Publications

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Curtailing Antipsychotic Use in LTC Medicine: Reducing Off-Label Antipsychotic Medication Use Among Maine Skilled Nursing Centers with the CALM Intervention

JAMDA
March 1, 2016
In 2012, ∼25% of skilled nursing center residents nationwide were prescribed antipsychotics, despite a 2005 Federal Drug Administration “black box” alert warning that these medications may increase residents' risk of heart failure, sudden death, and...

Caring for Patients Outside the Clinic: A Toolkit for Improving Quality and Efficiency

JAMDA
March 1, 2016
Patients receive medical care in a variety of settings including long-term care (LTC) nursing facilities, assisted living facilities, transitional care facilities, and private homes. The number of patients who require skilled nursing care either at...

Antipsychotic and Other Psychotropic Medications in Special Care Dementia Units: Outcomes Using a Mini Behavior Rating Scale and Objective Medication Use Guideline

JAMDA
March 1, 2016
National antipsychotic use in the long-stay residents has declined to 19% now. Efforts are underway to reduce this rate even further. In specialized dementia units, however, where patients with BPSD are concentrated, medication use rates are...

An Innovative State-Level Collaboration to Impact Polypharmacy in Indiana Nursing Homes

JAMDA
March 1, 2016
Reducing polypharmacy is a priority of CMS and AMDA. The Indiana State Department of Health (ISDH) has approved a collaborative proposal that will build an innovative infrastructure of quality improvement (QI) and formally engage nursing home...

Amiodarone Use in Post-Acute and Long-Term Care Residents

JAMDA
March 1, 2016
Amiodarone is a potent antiarrhythmic which is effective for maintaining sinus rhythm but with potentially disabling side effects. There are well known black-box warnings associated with its continued use: sudden death and deadly side effects...

Teaching and Improving Transitions of Care Upon Hospital Discharge

JAMDA
March 1, 2016
Teaching family practice resident physicians to perform a quality transition of care upon hospital discharge is an important and common skill. It is an area of medicine that has been shown in studies to be prone to communication and medical errors...

Improving Patient Safety One Handoff at a Time

JAMDA
March 1, 2016
In recent years, the SNF/LTC Industry has seen the demand for its services increase. This has been due in part to a shift in population demographics as well as to financial incentives for hospitals to reduce patient stays. This is driving the need...

Evaluating the Effects of a Long-Term Care Pharmacist Educator Component in a Family Medicine Residency Program

JAMDA
March 1, 2016
In anticipation of the changes required of our health care system to support a growing population of older adults, a geriatric pharmacy initiative designed to foster interest in geriatrics and long term care (LTC) as well as inter-professional...

You Left Me Speechless: A Case of Valproic Acid Induced Aphasia

JAMDA
March 1, 2016
Valproic acid (VPA) is commonly prescribed to treat epilepsy, bipolar disorder & migraine headaches. Though it has been associated with numerous adverse events, its effects on speech & one's ability to articulate has not been thoroughly...

Warfarin Induced Skin Necrosis: A Rare Complication of Warfarin Therapy with High Morbidity and Mortality

JAMDA
March 1, 2016
Warfarin is a commonly prescribed medication for patients in the post-acute or long-term care setting for conditions such as acute deep venous thrombosis (DVT), pulmonary embolus, or atrial fibrillation. Warfarin induced skin necrosis (WISN) has...