2024
Challenges in Health Care for Persons With Multiple Chronic Conditions—Where to Go and How to Get There?
Ouellet G, Ouellet J, Tinetti M. Challenges in Health Care for Persons With Multiple Chronic Conditions—Where to Go and How to Get There? JAMA Network Open 2024, 7: e2439837. PMID: 39418026, DOI: 10.1001/jamanetworkopen.2024.39837.Peer-Reviewed Original Research
2022
Benefits and harms of oral anticoagulants for atrial fibrillation in nursing home residents with advanced dementia
Ouellet GM, O'Leary JR, Leggett CG, Skinner J, Tinetti ME, Cohen AB. Benefits and harms of oral anticoagulants for atrial fibrillation in nursing home residents with advanced dementia. Journal Of The American Geriatrics Society 2022, 71: 561-568. PMID: 36310367, PMCID: PMC9957933, DOI: 10.1111/jgs.18108.Peer-Reviewed Original ResearchConceptsNursing home residentsAtrial fibrillationAdvanced dementiaHome residentsStroke riskLong-stay nursing home residentsMedicare Part D claimsDementia-related mortalityGuideline-recommended thresholdHarms of anticoagulationRetrospective cohort studyMultivariable survival analysisValvular heart diseaseRisk of deathPart D claimsMonths of lifeMinimum Data SetAnticoagulant discontinuationAnticoagulated individualsMean CHAVASc scoreCause mortalityMultivariable adjustmentOral anticoagulantsCohort studyThe association between beta‐blockers and outcomes in patients with heart failure and concurrent Alzheimer's disease and related dementias
Gilstrap L, Cohen A, Ouellet GM, Goyal P, Gladders B, Flint D, Skinner J. The association between beta‐blockers and outcomes in patients with heart failure and concurrent Alzheimer's disease and related dementias. Journal Of The American Geriatrics Society 2022, 71: 404-413. PMID: 36240493, DOI: 10.1111/jgs.18086.Peer-Reviewed Original ResearchConceptsHigh riskBB useHeart failureAlzheimer's diseaseLong-term mortality ratesConcurrent Alzheimer's diseaseBeta-blocker useReduced ejection fractionMedicare Part ARisk/benefitBB therapyEjection fractionContemporary patientsHFrEFHigh prevalenceSimilar riskMortality ratePatientsCognitive impairmentMortalityDiseaseADRDRiskTherapyOutcomes
2021
Anticoagulant Use for Atrial Fibrillation Among Persons With Advanced Dementia at the End of Life
Ouellet GM, Fried TR, Gilstrap LG, O’Leary J, Austin AM, Skinner JS, Cohen AB. Anticoagulant Use for Atrial Fibrillation Among Persons With Advanced Dementia at the End of Life. JAMA Internal Medicine 2021, 181: 1121-1123. PMID: 33970197, PMCID: PMC8111560, DOI: 10.1001/jamainternmed.2021.1819.Peer-Reviewed Original ResearchPresentation, Treatment, and Outcomes of Older Adults Hospitalized for Acute Myocardial Infarction According to Cognitive Status: The SILVER-AMI Study
Hajduk AM, Saczynski JS, Tsang S, Geda ME, Dodson JA, Ouellet GM, Goldberg RJ, Chaudhry SI. Presentation, Treatment, and Outcomes of Older Adults Hospitalized for Acute Myocardial Infarction According to Cognitive Status: The SILVER-AMI Study. The American Journal Of Medicine 2021, 134: 910-917. PMID: 33737057, PMCID: PMC8243828, DOI: 10.1016/j.amjmed.2021.03.003.Peer-Reviewed Original ResearchConceptsSevere cognitive impairmentAcute myocardial infarctionMyocardial infarctionCognitive impairmentOlder acute myocardial infarction patientsCognitive statusMultivariable-adjusted logistic regressionAcute myocardial infarction patientsOlder adultsRoutine cognitive screeningRisk of readmissionMedical record reviewRisk of deathPost-discharge periodMyocardial infarction patientsMyocardial infarction survivorsSILVER-AMI StudyComorbidity burdenHospital readmissionPoor outcomeRecord reviewFunctional statusInfarction patientsUnadjusted analysesInfarction survivors180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Ouellet G, Sybrant D, Gill TM, Chaudhry SI. 180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study. Open Heart 2021, 8: e001442. PMID: 33452007, PMCID: PMC7813425, DOI: 10.1136/openhrt-2020-001442.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionReadmission risk modelSelf-reported health statusMyocardial infarctionFunctional mobilityOlder adultsHealth statusDays of AMIFirst diastolic blood pressureChronic obstructive pulmonary diseaseIschemic ECG changesProspective cohort studyDiastolic blood pressureObstructive pulmonary diseaseLength of stayInitial heart rateFinal risk modelSILVER-AMI StudyRisk modelInitial hemoglobinCohort studyReadmission ratesBlood pressureEjection fractionHeart failure
2020
Clinician Perspectives on Incorporating Patients' Values‐Based Health Priorities in Decision‐Making
Ouellet GM, Kiwak E, Costello DM, Green AR, Geda M, Naik AD, Tinetti ME. Clinician Perspectives on Incorporating Patients' Values‐Based Health Priorities in Decision‐Making. Journal Of The American Geriatrics Society 2020, 69: 267-269. PMID: 33165913, PMCID: PMC7839399, DOI: 10.1111/jgs.16914.Peer-Reviewed Original ResearchRisk Model for Decline in Activities of Daily Living Among Older Adults Hospitalized With Acute Myocardial Infarction: The SILVER‐AMI Study
Hajduk AM, Dodson JA, Murphy TE, Tsang S, Geda M, Ouellet GM, Gill TM, Brush JE, Chaudhry SI. Risk Model for Decline in Activities of Daily Living Among Older Adults Hospitalized With Acute Myocardial Infarction: The SILVER‐AMI Study. Journal Of The American Heart Association 2020, 9: e015555. PMID: 33000681, PMCID: PMC7792390, DOI: 10.1161/jaha.119.015555.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionDaily living declineSILVER-AMI StudyDaily livingOlder patientsMonths postdischargeMyocardial infarctionFunctional declineImportant patient-centered outcomesPoor long-term outcomesLonger hospital stayLong-term outcomesPatient-centered outcomesGeriatric impairmentsHospital stayAMI survivorsClinical variablesMean ageMedical recordsRisk factorsRestorative therapyPhysical activityAMI hospitalizationPsychosocial factorsUS hospitalsCombating Heightened Social Isolation of Nursing Home Elders: The Telephone Outreach in the COVID-19 Outbreak Program
van Dyck LI, Wilkins KM, Ouellet J, Ouellet GM, Conroy ML. Combating Heightened Social Isolation of Nursing Home Elders: The Telephone Outreach in the COVID-19 Outbreak Program. American Journal Of Geriatric Psychiatry 2020, 28: 989-992. PMID: 32593495, PMCID: PMC7274114, DOI: 10.1016/j.jagp.2020.05.026.Peer-Reviewed Original ResearchConceptsWeekly phone callsNursing home residentsElderly residentsTelephone outreachHome residentsNursing homesSocial isolationVulnerable patient populationNursing home eldersLocal nursing homeCOVID-19 pandemicPhone callsPatient populationOlder adultsStudent volunteersVolunteersInitial reportInitial successStudent interest groupsResidentsPandemicSocial connectednessPersistent needSocial wellbeing
2019
Association of Patient Priorities–Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions
Tinetti ME, Naik AD, Dindo L, Costello DM, Esterson J, Geda M, Rosen J, Hernandez-Bigos K, Smith CD, Ouellet GM, Kang G, Lee Y, Blaum C. Association of Patient Priorities–Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions. JAMA Internal Medicine 2019, 179: 1688-1697. PMID: 31589281, PMCID: PMC6784811, DOI: 10.1001/jamainternmed.2019.4235.Peer-Reviewed Original ResearchMultiple chronic conditionsPrimary care practitionersUsual careHealth priorityPatient prioritiesChronic conditionsSelf-management tasksOlder adultsHealth careDiagnostic testsPatients' health prioritiesChronic illness careElectronic health record documentationNonrandomized clinical trialHealth care burdenMore chronic conditionsPrimary care practicesMental health scoresHealth record documentationCollaboRATE scoresUC participantsUC patientsIllness carePPC patientsUC groupChallenges and strategies in patients’ health priorities-aligned decision-making for older adults with multiple chronic conditions
Tinetti M, Dindo L, Smith CD, Blaum C, Costello D, Ouellet G, Rosen J, Hernandez-Bigos K, Geda M, Naik A. Challenges and strategies in patients’ health priorities-aligned decision-making for older adults with multiple chronic conditions. PLOS ONE 2019, 14: e0218249. PMID: 31181117, PMCID: PMC6557523, DOI: 10.1371/journal.pone.0218249.Peer-Reviewed Original ResearchConceptsPatients' health prioritiesMultiple chronic conditionsHealth priorityChronic conditionsPatient prioritiesPatient Priorities CarePrimary care cliniciansCare of patientsCare cliniciansPrimary carePatient outcomesCardiology practicePatientsCare optionsCare PilotCliniciansOlder adultsSerial trialsCarePriority careImplementation teamQualitative studyMultiple conditionsAdditional settingsMultiplicity of problemsHospital Readmission From Skilled Nursing Facilities (SNFs): Perspectives of Hospital and SNF Providers
Minges KE, Campbell Britton M, Clark BW, Ouellet GM, Hodshon B, Chaudhry SI. Hospital Readmission From Skilled Nursing Facilities (SNFs): Perspectives of Hospital and SNF Providers. Journal Of The American Medical Directors Association 2019, 20: 1050-1051. PMID: 31043356, DOI: 10.1016/j.jamda.2019.03.005.Peer-Reviewed Original ResearchFunctional Outcomes After Hip Fracture in Independent Community‐Dwelling Patients
Ouellet JA, Ouellet GM, Romegialli AM, Hirsch M, Berardi L, Ramsey CM, Cooney LM, Walke LM. Functional Outcomes After Hip Fracture in Independent Community‐Dwelling Patients. Journal Of The American Geriatrics Society 2019, 67: 1386-1392. PMID: 30964203, PMCID: PMC6941577, DOI: 10.1111/jgs.15870.Peer-Reviewed Original ResearchConceptsNumber of medicationsHospital deliriumCare hoursADL disabilityHip fractureCommunity-dwelling adults 65Community-Dwelling PatientsNew ADL disabilityHip fracture surgeryRetrospective cohort studyDaily living (ADL) disabilityHip fracture patientsProportion of patientsCharacteristics of hospitalizationsIndependent older adultsChart reviewCohort studyFracture patientsFracture surgeryPatient chartsPoor outcomeFunctional outcomeAcademic hospitalOpiate useDeliriumTreatment of Hypertension in Complex Older Adults: How Many Medications Are Needed?
Ouellet GM, McAvay G, Murphy TE, Tinetti ME. Treatment of Hypertension in Complex Older Adults: How Many Medications Are Needed? Gerontology And Geriatric Medicine 2019, 5: 2333721419856436. PMID: 31245434, PMCID: PMC6580710, DOI: 10.1177/2333721419856436.Peer-Reviewed Original ResearchMajor adverse cardiovascular eventsMedical Expenditure Panel SurveyAntihypertensive classesCardiovascular eventsOlder adultsMultivariable proportional hazards regressionAdverse cardiovascular eventsProportional hazards regressionGreater cardiovascular benefitTreatment of hypertensionComplex older adultsRisk of mortalityRepresentative community sampleAdditional antihypertensivesMultiple antihypertensivesHypertensive adultsCardiovascular benefitsHazards regressionExposure groupRepresentative cohortMobility disabilityInverse probabilityLongitudinal associationsHypertensionAdults
2018
COGNITIVE IMPAIRMENT AND SIX-MONTH OUTCOMES AMONG OLDER ADULTS WITH MYOCARDIAL INFARCTION: THE SILVER-AMI STUDY
Hajduk A, Saczynski J, Tsang S, Geda M, Dodson J, Ouellet G, Goldberg R, Chaudhry S. COGNITIVE IMPAIRMENT AND SIX-MONTH OUTCOMES AMONG OLDER ADULTS WITH MYOCARDIAL INFARCTION: THE SILVER-AMI STUDY. Innovation In Aging 2018, 2: 772-772. PMCID: PMC6228403, DOI: 10.1093/geroni/igy023.2857.Peer-Reviewed Original ResearchAcute myocardial infarctionSevere cognitive impairmentCognitive impairmentHospital readmissionAMI survivorsPoor outcomeMyocardial infarctionOlder adultsElderly AMI survivorsMedical record reviewRate of readmissionRisk of readmissionSix-month outcomesRisk of deathSILVER-AMI StudyAMI typeComorbidity burdenPatient ageRecord reviewUnadjusted analysesFunctional statusReadmissionSignificant associationCognitive statusCognitive screeningPrinciple of rational prescribing and deprescribing in older adults with multiple chronic conditions
Ouellet GM, Ouellet JA, Tinetti ME. Principle of rational prescribing and deprescribing in older adults with multiple chronic conditions. Therapeutic Advances In Drug Safety 2018, 9: 639-652. PMID: 30479739, PMCID: PMC6243421, DOI: 10.1177/2042098618791371.Peer-Reviewed Original ResearchMultiple chronic conditionsOptimal treatment regimensTreatment regimensOlder adultsChronic conditionsClinical trajectoriesMedication-related harmPatient's own prioritiesPatient's clinical trajectoryOptimal prescribingTherapeutic trialsPrescribed medicationsClinical statusHealth outcome goalsHealthy patientsRational prescribingPatient goalsClinical trialsPatient prioritiesPatientsSignificant burdenRegimensAdverse effectsAdultsLess benefitNational Prescribing Trends for High‐Risk Anticholinergic Medications in Older Adults
Rhee TG, Choi YC, Ouellet GM, Ross JS. National Prescribing Trends for High‐Risk Anticholinergic Medications in Older Adults. Journal Of The American Geriatrics Society 2018, 66: 1382-1387. PMID: 29582410, PMCID: PMC6097908, DOI: 10.1111/jgs.15357.Peer-Reviewed Original ResearchConceptsNational Ambulatory Medical Care SurveyAnticholinergic prescriptionsPhysician specialtyDrug classesPrescribing trendsOffice-based outpatient visitsOffice-based physician visitsAmbulatory Medical Care SurveyMultivariable logistic regression analysisOlder adultsNational prescribing trendsCommon drug classesLogistic regression analysisCross-sectional analysisSpecific physician specialtiesAnticholinergic medicationsPhysician visitsOutpatient visitsQuality prescribingCare SurveyFemale sexStratified analysisSouthern geographic regionsGreater oddsTotal visits
2017
Prehospital Delay in Older Adults with Acute Myocardial Infarction: The ComprehenSIVe Evaluation of Risk Factors in Older Patients with Acute Myocardial Infarction Study
Ouellet GM, Geda M, Murphy TE, Tsang S, Tinetti ME, Chaudhry SI. Prehospital Delay in Older Adults with Acute Myocardial Infarction: The ComprehenSIVe Evaluation of Risk Factors in Older Patients with Acute Myocardial Infarction Study. Journal Of The American Geriatrics Society 2017, 65: 2391-2396. PMID: 29044463, PMCID: PMC5681402, DOI: 10.1111/jgs.15102.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionAcute Myocardial Infarction StudyMyocardial Infarction StudyPrehospital delayOlder adultsOlder patientsHeart failureMyocardial infarctionRisk factorsFuture public health effortsContemporary national cohortMedical record abstractionPublic health effortsCross-sectional analysisAntiischemic therapyHospital presentationIndex hospitalizationHospital delaySymptom durationDiabetes mellitusClinical presentationComorbid conditionsRecord abstractionAtypical symptomsNonwhite raceCare Transitions Between Hospitals and Skilled Nursing Facilities: Perspectives of Sending and Receiving Providers
Britton MC, Ouellet GM, Minges KE, Gawel M, Hodshon B, Chaudhry SI. Care Transitions Between Hospitals and Skilled Nursing Facilities: Perspectives of Sending and Receiving Providers. The Joint Commission Journal On Quality And Patient Safety 2017, 43: 565-572. PMID: 29056176, PMCID: PMC5693352, DOI: 10.1016/j.jcjq.2017.06.004.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAttitude of Health PersonnelCommunicationHospital AdministrationHumansInsurance, Health, ReimbursementInterviews as TopicPatient DischargePatient ReadmissionPatient TransferQualitative ResearchQuality ImprovementRisk FactorsSeverity of Illness IndexSkilled Nursing FacilitiesUnited StatesConceptsSkilled nursing facilitiesCare transitionsNursing facilitiesSNF providersPatient-level risk factorsOptimal care settingAcute medical illnessUnplanned hospital readmissionComprehensive care planCost of careHospital readmissionMedical illnessComplex patientsRisk factorsMedicare patientsCare settingsCare plansPatient complexityHealth care institutionsPatient transferPsychosocial issuesHospitalPatientsSeparate hospitalsCare institutions
2015
Prostate Cancer in Elderly Men Screening, Active Surveillance, and Definitive Therapy
Roussel B, Ouellet GM, Mohile SG, Dale W. Prostate Cancer in Elderly Men Screening, Active Surveillance, and Definitive Therapy. Clinics In Geriatric Medicine 2015, 31: 615-629. PMID: 26476120, DOI: 10.1016/j.cger.2015.07.004.Peer-Reviewed Original Research