Publications

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De-Prescribing for Renal Function in Long-Term Care Residents with Chronic Kidney Disease

JAMDA
June 1, 2022
Polypharmacy is commonly encountered in Long-term Care (LTC) residents and associated with adverse drug events (ADEs) and worsening function. Data from a prior PI project1 resulted in an average deprescribing (DeP) of 1.3 medications per resident...

Becoming an Age-Friendly Health System

JAMDA
June 1, 2022
Age -Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and the Catholic Health Association of the U.S. The purpose of Age-...

Surveying Knowledge Gaps for a Post-Acute Care (PAC) Curriculum Taught by Geriatrics-trained Core Internal Medicine Program Faculty for Internal Medicine and Family Medicine Residents Learners

JAMDA
June 1, 2022
Preventable errors in care transitions for the elderly are responsible for up to one third of costly hospital readmissions. The 2009 Institute of Medicine sentinel report outlined a critical need to expand geriatrics competencies in residencies...

Geriatrics Fellow-led Educational Session for Nursing Home Staff About High-Risk Medications

JAMDA
June 1, 2022
Older adults in skilled nursing facilities are often complex and at high-risk for polypharmacy and adverse medication reactions. To address these issues, an important step is to be able to identify medications that are high-risk for older adults...

Hurdles Faced by Healthcare Providers in Titrating Phenytoin Dosage in Long-Term Care

JAMDA
June 1, 2022
Medications are associated with development of adverse drug events (ADEs), some more than others, due to alteration in pharmacokinetics and dynamics with age. Phenytoin efficacy and toxicity relate to drug levels, interaction with cytochrome P450,...

Cancer as a Consideration for a Non-healing Lower Extremity Wound

JAMDA
June 1, 2022
Lower extremity wounds are common among elderly patients living in assisted living and long-term care facilities, with prevalence in this population ranging from 11-15% (Takahashi et al. "A retrospective cohort study of factors that affect healing...

A Hidden Gastro-Vascular Etiology of Abdominal Pain; A Case Report of Cast Syndrome

JAMDA
June 1, 2022
Superior mesenteric artery (SMA) syndrome or Cast syndrome is an uncommon clinical entity characterized by compression of the transverse portion of the duodenum between the aorta and the superior mesenteric artery. This condition typically affects...

The Ambiguous Reality of Prescribing in Geriatric Practice

JAMDA
June 1, 2022
Every medical care provider wants to do the right thing. The challenge in care of older persons is that the “right” thing is often unclear. Older patients have extraordinary physiological, functional, and prognostic diversity, and this means that...

The Impact of Dementia on Diabetes Control: An Evaluation of HbA1c Trajectories and Care Outcomes in Linked Primary and Specialist Care Data

JAMDA
May 31, 2022
Diabetes self-care may become increasingly challenging as cognition declines. We sought to characterize glycated hemoglobin A1c (HbA1c) trajectories, markers of diabetes-related management, health care utilization, and mortality in people with...

Medicare Physician Payment Reform Principles Call for a Rational Payment System

Policy Snapshot
May 27, 2022
The Medicare physician payment system needs an overhaul to remedy financial instabilities impacting physician practices due to the pandemic, statutory payment cuts, lack of inflationary updates, and significant administrative burdens. Under the...