Open Access. Powered by Scholars. Published by Universities.®
Articles 1 - 9 of 9
Full-Text Articles in Medicine and Health Sciences
Characteristics, Treatment Practices, And In-Hospital Outcomes Of Older Adults Hospitalized With Acute Myocardial Infarction, Han-Yang Chen, David Mcmanus, Jane Saczynski, Jerry Gurwitz, Joel Gore, Jorge Yarzebski, Robert Goldberg
Characteristics, Treatment Practices, And In-Hospital Outcomes Of Older Adults Hospitalized With Acute Myocardial Infarction, Han-Yang Chen, David Mcmanus, Jane Saczynski, Jerry Gurwitz, Joel Gore, Jorge Yarzebski, Robert Goldberg
Jorge L. Yarzebski
OBJECTIVES: To examine overall and decade-long trends (1999-2009), characteristics, treatment practices, and hospital outcomes in individuals aged 65 and older hospitalized for acute myocardial infarction (AMI) and to describe how these factors varied in the youngest, middle, and oldest-old individuals.
DESIGN: Retrospective cohort study.
SETTING: Population-based Worcester Heart Attack Study.
MEASUREMENTS: Analyses were conducted to examine the sociodemographic and clinical characteristics, cardiac treatments, and hospital outcomes of older adults in three age strata (65-74, 75-84, > /=85).
PARTICIPANTS: The study sample consisted of 3,851 individuals aged 65 and older hospitalized with AMI every other year between 1999 and 2009; 32% were …
Use Of Medications Of Questionable Benefit In Advanced Dementia, Jennifer Tjia, Becky Briesacher, Daniel Peterson, Qin Liu, Susan Andrade, Susan Mitchell
Use Of Medications Of Questionable Benefit In Advanced Dementia, Jennifer Tjia, Becky Briesacher, Daniel Peterson, Qin Liu, Susan Andrade, Susan Mitchell
Jennifer Tjia
IMPORTANCE: Advanced dementia is characterized by severe cognitive impairment and complete functional dependence. Patients' goals of care should guide the prescribing of medication during such terminal illness. Medications that do not promote the primary goal of care should be minimized. OBJECTIVES: To estimate the prevalence of medications with questionable benefit used by nursing home residents with advanced dementia, identify resident- and facility-level characteristics associated with such use, and estimate associated medication expenditures. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of medication use by nursing home residents with advanced dementia using a nationwide long-term care pharmacy database linked to the Minimum Data …
Statin Discontinuation In Nursing Home Residents With Advanced Dementia, Jennifer Tjia, Sarah Cutrona, Daniel Peterson, George Reed, Susan Andrade, Susan Mitchell
Statin Discontinuation In Nursing Home Residents With Advanced Dementia, Jennifer Tjia, Sarah Cutrona, Daniel Peterson, George Reed, Susan Andrade, Susan Mitchell
Jennifer Tjia
OBJECTIVES: To describe patterns of, and factors associated with, statin use and discontinuation in nursing home (NH) residents progressing to advanced dementia and followed for at least 90 days.
DESIGN: Retrospective inception cohort using a dataset linking 2007 to 2008 Minimum Data Set (MDS) to Medicare denominator and Part D files.
SETTING: All NHs in five states (Minnesota, Massachusetts, Pennsylvania, California, Florida).
PARTICIPANTS: NH residents with dementia.
MEASUREMENTS: Residents who developed advanced dementia were observed from baseline (date of progression to very severe cognitive impairment with eating problems) and followed for at least 90 days to statin discontinuation or death. …
Antipsychotic Use In Nursing Homes Varies By Psychiatric Consultant, Jennifer Tjia, Terry Field, Celeste Lemay, Kathleen Mazor, Michelle Pandolfi, Ann Spenard, Shih-Yieh Ho, Abir Kanaan, Jennifer Donovan, Jerry Gurwitz, Becky Briesacher
Antipsychotic Use In Nursing Homes Varies By Psychiatric Consultant, Jennifer Tjia, Terry Field, Celeste Lemay, Kathleen Mazor, Michelle Pandolfi, Ann Spenard, Shih-Yieh Ho, Abir Kanaan, Jennifer Donovan, Jerry Gurwitz, Becky Briesacher
Jennifer Tjia
BACKGROUND: The relationship between psychiatric consultation and antipsychotic prescribing in nursing homes (NH) is unknown. OBJECTIVE: To identify the association between psychiatric consultant groups and NH-level antipsychotic prescribing after adjustment for resident case-mix and facility characteristics. RESEARCH DESIGN AND SUBJECTS: Nested cross-sectional study of 60 NHs in a cluster randomized trial. We linked facility leadership surveys to October 2009-September 2010 Minimum Data Set, Nursing Home Compare, the US Census, and pharmacy dispensing data. MEASURES: The main exposure is the psychiatric consultant group and the main outcome is NH-level prevalence of atypical antipsychotic use. We calculated annual means and interquartile ranges …
Use Of Mechanical Ventilation By Patients With And Without Dementia, 2001 Through 2011, Tara Lagu, Marya Zilberberg, Jennifer Tjia, Penelope Pekow, Peter Lindenauer
Use Of Mechanical Ventilation By Patients With And Without Dementia, 2001 Through 2011, Tara Lagu, Marya Zilberberg, Jennifer Tjia, Penelope Pekow, Peter Lindenauer
Jennifer Tjia
Increasing demand for US critical care resources, including beds, intensivists, and invasive mechanical ventilation (IMV),has placed substantial strain on the critical care system. Since 2000, elderly patients treated in the intensive care unit have received higher intensity care (and have experienced lower mortality rates) than historical cohorts. Yet certain populations of elderly patients exposed to intensive care experience substantial long-term adverse effects, including functional decline and excess mortality. Patients with dementia receiving IMV, for example, are at high risk for delirium, which confers a 3.2-fold increased risk of 6-month mortality. The increasing use of aggressive therapies suggests that demand for …
An Electronic Health Record-Based Intervention To Increase Follow-Up Office Visits And Decrease Rehospitalization In Older Adults, Jerry Gurwitz, Terry Field, Jessica Ogarek, Jennifer Tjia, Sarah Cutrona, Leslie Harrold, Shawn Gagne, Peggy Preusse, Jennifer Donovan, Abir Kanaan, George Reed, Lawrence Garber
An Electronic Health Record-Based Intervention To Increase Follow-Up Office Visits And Decrease Rehospitalization In Older Adults, Jerry Gurwitz, Terry Field, Jessica Ogarek, Jennifer Tjia, Sarah Cutrona, Leslie Harrold, Shawn Gagne, Peggy Preusse, Jennifer Donovan, Abir Kanaan, George Reed, Lawrence Garber
Jennifer Tjia
OBJECTIVES: To assess the effect of an electronic health record-based transitional care intervention involving automated alerts to primary care providers and staff when older adults were discharged from the hospital.
DESIGN: Randomized controlled trial.
SETTING: Large multispecialty group practice.
PARTICIPANTS: Individuals aged 65 and older discharged from hospital to home.
INTERVENTION: In addition to notifying primary care providers about the individual's recent discharge, the system provided information about new drugs added during the inpatient stay, warnings about drug-drug interactions, recommendations for dose changes and laboratory monitoring of high-risk medications, and alerts to the primary care provider's support staff to schedule …
Adverse Drug Events After Hospital Discharge In Older Adults: Types, Severity, And Involvement Of Beers Criteria Medications, Abir Kanaan, Jennifer Donovan, Nerissa Duchin, Terry Field, Jennifer Tjia, Sarah Cutrona, Shawn Gagne, Lawrence Garber, Peggy Preusse, Leslie Harrold, Jerry Gurwitz
Adverse Drug Events After Hospital Discharge In Older Adults: Types, Severity, And Involvement Of Beers Criteria Medications, Abir Kanaan, Jennifer Donovan, Nerissa Duchin, Terry Field, Jennifer Tjia, Sarah Cutrona, Shawn Gagne, Lawrence Garber, Peggy Preusse, Leslie Harrold, Jerry Gurwitz
Jennifer Tjia
OBJECTIVES: To characterize adverse drug events (ADEs) occurring within the high-risk 45-day period after hospitalization in older adults.
DESIGN: Clinical pharmacists reviewed the ambulatory records of 1,000 consecutive discharges.
SETTING: A large multispecialty group practice closely aligned with a Massachusetts-based health plan.
PARTICIPANTS: Hospitalized individuals aged 65 and older discharged home.
MEASUREMENTS: Possible drug-related incidents occurring during the 45-day period after hospitalization were identified and presented to a pair of physician-reviewers who classified incidents as to whether an ADE was present, whether the event was preventable, and the severity of the event. Medications implicated in ADEs were further characterized according …
Antipsychotic Use Among Nursing Home Residents, Becky Briesacher, Jennifer Tjia, Terry Field, Daniel Peterson, Jerry Gurwitz
Antipsychotic Use Among Nursing Home Residents, Becky Briesacher, Jennifer Tjia, Terry Field, Daniel Peterson, Jerry Gurwitz
Jennifer Tjia
The prescribing of antipsychotic medications persists at high levels in US nursing homes (NHs) despite extensive data demonstrating marginal clinical benefits and serious adverse effects, including death.1- 2 However, imprecise and outdated data have limited the understanding of the current state of antipsychotic medication prescribing in NHs.3 We analyzed recent and detailed NH prescription data to address: (1) What is the current level of antipsychotic use? (2) Does antipsychotic use in NHs display geographic variation? and (3) Which antipsychotics are most commonly prescribed?
Development Of Abbreviated Measures To Assess Patient Trust In A Physician, A Health Insurer, And The Medical Profession, Elizabeth Dugan, Felicia Trachtenberg, Mark Hall
Development Of Abbreviated Measures To Assess Patient Trust In A Physician, A Health Insurer, And The Medical Profession, Elizabeth Dugan, Felicia Trachtenberg, Mark Hall
Elizabeth Dugan
BACKGROUND: Despite the recent proliferation in research on patient trust, it is seldom a primary outcome, and is often a peripheral area of interest. The length of our original scales to measure trust may limit their use because of the practical needs to minimize both respondent burden and research cost. The objective of this study was to develop three abbreviated scales to measure trust in: (1) a physician, (2) a health insurer, and (3) the medical profession. METHODS: Data from two samples were used. The first was a telephone survey of English-speaking adults in the United States (N = 1117) …