontinuations at scale is important for developing evidence about deprescribing. Gaps in dispensing often serve as proxies discontinuation but are imprecise. We categorize reasons gaps to inform data‐based methods accurately identify discontinuations. Methods Using pharmacy data, we purposively sampled from a population of adults age 65+ with 2+ chronic conditions who experienced 90‐day gap dispensing—with and without subsequent fills—of...
When patients are not adequately engaged in decision making, they may be at risk of regret. Our objective was to explore patients' perceptions their decision-making experiences related implantable cardioverter defibrillators (ICDs).Cross-sectional, mailed survey 412 who received an ICD without cardiac resynchronization therapy for any indication between 2006 and 2009. Patients were asked about participation regret.A total 295 with ICDs responded (72% response rate). Overall, 79% reported...
Abstract Background people living with cognitive impairment commonly take multiple medications including potentially inappropriate (PIMs), which puts them at risk of medication related harms. Aims to explore willingness have a deprescribed older (dementia or mild impairment) and chronic conditions assess the relationship between willingness, patient characteristics belief about medications. Methods cross-sectional study using results from revised Patients’ Attitudes Towards Deprescribing...
Objective To examine the use of antimuscarinics for treating urinary incontinence ( UI ) in older adults with varying levels cognition. Design Cross‐sectional. Setting National Alzheimer's Coordinating Center from 2005 through 2015. Participants Community‐dwelling men and women aged 65 (N = 24,106). Measurements Clinicians staff evaluated each participant's dementia status during annual in‐person assessments. or their informants reported all medications taken 2 weeks before study visit....
Importance Physicians endorse deprescribing of risky or unnecessary medications for older adults (aged ≥65 years) with dementia, but there is a lack information on what influences decisions to deprescribe in this population. Objective To understand how physicians make moderate dementia and ethical pragmatic concerns influencing those decisions. Design, Setting, Participants A cross-sectional national mailed survey study random sample 3000 primary care from the American Medical Association...