Featured Publications
Outcome Goals and Health Care Preferences of Older Adults With Multiple Chronic Conditions
Tinetti ME, Costello DM, Naik AD, Davenport C, Hernandez-Bigos K, Van Liew JR, Esterson J, Kiwak E, Dindo L. Outcome Goals and Health Care Preferences of Older Adults With Multiple Chronic Conditions. JAMA Network Open 2021, 4: e211271. PMID: 33760091, PMCID: PMC7991967, DOI: 10.1001/jamanetworkopen.2021.1271.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsHealth care preferencesHealth care activitiesCare preferencesChronic conditionsCare activitiesOlder adultsRealistic outcome goalsEmergency department visitsHealth care visitsPrimary care practicesCross-sectional studyHealth-related barriersOutcome goalsEligible patientsPain medicationCare visitsDepartment visitsSleep medicationHealth outcome goalsMean ageCare studiesGlucose levelsMAIN OUTCOMEMedicationsAssociation 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 groupDecision Making for Older Adults With Multiple Chronic Conditions: Executive Summary for the American Geriatrics Society Guiding Principles on the Care of Older Adults With Multimorbidity
Boyd C, Smith CD, Masoudi FA, Blaum CS, Dodson JA, Green AR, Kelley A, Matlock D, Ouellet J, Rich MW, Schoenborn NL, Tinetti ME. Decision Making for Older Adults With Multiple Chronic Conditions: Executive Summary for the American Geriatrics Society Guiding Principles on the Care of Older Adults With Multimorbidity. Journal Of The American Geriatrics Society 2019, 67: 665-673. PMID: 30663782, DOI: 10.1111/jgs.15809.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsPatients' health prioritiesHealth priorityAmerican Geriatrics SocietyOlder adultsChronic conditionsSpecialty careGeriatrics SocietySystematic reviewHealth trajectoriesOlder peopleAction stepsCareAdultsMultimorbidityCliniciansCommunication scriptsExecutive summaryHealthPotential benefitsAlign decisionsPatientsReviewGeriatriciansCardiologistsAntihypertensive Medications and Serious Fall Injuries in a Nationally Representative Sample of Older Adults
Tinetti ME, Han L, Lee DS, McAvay GJ, Peduzzi P, Gross CP, Zhou B, Lin H. Antihypertensive Medications and Serious Fall Injuries in a Nationally Representative Sample of Older Adults. JAMA Internal Medicine 2014, 174: 588-595. PMID: 24567036, PMCID: PMC4136657, DOI: 10.1001/jamainternmed.2013.14764.Peer-Reviewed Original ResearchConceptsSerious fall injuriesAdjusted hazard ratioAntihypertensive medicationsMultiple chronic conditionsFall injuriesAntihypertensive groupHazard ratioOlder adultsChronic conditionsAntihypertensive medication classesStandardized daily doseAntihypertensive medication useCommunity-living adultsPropensity score adjustmentTraumatic brain injuryHealthy older adultsMedication intensityCardiovascular eventsMedication classesDaily doseHip fractureMedication useNationally Representative SampleHead injuryBrain injuryAnti-Hypertensive Medications and Cardiovascular Events in Older Adults with Multiple Chronic Conditions
Tinetti ME, Han L, McAvay GJ, Lee DS, Peduzzi P, Dodson JA, Gross CP, Zhou B, Lin H. Anti-Hypertensive Medications and Cardiovascular Events in Older Adults with Multiple Chronic Conditions. PLOS ONE 2014, 9: e90733. PMID: 24614535, PMCID: PMC3948696, DOI: 10.1371/journal.pone.0090733.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsAnti-hypertensive treatmentCardiovascular eventsAnti-hypertensive medicationsHigh-intensity groupChronic conditionsOlder adultsHazard ratioPropensity scoreIntensity groupStandardized daily doseCommunity-living participantsPropensity score adjustmentCV eventsMedication intensityLess comorbidityDaily doseRandomized trialsMAIN OUTCOMERepresentative cohortScore adjustmentSurvey cohortRCT resultsCohortMortalityPotential Therapeutic Competition in Community-Living Older Adults in the U.S.: Use of Medications That May Adversely Affect a Coexisting Condition
Lorgunpai SJ, Grammas M, Lee DS, McAvay G, Charpentier P, Tinetti ME. Potential Therapeutic Competition in Community-Living Older Adults in the U.S.: Use of Medications That May Adversely Affect a Coexisting Condition. PLOS ONE 2014, 9: e89447. PMID: 24586786, PMCID: PMC3934884, DOI: 10.1371/journal.pone.0089447.Peer-Reviewed Original ResearchConceptsChronic conditionsMedication classesDisease guidelinesOlder adultsCommunity-living older adultsCross-sectional descriptive studyAdverse medication effectsCommon chronic conditionsMultiple chronic conditionsUse of medicationsClinical outcomesCoexisting conditionsMedication effectsClinical priorityMedicare claimsMedicationsStudy conditionsAdults 65Systematic reviewDescriptive studyPerson interviewsOlder AmericansAdultsFrequency of usePrevalenceContribution of Individual Diseases to Death in Older Adults with Multiple Diseases
Tinetti ME, McAvay GJ, Murphy TE, Gross CP, Lin H, Allore HG. Contribution of Individual Diseases to Death in Older Adults with Multiple Diseases. Journal Of The American Geriatrics Society 2012, 60: 1448-1456. PMID: 22734792, PMCID: PMC3419332, DOI: 10.1111/j.1532-5415.2012.04077.x.Peer-Reviewed Original ResearchConceptsOlder adultsSingle underlying causeRespiratory diseaseMedicare Current Beneficiary Survey participantsChronic lower respiratory diseasesUnderlying causeAcute kidney injuryLower respiratory diseaseAverage attributable fractionKidney injuryHazard ratioHeart failureLiver diseaseAcute eventMyocardial infarctionUnintentional injuriesAcute diseaseAttributable fractionNational representative sampleMedicare beneficiariesOlder adults' experiencesDiseaseIndividual diseasesDeathConfidence intervalsHealth Outcome Priorities Among Competing Cardiovascular, Fall Injury, and Medication‐Related Symptom Outcomes
Tinetti ME, McAvay GJ, Fried TR, Allore HG, Salmon JC, Foody JM, Bianco L, Ginter S, Fraenkel L. Health Outcome Priorities Among Competing Cardiovascular, Fall Injury, and Medication‐Related Symptom Outcomes. Journal Of The American Geriatrics Society 2008, 56: 1409-1416. PMID: 18662210, PMCID: PMC3494099, DOI: 10.1111/j.1532-5415.2008.01815.x.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsActivities of Daily LivingAgedAlzheimer DiseaseAntihypertensive AgentsAttitude to HealthCardiovascular DiseasesDecision MakingDepressive DisorderFemaleGeriatric AssessmentHealth PrioritiesHealth SurveysHumansIndividualityMaleMobility LimitationPulmonary Disease, Chronic ObstructiveWounds and InjuriesConceptsFall injuriesMedication symptomsAntihypertensive medicationsCardiovascular eventsCardiovascular outcomesChronic obstructive pulmonary diseaseBlood pressure reductionObstructive pulmonary diseaseSerious fall injuriesSymptom-related outcomesPulmonary diseaseSymptom outcomesHigh riskDepressive symptomsLower riskHealth outcomesInterindividual variabilityInjuryIntact personsMedicationsPressure reductionSymptomsRisk estimatesOlder adultsLower cognition
2024
Patient Priorities Care: Priorities Aligned Decision Making for Persons with Multiple Chronic Conditions
Ouellet J, Samper-Ternent R, Tinetti M, Bonds Johnson K, Mecca M. Patient Priorities Care: Priorities Aligned Decision Making for Persons with Multiple Chronic Conditions. 2024, 353-358. DOI: 10.1007/978-3-031-56204-4_37.ChaptersMultiple chronic conditionsChronic conditionsOlder adultsHealth outcome goalsSelf-management tasksFragmented careGuideline-recommended treatmentSpecialist visitsDisease-basedCombination of medicationsOutcome goalsSilo approachAdultsDecision-makingDiagnostic testsCareClinical trialsHealthVisitsCliniciansHarmMedicationPersonsRecommendations
2023
PERSONS LIVING WITH DEMENTIA AND MULTIPLE CHRONIC CONDITIONS IDENTIFYING HEALTH PRIORITIES WITH CARE PARTNERS
Vu T, Mroz E, Hernandez-Bigos K, Chow D, Samper-Ternent R, Johnson K, Tinetti M, Monin J. PERSONS LIVING WITH DEMENTIA AND MULTIPLE CHRONIC CONDITIONS IDENTIFYING HEALTH PRIORITIES WITH CARE PARTNERS. Innovation In Aging 2023, 7: 416-416. PMCID: PMC10736172, DOI: 10.1093/geroni/igad104.1374.Peer-Reviewed Original ResearchMultiple chronic conditionsHealth care prioritiesCare partnersChronic conditionsHealth priorityCare prioritiesPilot studyYears of ageEvidence-based toolsPatient prioritiesOlder personsPLWDCare decisionsHealth goalsCare recipientsHealthcare goalsOlder adultsDementiaOpen-ended questionsAgeThematic analysisPERSONS LIVINGEarly stagesYearsRecipientsHEALTH PRIORITIES ALIGNED DECISION MAKING FOR DISCRETE DECISIONS
Banks J, Soni S, Madrid V, Samper-Ternent R, Arain S, Tinetti M, Naik A. HEALTH PRIORITIES ALIGNED DECISION MAKING FOR DISCRETE DECISIONS. Innovation In Aging 2023, 7: 923-923. PMCID: PMC10739269, DOI: 10.1093/geroni/igad104.2965.Peer-Reviewed Original ResearchPeripheral arterial diseaseMultiple chronic conditionsOlder adultsDisease-specific markersOlder patientsRevascularization proceduresArterial diseaseChronic conditionsVascular surgeryPilot trialHealth professionalsPatient stakeholdersPatientsMean percentageRevascularizationCaregiversAdultsOutcomesParticipant feedbackComplicationsIntervention decisionsSurgeryDiscrete interventionsDiseaseCardiologyChanges in Older Adult Trauma Quality When Evaluated Using Longer-Term Outcomes vs In-Hospital Mortality
Zogg C, Cooper Z, Peduzzi P, Falvey J, Castillo-Angeles M, Kodadek L, Staudenmayer K, Davis K, Tinetti M, Lichtman J. Changes in Older Adult Trauma Quality When Evaluated Using Longer-Term Outcomes vs In-Hospital Mortality. JAMA Surgery 2023, 158: e234856. PMID: 37792354, PMCID: PMC10551815, DOI: 10.1001/jamasurg.2023.4856.Peer-Reviewed Original ResearchConceptsHospital-level factorsTraumatic brain injurySevere traumatic brain injuryHospital mortalityTrauma QualityOlder adultsHip fractureComposite scoreHigher risk-adjusted oddsLevel 1 trauma centerIn-Hospital MortalityRisk-adjusted oddsLong-term outcomesMultivariable logistic regressionNontrauma centersTrauma patientsTerm outcomesTrauma centerPrimary diagnosisBrain injuryTrauma systemMAIN OUTCOMEMedicare feeService claimsForms of trauma
2019
IMPLEMENTATION OF PATIENT PRIORITIES CARE WITHIN A VA GERIATRICS CLINIC
Freytag J, Dindo L, Catic A, Naik A, Tinetti M. IMPLEMENTATION OF PATIENT PRIORITIES CARE WITHIN A VA GERIATRICS CLINIC. Innovation In Aging 2019, 3: s774-s774. PMCID: PMC6846413, DOI: 10.1093/geroni/igz038.2844.Peer-Reviewed Original ResearchPatient Priorities CareMultiple chronic conditionsGeriatric clinicPatient prioritiesUsual careOlder adultsSingle disease guidelinesRetrospective cohort studySelf-care recommendationsMore recommendationsUC patientsCohort studyPrimary clinicianChronic conditionsMedical recordsMultimorbid adultsSame clinicianCare workflowClinicCliniciansPatientsWay cliniciansCareMedicationsPriority careChallenges 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 problems
2018
PATIENT PRIORITIES CARE: MOVING FROM DISEASE-BASED TO PATIENT PRIORITIES-ALIGNED DECISION-MAKING
Tinetti M. PATIENT PRIORITIES CARE: MOVING FROM DISEASE-BASED TO PATIENT PRIORITIES-ALIGNED DECISION-MAKING. Innovation In Aging 2018, 2: 642-643. PMCID: PMC6227531, DOI: 10.1093/geroni/igy023.2400.Peer-Reviewed Original ResearchFeasibility of Implementing Patient Priorities Care for Older Adults with Multiple Chronic Conditions
Blaum CS, Rosen J, Naik AD, Smith CD, Dindo L, Vo L, Hernandez‐Bigos K, Esterson J, Geda M, Ferris R, Costello D, Acampora D, Meehan T, Tinetti ME. Feasibility of Implementing Patient Priorities Care for Older Adults with Multiple Chronic Conditions. Journal Of The American Geriatrics Society 2018, 66: 2009-2016. PMID: 30281777, PMCID: PMC7015118, DOI: 10.1111/jgs.15465.Peer-Reviewed Original ResearchConceptsPatient Priorities CarePrimary care providersMultiple chronic conditionsOlder adultsChronic conditionsElectronic health record supportStudy-Act cyclesImplementation feasibility studyClinical championsHealth outcome goalsPrimary careClinicians' perceptionsTreatment decisionsPatient prioritiesClinic workflowClinician concernsCardiology practiceCare providersPDSA cyclesEHR documentationClinical settingHealthcare preferencesPriority discussionInterprofessional communicationClinicians
2016
Patient Priority–Directed Decision Making and Care for Older Adults with Multiple Chronic Conditions
Tinetti ME, Esterson J, Ferris R, Posner P, Blaum CS. Patient Priority–Directed Decision Making and Care for Older Adults with Multiple Chronic Conditions. Clinics In Geriatric Medicine 2016, 32: 261-275. PMID: 27113145, DOI: 10.1016/j.cger.2016.01.012.Peer-Reviewed Original Research
2015
Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study
Tinetti ME, McAvay G, Trentalange M, Cohen AB, Allore HG. Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study. The BMJ 2015, 351: h4984. PMID: 26432468, PMCID: PMC4591503, DOI: 10.1136/bmj.h4984.Peer-Reviewed Original ResearchConceptsSerotonin-norepinephrine reuptake inhibitorsMultiple chronic conditionsSelective serotonin reuptake inhibitorsAdjusted hazard ratioRisk of deathCalcium channel blockersChronic conditionsHazard ratioΒ-blockersCohort studyReuptake inhibitorsAtrial fibrillationOlder adultsChannel blockersCardiovascular drugsSSRIs/serotonin-norepinephrine reuptake inhibitorsRenin-angiotensin system blockersNorepinephrine reuptake inhibitorsSerotonin reuptake inhibitorsCommon combinationRAS blockersSystem blockersStudy drugHeart failureThromboembolic disease
2006
Perceptions of physicians on the barriers and facilitators to integrating fall risk evaluation and management into practice
Chou W, Tinetti M, King M, Irwin K, Fortinsky R. Perceptions of physicians on the barriers and facilitators to integrating fall risk evaluation and management into practice. Journal Of General Internal Medicine 2006, 21: 117-122. DOI: 10.1007/s11606-006-0244-3.Peer-Reviewed Original ResearchPrimary care providersFall risk evaluationCare providersPatient factorsPhysician factorsSelf-reported facilitatorsHigh-risk patientsAppropriateness of referralsFall risk managementRisk factor evaluationHealth care providersPerceptions of physiciansOlder patientsPatient barriersConsiderable morbidityLogistical factorsOutreach visitsPrimary carePhysicians' perceptionsImmobile patientsClinical practicePatientsAvailability of transportationOlder adultsRisk evaluation
2001
The Design and Implementation of a Restorative Care Model for Home Care
Baker D, Gottschalk M, Eng C, Weber S, Tinetti M. The Design and Implementation of a Restorative Care Model for Home Care. The Gerontologist 2001, 41: 257-263. PMID: 11327492, DOI: 10.1093/geront/41.2.257.Peer-Reviewed Original ResearchConceptsFunctional outcomeOlder adultsAcute disease processHome careMultidisciplinary work groupHome health aidesHome-based careOlder patientsChronic disabilityPractice patternsHome care agenciesCare modelPatient progressRehabilitative interventionsDisease processMedical treatmentHealth aidesFunctional independenceCareCare agenciesPersonal careAdultsOutcomesPatientsWork groups