2022
Development and pilot testing of EHR-nudges to reduce overuse in older primary care patients
Rowe T, Brown T, Lee J, Linder J, Meeker D, Doctor J, Goldstein N, Fox C, Persell S. Development and pilot testing of EHR-nudges to reduce overuse in older primary care patients. Archives Of Gerontology And Geriatrics 2022, 104: 104794. PMID: 36115068, PMCID: PMC9682472, DOI: 10.1016/j.archger.2022.104794.Peer-Reviewed Original ResearchConceptsProstate-specific antigenUA/UCCDS alertsOlder adultsCommon conditionUnnecessary testingOlder primary care patientsClinical decision support alertsNon-specific reasonsOral hypoglycemic medicationsOvertreatment of diabetesPrimary care patientsPrimary care physiciansLarge health systemDecision support alertsHypoglycemic medicationsOveruse measuresCare patientsCare physiciansSignificant morbidityUrine cultureProstate cancerAmbulatory careClinical actionsAdult menA Qualitative Description of Clinician Free-Text Rationales Entered within Accountable Justification Interventions
Brown T, Zelch B, Lee J, Doctor J, Linder J, Sullivan M, Goldstein N, Rowe T, Meeker D, Knight T, Friedberg M, Persell S. A Qualitative Description of Clinician Free-Text Rationales Entered within Accountable Justification Interventions. Applied Clinical Informatics 2022, 13: 820-827. PMID: 36070799, PMCID: PMC9451951, DOI: 10.1055/s-0042-1756366.Peer-Reviewed Original ResearchConceptsClinical content areasClinical appropriatenessClinical decision support alertsPrimary care physiciansDecision support alertsAppropriate clinical decisionsUnique cliniciansOpioid prescribingCare physiciansClinical detailsAccountable justificationCDS alertsPilot interventionClinical decisionClinical casesCliniciansParticular diagnosisOlder adultsInterventionPhysiciansDelphi techniquePolypharmacyPrescribingPatientsSymptomsDevelopment of High-Risk Geriatric Polypharmacy Electronic Clinical Quality Measures and a Pilot Test of EHR Nudges Based on These Measures
Persell S, Brown T, Doctor J, Fox C, Goldstein N, Handler S, Hanlon J, Lee J, Linder J, Meeker D, Rowe T, Sullivan M, Friedberg M. Development of High-Risk Geriatric Polypharmacy Electronic Clinical Quality Measures and a Pilot Test of EHR Nudges Based on These Measures. Journal Of General Internal Medicine 2022, 37: 2777-2785. PMID: 34993860, PMCID: PMC9411452, DOI: 10.1007/s11606-021-07296-1.Peer-Reviewed Original ResearchConceptsHigh-risk criteriaNon-dihydropyridine calcium channel blockersMore high-risk criteriaSingle large health systemThree-arm pilotChronic kidney diseaseHigh-risk medicationsCalcium channel blockersLarge health systemDrug-drug interactionsClinical quality measuresElectronic health recordsEHR alertMain MeasuresRatesMore medicationsPatients 65Older patientsHeart failureKey ResultsAmongKidney diseaseNovel electronic health recordPolypharmacyChannel blockersFall historyPatients
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
Engaging heart failure patients from a clinical data research network: A survey on willingness to participate in different types of research.
Choi Y, López J, Meeker D, Ohno-Machado L, Kim K. Engaging heart failure patients from a clinical data research network: A survey on willingness to participate in different types of research. AMIA Annual Symposium Proceedings 2020, 2019: 305-312. PMID: 32308823, PMCID: PMC7153117.Peer-Reviewed Original ResearchConceptsClinical Data Research NetworkHeart failure patientsLarge cohort studyResearch participationResearch NetworkCohort studyFailure patientsOne-time surveyPatient cohortObservational studyPatient motivationWeight controlSignificant associationClinical researchPatientsPrecision medicineHealth dataRecruitment effortsNational effortsActivity interestsSurgeryCohortClinician-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
2019
Patient Commitment to Health (PACT-Health) in the Heart Failure Population: A Focus Group Study of an Active Communication Framework for Patient-Centered Health Behavior Change
Meeker D, Goldberg J, Kim K, Peneva D, De Oliveira Campos H, Maclean R, Selby V, Doctor J. Patient Commitment to Health (PACT-Health) in the Heart Failure Population: A Focus Group Study of an Active Communication Framework for Patient-Centered Health Behavior Change. Journal Of Medical Internet Research 2019, 21: e12483. PMID: 31389339, PMCID: PMC6701162, DOI: 10.2196/12483.Peer-Reviewed Original ResearchConceptsHeart failure populationHeart failureFailure populationHealth coachingDietary habitsMedication adherence barriersPatient-centered themesChronic heart failurePatient focus groupsHealth behavior changeRegimen complexityAdherence barriersMedication adherenceExercise regimensDisease progressionExercise habitsLocal cardiologistsLifestyle changesPatient commitmentCare providersFocus groupsSide effectsSemistructured interview toolPatientsAppropriate exercise
2016
Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial
Meeker D, Linder J, Fox C, Friedberg M, Persell S, Goldstein N, Knight T, Hay J, Doctor J. Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial. JAMA 2016, 315: 562-570. PMID: 26864410, PMCID: PMC6689234, DOI: 10.1001/jama.2016.0275.Peer-Reviewed Original ResearchConceptsAcute respiratory tract infectionsInappropriate antibiotic prescribingAntibiotic prescribing ratesRespiratory tract infectionsPrimary care practicesAntibiotic prescribingPrescribing ratesTract infectionsAccountable justificationCare practicesBehavioral interventionsElectronic health recordsClinical trialsAntibiotic prescribing guidelinesElectronic order setsPatients' electronic health recordsAdult patientsPrescribing guidelinesAmbulatory visitsMonth 18Concomitant infectionNonantibiotic treatmentIntervention periodMonths preinterventionMAIN OUTCOME
2015
Symptom trends in the last year of life from 1998 to 2010: a cohort study.
Singer A, Meeker D, Teno J, Lynn J, Lunney J, Lorenz K. Symptom trends in the last year of life from 1998 to 2010: a cohort study. Annals Of Internal Medicine 2015, 162: 175-83. PMID: 25643305, PMCID: PMC4346253, DOI: 10.7326/m13-1609.Peer-Reviewed Original ResearchConceptsProxy reportsPain intensitySymptom prevalenceLife careProxy-reported painChronic lung diseaseCongestive heart failureManagement of painPrevalence of depressionEnd of lifeCohort studySevere painHeart failureLung diseaseObservational studyTroubling symptomsSudden deathIndividual symptomsAlarming symptomsPainFamily respondentsHRS participantsSymptom trendsPrevalenceRepresentative longitudinal survey
2014
Time of Day and the Decision to Prescribe Antibiotics
Linder J, Doctor J, Friedberg M, Nieva H, Birks C, Meeker D, Fox C. Time of Day and the Decision to Prescribe Antibiotics. JAMA Internal Medicine 2014, 174: 2029-2031. PMID: 25286067, PMCID: PMC4648561, DOI: 10.1001/jamainternmed.2014.5225.Peer-Reviewed Original ResearchNudging Physician Prescription Decisions by Partitioning the Order Set: Results of a Vignette-Based Study
Tannenbaum D, Doctor J, Persell S, Friedberg M, Meeker D, Friesema E, Goldstein N, Linder J, Fox C. Nudging Physician Prescription Decisions by Partitioning the Order Set: Results of a Vignette-Based Study. Journal Of General Internal Medicine 2014, 30: 298-304. PMID: 25394536, PMCID: PMC4351289, DOI: 10.1007/s11606-014-3051-2.Peer-Reviewed Original ResearchConceptsEHR order setsPrimary care providersElectronic health recordsNarrow-spectrum antibioticsOrder setsTreatment menuTreatment choiceCare providersMain MeasuresThe main outcomeAggressive treatment optionsAcute respiratory infectionsPhysician prescription decisionsBroad-spectrum antibioticsRespiratory infectionsPrescribing practicesCounter medicationsTreatment optionsPrescription decisionsMAIN OUTCOMEPatient careTypical signsBackgroundHealthcare professionalsPrescription drugsProvider decisionsAggressive optionsNudging Guideline-Concordant Antibiotic Prescribing: A Randomized Clinical Trial
Meeker D, Knight T, Friedberg M, Linder J, Goldstein N, Fox C, Rothfeld A, Diaz G, Doctor J. Nudging Guideline-Concordant Antibiotic Prescribing: A Randomized Clinical Trial. JAMA Internal Medicine 2014, 174: 425-431. PMID: 24474434, PMCID: PMC4648560, DOI: 10.1001/jamainternmed.2013.14191.Peer-Reviewed Original ResearchConceptsAcute respiratory infectionsInappropriate antibiotic prescribingAntibiotic prescribing ratesPrescribing ratesAntibiotic prescribingClinical trialsIntervention periodOutpatient primary care clinicsInappropriate prescribing ratePrimary care clinicsAppropriate antibiotic prescriptionRandomized clinical trialsExamination roomLow-cost interventionStandard practice controlsQuality improvement effortsARI diagnosesARI visitsAntibiotic prescriptionsPatient ageRespiratory infectionsCare clinicsInsurance statusMAIN OUTCOMEClinical practice
2010
Coverage and Preventive Screening
Meeker D, Joyce G, Malkin J, Teutsch S, Haddix A, Goldman D. Coverage and Preventive Screening. Health Services Research 2010, 46: 173-184. PMID: 21029084, PMCID: PMC3034268, DOI: 10.1111/j.1475-6773.2010.01188.x.Peer-Reviewed Original ResearchConceptsFecal occult blood testFirst-dollar coveragePreventive careControl groupOccult blood testLow-deductible plansHealth care servicesEligible patientsBlood testsPapanicolaou smearsPreventive servicesPreventive screeningHealthy individualsCare servicesPocket costsPatientsDeductible plansSecular trendsCareSignificant changes