2024
Reducing Care Overuse in Older Patients Using Professional Norms and Accountability : A Cluster Randomized Controlled Trial.
Persell S, Petito L, Lee J, Meeker D, Doctor J, Goldstein N, Fox C, Rowe T, Linder J, Chmiel R, Peprah Y, Brown T. Reducing Care Overuse in Older Patients Using Professional Norms and Accountability : A Cluster Randomized Controlled Trial. Annals Of Internal Medicine 2024, 177: 324-334. PMID: 38315997, DOI: 10.7326/m23-2183.Peer-Reviewed Original ResearchCase-based educationHealth systemOlder primary care patientsCluster randomized controlled trialPrimary care internal medicineClinical decision support toolRates of uncontrolled diabetesClinician decision supportPrimary care patientsPrimary care cliniciansProstate-specific antigenOvertreatment of diabetesNational Institute on AgingMonths of interventionDecision supportRates of PSA testingHemoglobin A<sub>1c</sub>Older adult patientsInstitute on AgingSingle Health SystemUrine testsPSA testingRandomized controlled trialsCare cliniciansEmergency care
2021
Design of Behavioral Economic Applications to Geriatrics Leveraging Electronic Health Records (BEAGLE): A pragmatic cluster randomized controlled trial
Brown T, Rowe T, Lee J, Petito L, Chmiel R, Ciolino J, Doctor J, Fox C, Goldstein N, Kaiser D, Linder J, Meeker D, Peprah Y, Persell S. Design of Behavioral Economic Applications to Geriatrics Leveraging Electronic Health Records (BEAGLE): A pragmatic cluster randomized controlled trial. Contemporary Clinical Trials 2021, 112: 106649. PMID: 34896294, PMCID: PMC8724916, DOI: 10.1016/j.cct.2021.106649.Peer-Reviewed Original ResearchConceptsPrimary care clinicsProstate-specific antigenCo-primary outcomesElectronic health recordsCare clinicsOlder adultsClinician educationParallel armsPragmatic cluster-randomized trialNon-specific reasonsOvertreatment of diabetesClinical decision support interventionHealth recordsPrimary care cliniciansChoosing Wisely campaignLarge regional health systemCluster-randomized trialDecision support interventionsPragmatic clusterRegional health systemOlder patientsStudy armsCare cliniciansDiabetes measuresUrine testing
2020
Clinician-Level Variation in Three Measures Representing Overuse Based on the American Geriatrics Society Choosing Wisely Statement
Rowe T, Brown T, Lee J, Linder J, Friedberg M, Doctor J, Meeker D, Ciolino J, Persell S. Clinician-Level Variation in Three Measures Representing Overuse Based on the American Geriatrics Society Choosing Wisely Statement. Journal Of General Internal Medicine 2020, 35: 1797-1802. PMID: 32128687, PMCID: PMC7280408, DOI: 10.1007/s11606-020-05748-8.Peer-Reviewed Original ResearchConceptsDiabetes measuresPSA measuresUrine cultureOlder adultsUrinalysis/urine cultureProstate-specific antigen (PSA) testingHealth systemNon-specific reasonsOral hypoglycemic medicationsOveruse of testingInappropriate useSame health systemMedical servicesIntermediate outcome measuresClinical quality measuresDesignRetrospective analysisHypoglycemic medicationsElderly patientsAntigen testingDiabetes mellitusCare cliniciansHighest quartileOffice visitsOdds ratioOutcome measures
2016
Behavioral interventions to reduce inappropriate antibiotic prescribing: a randomized pilot trial
Persell S, Doctor J, Friedberg M, Meeker D, Friesema E, Cooper A, Haryani A, Gregory D, Fox C, Goldstein N, Linder J. Behavioral interventions to reduce inappropriate antibiotic prescribing: a randomized pilot trial. BMC Infectious Diseases 2016, 16: 373. PMID: 27495917, PMCID: PMC4975897, DOI: 10.1186/s12879-016-1715-8.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdultAnti-Bacterial AgentsBehaviorDecision MakingDecision Support Systems, ClinicalEducation, Medical, ContinuingFemaleHumansInappropriate PrescribingInterprofessional RelationsMaleMiddle AgedPharyngitisPhysicians, Primary CarePilot ProjectsPractice Patterns, Physicians'PrescriptionsRespiratory Tract InfectionsSinusitisConceptsAcute respiratory infectionsInappropriate antibiotic prescribingAntibiotic prescribingRespiratory infectionsDiagnosis/symptomsARI diagnosesBehavioral interventionsAntibiotic prescribing ratesRandomized pilot trialPre-intervention yearInappropriate prescribingPrescribing ratesCare cliniciansAccountable justificationPilot trialPrescribingIntervention yearPharyngitisInfectionFloor effectsSymptomsDiagnosisPeer comparisonInterventionHawthorne effect