1,044 results on '"Hanlon, Joseph T."'
Search Results
2. Development of High-Risk Geriatric Polypharmacy Electronic Clinical Quality Measures and a Pilot Test of EHR Nudges Based on These Measures
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Persell, Stephen D., Brown, Tiffany, Doctor, Jason N., Fox, Craig R., Goldstein, Noah J., Handler, Steven M., Hanlon, Joseph T, Lee, Ji Young, Linder, Jeffrey A., Meeker, Daniella, Rowe, Theresa A, Sullivan, Mark D., and Friedberg, Mark W.
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- 2022
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3. Pharmacotherapy in Older Adults with Cardiovascular Disease: Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop.
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Schwartz, Janice B, Schmader, Kenneth E, Hanlon, Joseph T, Abernethy, Darrell R, Gray, Shelly, Dunbar-Jacob, Jacqueline, Holmes, Holly M, Murray, Michael D, Roberts, Robert, Joyner, Michael, Peterson, Josh, Lindeman, David, Tai-Seale, Ming, Downey, Laura, and Rich, Michael W
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Humans ,Cardiovascular Diseases ,Cardiovascular Agents ,Polypharmacy ,Geriatrics ,Cardiology ,Aged ,Aged ,80 and over ,Medicare ,Societies ,Medical ,United States ,Female ,Male ,National Institute on Aging (U.S.) ,Drug Prescriptions ,Medication Adherence ,Deprescriptions ,adherence ,adverse effects ,cardiovascular medication ,de-prescribing ,polypharmacy ,Patient Safety ,Cardiovascular ,Clinical Research ,Heart Disease ,Health Services ,Aging ,Health and social care services research ,8.1 Organisation and delivery of services ,Good Health and Well Being ,Medical and Health Sciences - Abstract
ObjectivesTo identify the top priority areas for research to optimize pharmacotherapy in older adults with cardiovascular disease (CVD).DesignConsensus meeting.SettingMultidisciplinary workshop supported by the National Institute on Aging, the American College of Cardiology, and the American Geriatrics Society, February 6-7, 2017.ParticipantsLeaders in the Cardiology and Geriatrics communities, (officers in professional societies, journal editors, clinical trialists, Division chiefs), representatives from the NIA; National Heart, Lung, and Blood Institute; Food and Drug Administration; Centers for Medicare and Medicaid Services, Alliance for Academic Internal Medicine, Patient-Centered Outcomes Research Institute, Agency for Healthcare Research and Quality, pharmaceutical industry, and trainees and early career faculty with interests in geriatric cardiology.MeasurementsSummary of workshop proceedings and recommendations.ResultsTo better align older adults' healthcare preferences with their care, research is needed to improve skills in patient engagement and communication. Similarly, to coordinate and meet the needs of older adults with multiple comorbidities encountering multiple healthcare providers and systems, systems and disciplines must be integrated. The lack of data from efficacy trials of CVD medications relevant to the majority of older adults creates uncertainty in determining the risks and benefits of many CVD therapies; thus, developing evidence-based guidelines for older adults with CVD is a top research priority. Polypharmacy and medication nonadherence lead to poor outcomes in older people, making research on appropriate prescribing and deprescribing to reduce polypharmacy and methods to improve adherence to beneficial therapies a priority.ConclusionThe needs and circumstances of older adults with CVD differ from those that the current medical system has been designed to meet. Optimizing pharmacotherapy in older adults will require new data from traditional and pragmatic research to determine optimal CVD therapy, reduce polypharmacy, increase adherence, and meet person-centered goals. Better integration of the multiple systems and disciplines involved in the care of older adults will be essential to implement and disseminate best practices. J Am Geriatr Soc 67:371-380, 2019.
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- 2019
4. Anxiety symptoms and risk of dementia and mild cognitive impairment in the oldest old women
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Kassem, Ahmed M, Ganguli, Mary, Yaffe, Kristine, Hanlon, Joseph T, Lopez, Oscar L, Wilson, John W, Ensrud, Kristine, Cauley, Jane A, and Group, for the Study of Osteoporotic Fractures Research
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Health Services and Systems ,Health Sciences ,Psychology ,Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD) ,Aging ,Brain Disorders ,Acquired Cognitive Impairment ,Alzheimer's Disease ,Behavioral and Social Science ,Mental Health ,Neurodegenerative ,Dementia ,Clinical Research ,Aetiology ,2.3 Psychological ,social and economic factors ,Neurological ,Mental health ,Aged ,Aged ,80 and over ,Anxiety ,Anxiety Disorders ,Cognitive Dysfunction ,Female ,Follow-Up Studies ,Humans ,Risk ,United States ,epidemiology ,community sample ,Study of Osteoporotic Fractures (SOF) Research Group ,Medical and Health Sciences ,Studies in Human Society ,Psychology and Cognitive Sciences ,Geriatrics ,Health sciences ,Human society - Abstract
ObjectivesResearch is limited and findings conflict regarding anxiety as a predictor of future cognitive decline in the oldest old persons. We examined the relationship between levels of and changes in anxiety symptoms, and subsequent dementia and mild cognitive impairment (MCI) in the oldest old women.MethodWe conducted secondary analyses of data collected from 1425 community-dwelling women (mean age = 82.8, SD ±3.1 years) followed on average for five years. The Goldberg Anxiety Scale was used to assess anxiety symptoms at baseline, and an expert clinical panel adjudicated dementia and MCI at follow-up. Participants with probable cognitive impairment at baseline were excluded.ResultsAt baseline, 190 (13%) women had moderate/severe anxiety symptoms and 403 (28%) had mild anxiety symptoms. Compared with those with no anxiety symptoms at baseline, women with mild anxiety symptoms were more likely to develop dementia at follow-up (multivariable-adjusted odds ratio = 1.66, 95% confidence interval 1.12-2.45). No significant association was observed between anxiety symptoms and MCI.ConclusionIn the oldest old women, our findings suggest that mild anxiety symptoms may predict future risk of dementia, but not MCI. Future studies should explore potential biological mechanisms underlying associations of anxiety with cognitive impairment.
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- 2018
5. Antihypertensive Deprescribing in Older Adult Veterans at End of Life Admitted to Veteran Affairs Nursing Homes
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Vu, Michelle, Sileanu, Florentina E., Aspinall, Sherrie L., Niznik, Joshua D., Springer, Sydney P., Mor, Maria K., Zhao, Xinhua, Ersek, Mary, Hanlon, Joseph T., Gellad, Walid F., Schleiden, Loren J., Thorpe, Joshua M., and Thorpe, Carolyn T.
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- 2021
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6. Anxiety symptoms and risk of cognitive decline in older community-dwelling men
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Kassem, Ahmed M, Ganguli, Mary, Yaffe, Kristine, Hanlon, Joseph T, Lopez, Oscar L, Wilson, John W, and Cauley, Jane A
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Biological Psychology ,Psychology ,Brain Disorders ,Aging ,Behavioral and Social Science ,Sleep Research ,Mental Health ,Depression ,Neurosciences ,Clinical Research ,Mental health ,Activities of Daily Living ,Aged ,Aged ,80 and over ,Anxiety ,Cognition ,Cognitive Dysfunction ,Executive Function ,Geriatric Assessment ,Humans ,Independent Living ,Linear Models ,Male ,Prospective Studies ,Psychiatric Status Rating Scales ,Risk Assessment ,United States ,aging ,community sample ,epidemiology ,executive function ,Osteoporotic Fractures in Men (MrOS) Study Research Group ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Geriatrics ,Applied and developmental psychology - Abstract
BackgroundPrevious research regarding anxiety as a predictor of future cognitive decline in older adults is limited and inconsistent. We examined the independent relationship between anxiety symptoms and subsequent cognitive decline.MethodsWe included 2,818 community-dwelling older men (mean age = 76.1, SD ±5.3 years) who were followed on an average for 3.4 years. We assessed anxiety symptoms at baseline using the Goldberg Anxiety Scale (GAS; range = 0-9). We assessed cognitive function at baseline and at two subsequent visits using the Modified Mini-Mental State Examination (3MS; global cognition) and the Trails B test (executive function).ResultsAt baseline, there were 690 (24%) men with mild anxiety symptoms (GAS 1-4) and 226 (8%) men with moderate/severe symptoms (GAS 5-9). Men with anxiety symptoms were more likely to have depressed mood, poor sleep, more chronic medical conditions, and more impairment in activities of daily living compared to those with no anxiety symptoms. Compared to those with no anxiety symptoms at baseline, men with any anxiety symptoms were more likely to have substantial worsening in Trails B completion time (OR = 1.56, 95% CI 1.19, 2.05). The association was attenuated after adjusting for potential confounders, including depression and poor sleep, but remained significant (OR = 1.40, 95% CI 1.04, 1.88).ConclusionIn cognitively healthy older men, mild anxiety symptoms may potentially predict future decline in executive functioning. Anxiety is likely a manifestation of an underlying neurodegenerative process rather than a cause.
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- 2017
7. Interventions to Reduce Fall-Risk-Increasing Drug Use to Prevent Falls: A Narrative Review of Randomized Trials
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Gray, Shelly L., Elsisi, Zizi, Phelan, Elizabeth A., and Hanlon, Joseph T.
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- 2021
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8. Medication use quality and safety in older adults: 2022 update.
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Gray, Shelly L., Brandt, Nicole, Schmader, Kenneth E., and Hanlon, Joseph T.
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INAPPROPRIATE prescribing (Medicine) ,PATIENT safety ,MEDICAL quality control ,DRUG side effects ,DEPRESCRIBING ,POLYPHARMACY ,PHYSICIAN practice patterns ,HEALTH promotion ,DRUG prescribing ,DRUG utilization ,COGNITION ,OLD age - Abstract
Improving the quality of medication use and medication safety are important priorities for healthcare providers who care for older adults. The objective of this article was to identify four exemplary articles with this focus in 2022. We selected high‐quality studies from an OVID search and hand searching of major high impact journals that advanced the field of research forward. The chosen articles cover domains related to deprescribing, medication safety, and optimizing medication use. The MedSafer Study, a cluster randomized clinical trial in Canada, evaluated whether patient specific deprescribing reports generated by electronic decision support software resulted in reduced adverse drug events in the 30 days post hospital discharge in older adults (domain: deprescribing). The second study, a retrospective cohort study using data from Premier Healthcare Database, examined in‐hospital adverse clinical events associated with perioperative gabapentin use among older adults undergoing major surgery (domain: medication safety). The third study used an open‐label parallel controlled trial in 39 Australian aged‐care facilities to examine the effectiveness of a pharmacist‐led intervention to reduce medication‐induced deterioration and adverse reactions (domain: optimizing medication use). Lastly, the fourth study engaged experts in a Delphi method process to develop a consensus list of clinically important prescribing cascades that adversely affect older persons' health to aid clinicians to identify, prevent, and manage prescribing cascades (domain: optimizing medication use). Collectively, this review succinctly highlights pertinent topics related to promoting safe use of medications and promotes awareness of optimizing older adults' medication regimens. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Prescribing Patterns of Heart Failure-Exacerbating Medications Following a Heart Failure Hospitalization
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Goyal, Parag, Kneifati-Hayek, Jerard, Archambault, Alexi, Mehta, Krisha, Levitan, Emily B., Chen, Ligong, Diaz, Ivan, Hollenberg, James, Hanlon, Joseph T., Lachs, Mark S., Maurer, Mathew S., and Safford, Monika M.
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- 2020
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10. Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults
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Marcum, Zachary A, Perera, Subashan, Thorpe, Joshua M, Switzer, Galen E, Castle, Nicholas G, Strotmeyer, Elsa S, Simonsick, Eleanor M, Ayonayon, Hilsa N, Phillips, Caroline L, Rubin, Susan, Zucker-Levin, Audrey R, Bauer, Douglas C, Shorr, Ronald I, Kang, Yihuang, Gray, Shelly L, Hanlon, Joseph T, and Study, Health ABC
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Biomedical and Clinical Sciences ,Clinical Sciences ,Aging ,Depression ,Mental Health ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Injuries and accidents ,Accidental Falls ,Adult ,Aged ,Aged ,80 and over ,Antidepressive Agents ,Dose-Response Relationship ,Drug ,Drug Utilization ,Female ,Fractures ,Bone ,Humans ,Longitudinal Studies ,Male ,Multivariate Analysis ,Odds Ratio ,Recurrence ,Risk ,Self Report ,Selective Serotonin Reuptake Inhibitors ,United States ,antidepressants ,aging ,drug-related problems ,epidemiology ,geriatrics ,outcomes research/analysis ,pharmacoepidemiology ,Health ABC Study ,Pharmacology and Pharmaceutical Sciences ,Pharmacology & Pharmacy ,Clinical sciences ,Pharmacology and pharmaceutical sciences - Abstract
BackgroundFew studies have compared the risk of recurrent falls across various antidepressant agents-using detailed dosage and duration data-among community-dwelling older adults, including those who have a history of a fall/fracture.ObjectiveTo examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders.MethodsThis was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection.ResultsUsing multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63).ConclusionAntidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls.
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- 2016
11. Impact of Drug–Drug and Drug–Disease Interactions on Gait Speed in Community-Dwelling Older Adults
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Naples, Jennifer G, Marcum, Zachary A, Perera, Subashan, Newman, Anne B, Greenspan, Susan L, Gray, Shelly L, Bauer, Douglas C, Simonsick, Eleanor M, Shorr, Ronald I, and Hanlon, Joseph T
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Pharmacology and Pharmaceutical Sciences ,Biomedical and Clinical Sciences ,Clinical Sciences ,Brain Disorders ,Clinical Research ,Aging ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Good Health and Well Being ,Adult ,Aged ,Dose-Response Relationship ,Drug ,Drug Interactions ,Drug-Related Side Effects and Adverse Reactions ,Female ,Gait ,Health Status ,Humans ,Longitudinal Studies ,Male ,Odds Ratio ,Pharmaceutical Preparations ,Prevalence ,Walking Speed ,Geriatrics ,Clinical sciences ,Pharmacology and pharmaceutical sciences - Abstract
BackgroundGait speed decline, an early marker of functional impairment, is a sensitive predictor of adverse health outcomes in older adults. The effect of potentially inappropriate medications, including drug-disease and drug-drug interactions, on gait speed decline is not well known.ObjectiveThe aim of this study was to determine if drug interactions impair functional status as measured by gait speed.MethodsThe sample included 2402 older adults with medication and gait speed data from the Health, Aging and Body Composition study. The independent variable was the frequency of drug-disease and/or drug-drug interactions at baseline and 3 additional years. The main outcome was a clinically meaningful gait speed decline of ≥0.1 m/s the year following drug interaction assessment. Adjusted odds ratios and 95 % confidence intervals (CIs) were calculated using multivariate generalized estimating equations for both the overall sample and a sample stratified by gait speed at time of drug interaction assessment.ResultsThe prevalence of drug-disease and drug-drug interactions ranged from 7.6 to 9.3 and 10.5 to 12.3 %, respectively, with few participants (3.8-5.7 %) having multiple drug interactions. At least 22 % of participants had a gait speed decline of ≥0.1 m/s annually. Drug interactions were not significantly associated with gait speed decline overall or in the stratified sample of fast walkers. There was some evidence, however, that drug interactions increased the risk of gait speed decline among those participants with slower gait speeds, though p values did not reach statistical significance (adjusted odds ratio 1.22; 95 % CIs 0.96-1.56; p = 0.11). Moreover, a marginally significant dose-response relationship was seen with multiple drug interactions and gait speed decline (adjusted odds ratio 1.40; 95 % CIs 0.95-2.04; p = 0.08).ConclusionsDrug interactions may increase the likelihood of gait speed decline among older adults with evidence of preexisting debility. Future studies should focus on frail elders with less physiological reserve who may be more susceptible to the harms associated with potentially inappropriate medications.
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- 2016
12. Antihypertensive Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study
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Marcum, Zachary A, Perera, Subashan, Newman, Anne B, Thorpe, Joshua M, Switzer, Galen E, Gray, Shelly L, Simonsick, Eleanor M, Shorr, Ronald I, Bauer, Douglas C, Castle, Nicholas G, Studenski, Stephanie A, and Hanlon, Joseph T
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Prevention ,Clinical Research ,Aging ,Accidental Falls ,Aged ,Antihypertensive Agents ,Female ,Humans ,Independent Living ,Longitudinal Studies ,Male ,Prospective Studies ,Falls ,Medication ,Epidemiology ,Drug related ,Health ABC Study ,Clinical Sciences ,Gerontology ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundDespite wide-spread use of antihypertensives in older adults, the literature is unclear about their association with incident recurrent falls over time.MethodsHealth, Aging and Body Composition study participants (n = 2,948) who were well functioning at baseline (1997) were followed to Year 7 (2004). The main outcome was recurrent falls (≥2) in the ensuing 12 months. Antihypertensive use was examined as: (a) any versus none, (b) long- versus short-term (≥2 vs
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- 2015
13. Anticholinergic Use and Recurrent Falls in Community-Dwelling Older Adults
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Marcum, Zachary A, Perera, Subashan, Thorpe, Joshua M, Switzer, Galen E, Gray, Shelly L, Castle, Nicholas G, Strotmeyer, Elsa S, Simonsick, Eleanor M, Bauer, Douglas C, Shorr, Ronald I, Studenski, Stephanie A, Hanlon, Joseph T, and Study, USA Health ABC
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Pharmacology and Pharmaceutical Sciences ,Biomedical and Clinical Sciences ,Clinical Sciences ,Prevention ,Aging ,Behavioral and Social Science ,Accidental Falls ,Aged ,Cholinergic Antagonists ,Female ,Humans ,Male ,Odds Ratio ,Prospective Studies ,Recurrence ,Self Report ,cholinergic antagonist ,accidental falls ,older adults ,pharmacoepidemiology ,Health ABC Study ,USA ,Pharmacology & Pharmacy ,Clinical sciences ,Pharmacology and pharmaceutical sciences - Abstract
BackgroundAlthough it is generally accepted that anticholinergic use may lead to a fall, results from studies assessing the association between anticholinergic use and falls are mixed. In addition, direct evidence of an association between use of anticholinergic medications and recurrent falls among community-dwelling elders is not available.ObjectiveTo assess the association between anticholinergic use across multiple anticholinergic subclasses, including over-the-counter medications, and recurrent falls.MethodsThis was a longitudinal analysis of 2948 participants, with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Self-reported use of anticholinergic medication was identified at years 1, 2, 3, 5, and 6 as defined by the list from the 2015 American Geriatrics Society Beers Criteria. Dosage and duration were also examined. The main outcome was recurrent falls (≥2) in an ensuing 12-month period from each medication data collection.ResultsUsing multivariable generalized estimating equation models, controlling for demographic, health status/behaviors, and access-to-care factors, a 34% increase in likelihood of recurrent falls in anticholinergic users (adjusted odds ratio = 1.34; 95% CI = 0.93-1.93) was observed, but the results were not statistically significant; similar results were found with higher doses and longer duration of use.ConclusionIncreased point estimates suggest an association of anticholinergic use with recurrent falls, but the associations did not reach statistical significance. Future studies are needed for more definitive evidence and to examine other measures of anticholinergic burden and associations with more intermediate adverse effects such as cognitive function.
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- 2015
14. Statins and brain integrity in older adults: Secondary analysis of the Health ABC study
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Nadkarni, Neelesh K, Perera, Subashan, Hanlon, Joseph T, Lopez, Oscar, Newman, Anne B, Aizenstein, Howard, Elam, Marshall, Harris, Tamara B, Kritchevsky, Stephen, Yaffe, Kristine, and Rosano, Caterina
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Biomedical and Clinical Sciences ,Neurosciences ,Clinical Sciences ,Biomedical Imaging ,Brain Disorders ,Clinical Research ,Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD) ,Dementia ,Alzheimer's Disease ,Acquired Cognitive Impairment ,Aging ,Neurodegenerative ,Aetiology ,2.1 Biological and endogenous factors ,Neurological ,Aged ,Aged ,80 and over ,Alzheimer Disease ,Anisotropy ,Brain ,Cohort Studies ,Diffusion Magnetic Resonance Imaging ,Female ,Gray Matter ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Male ,White Matter ,Statins ,White matter hyperintensities ,Fractional anisotropy ,Mean diffusivity ,Cognition ,Older adults ,Geriatrics ,Clinical sciences ,Biological psychology - Abstract
IntroductionWe examined whether statins are associated with better cerebral white (WM) and gray matter (GM) indices in community-dwelling elders.MethodsIn 295 older adults, we compared white matter hyperintensities (WMH) on brain magnetic resonance imaging and, total WM fractional anisotropy (FA) and GM mean diffusivity (MD) on diffusion tensor imaging, of Alzheimer's disease (AD) relevant regions in statin-exposed and statin-unexposed participants stratified by Modified Mini-Mental Status Examination (3MS) score.ResultsThere was no overall effect of statin exposure on cerebral structural indices. The interaction between statin exposure and 3MS was significant for total-WMH and WM FA (both P < .05) but not GM MD. In the lowest 3MS tertile (mean: 86), statin-exposed individuals had lower total-WMH and higher WM FA (P = .005 and P = .044) and FA of tracts linked to clinical AD (P-value range= .005-.04) despite statistical adjustments. These differences were not significant in the two higher 3MS tertiles.DiscussionStatins may benefit WM in older adults vulnerable to dementia.
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- 2015
15. Use of a medication-based risk adjustment index to predict mortality among veterans dually-enrolled in VA and medicare
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Radomski, Thomas R., Zhao, Xinhua, Hanlon, Joseph T., Thorpe, Joshua M., Thorpe, Carolyn T., Naples, Jennifer G., Sileanu, Florentina E., Cashy, John P., Hale, Jennifer A., Mor, Maria K., Hausmann, Leslie R.M., Donohue, Julie M., Suda, Katie J., Stroupe, Kevin T., Good, Chester B., Fine, Michael J., and Gellad, Walid F.
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- 2019
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16. Statin Use and Decline in Gait Speed in Community‐Dwelling Older Adults
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Lo‐Ciganic, Wei‐Hsuan, Perera, Subashan, Gray, Shelly L, Boudreau, Robert M, Zgibor, Janice C, Strotmeyer, Elsa S, Donohue, Julie M, Bunker, Clareann H, Newman, Anne B, Simonsick, Eleanor M, Bauer, Douglas C, Satterfield, Suzanne, Caserotti, Paolo, Harris, Tamara, Shorr, Ronald I, Hanlon, Joseph T, and Study the Health, Aging and Body Composition
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Aging ,Clinical Research ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Good Health and Well Being ,Aged ,Body Composition ,Dose-Response Relationship ,Drug ,Female ,Gait ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Longitudinal Studies ,Male ,hydroxymethylglutaryl-CoA reductase inhibitors ,statins ,gait speed ,physical function ,aged ,Health ,Aging and Body Composition Study ,Medical and Health Sciences ,Geriatrics ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
ObjectivesTo examine the association between statin use and objectively assessed decline in gait speed in community-dwelling older adults.DesignLongitudinal cohort study.SettingHealth, Aging and Body Composition (Health ABC) Study.ParticipantsTwo thousand five participants aged 70-79 at baseline with medication and gait speed data at 1998-99, 1999-2000, 2001-02, and 2002-03.MeasurementsThe independent variables were any statin use and their standardized daily doses (low, moderate, high) and lipophilicity. The primary outcome measure was decline in gait speed of 0.1 m/s or more in the following year of statin use. Multivariable generalized estimating equations were used, adjusting for demographic characteristics, health-related behaviors, health status, and access to health care.ResultsStatin use increased from 16.2% in 1998-99 to 25.6% in 2002-03. The overall proportions of those with decline in gait speed of 0.1 m/s or more increased from 22.2% in 1998 to 23.9% in 2003. Statin use was not associated with decline in gait speed of 0.1 m/s or more (adjusted odds ratio (AOR) = 0.90, 95% confidence interval (CI) = 0.77-1.06). Similar nonsignificant trends were also seen with the use of hydrophilic or lipophilic statins. Users of low-dose statins were found to have a 22% lower risk of decline in gait speed than nonusers (AOR = 0.78, 95% CI = 0.61-0.99), which was mainly driven by the results from 1999-2000 follow-up.ConclusionThese results suggest that statin use did not increase decline in gait speed in community-dwelling older adults.
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- 2015
17. Gastroprotective Agent Underuse in High‐Risk Older Daily Nonsteroidal Anti‐Inflammatory Drug Users over Time
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Marcum, Zachary A, Hanlon, Joseph T, Strotmeyer, Elsa S, Newman, Anne B, Shorr, Ronald I, Simonsick, Eleanor M, Bauer, Douglas C, Boudreau, Robert, Donohue, Julie M, Perera, Subashan, and Study the Health, Aging and Body Composition
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Aging ,Prevention ,Clinical Research ,Aged ,Aged ,80 and over ,Anti-Inflammatory Agents ,Non-Steroidal ,Anticoagulants ,Aspirin ,Controlled Before-After Studies ,Cyclooxygenase 2 Inhibitors ,Female ,Humans ,Insurance ,Pharmaceutical Services ,Male ,Peptic Ulcer ,Prospective Studies ,Proton Pump Inhibitors ,Warfarin ,nonsteroidal anti-inflammatory drug ,older adults ,gastroprotection ,Health ,Aging and Body Composition Study ,Medical and Health Sciences ,Geriatrics ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
ObjectivesTo examine whether older adults taking nonsteroidal anti-inflammatory drugs (NSAIDs) decreased the underuse of gastroprotective agents over time.DesignBefore-and-after study.SettingHealth, Aging and Body Composition Study.ParticipantsDaily users of a NSAID (prescription and over the counter (OTC)) at visits in 2002-03 (preperiod; n = 404) and 2006-07 (postperiod; n = 172). The sample had a mean ± standard deviation age of 78.2 ± 2.7 at the preperiod visit and 81.9 ± 2.7 at the postperiod visit. The majority were white and female and had 12 or more years of education.MeasurementsUnderusers were defined as persons taking nonselective NSAIDs who were at risk of peptic ulcer disease (PUD; because of current warfarin or glucocorticoid use or history of PUD) and not using a proton pump inhibitor (PPI) or persons taking cyclooxygenase 2 (COX-2) selective NSAIDs and aspirin who were at risk of PUD (having at least one risk factor) and not using a PPI.ResultsDaily NSAID use decreased from 17.6% to 11.3% (P < .001), and gastroprotective agent underuse decreased from 23.5% to 15.1% (P = .008). Controlling for important covariates, having prescription insurance was somewhat protective against underuse in the preperiod (adjusted odds ratio (AOR) = 0.78, 95% confidence interval (CI) = 0.46-1.34; P = .37), but more so and significantly in the postperiod (AOR = 0.41, 95% CI = 0.18-0.93; P = .03). Having prescription insurance was more protective in the post- than in the preperiod (less gastroprotective agent underuse; adjusted ratio of OR = 0.53, 95% CI = 0.22-1.29; P = .16), but this increased protection was not statistically significant.ConclusionIn older daily NSAID users at high risk of PUD, having prescription insurance and adequate gastroprotective use was more common in the post- than in the preperiod.
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- 2014
18. Patterns of opioid prescriptions received prior to unintentional prescription opioid overdose death among Veterans
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Moyo, Patience, Zhao, Xinhua, Thorpe, Carolyn T., Thorpe, Joshua M., Sileanu, Florentina E., Cashy, John P., Hale, Jennifer A., Mor, Maria K., Radomski, Thomas R., Donohue, Julie M., Hausmann, Leslie R.M., Hanlon, Joseph T., Good, Chester B., Fine, Michael J., and Gellad, Walid F.
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- 2019
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19. Characteristics of dual drug benefit use among veterans with dementia enrolled in the Veterans Health Administration and Medicare Part D
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Schleiden, Loren J., Thorpe, Carolyn T., Cashy, John P., Gellad, Walid F., Good, Chester B., Hanlon, Joseph T., Mor, Maria K., Niznik, Joshua D., Pleis, John R., Van Houtven, Courtney H., and Thorpe, Joshua M.
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- 2019
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20. Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease, diabetes mellitus, and/or hypertension
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Marcum, Zachary A, Zheng, Yan, Perera, Subashan, Strotmeyer, Elsa, Newman, Anne B, Simonsick, Eleanor M, Shorr, Ronald I, Bauer, Douglas C, Donohue, Julie M, Hanlon, Joseph T, and Study, Health ABC
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Health Services and Systems ,Public Health ,Health Sciences ,Heart Disease ,Behavioral and Social Science ,Aging ,Cardiovascular ,Heart Disease - Coronary Heart Disease ,Management of diseases and conditions ,7.1 Individual care needs ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Coronary Disease ,Diabetes Mellitus ,Female ,Humans ,Hypertension ,Male ,Medication Adherence ,Prevalence ,Self Report ,Medication adherence ,Chronic disease ,Health ABC Study ,Pharmacology and Pharmaceutical Sciences ,Public Health and Health Services ,Pharmacology & Pharmacy ,Health services and systems ,Public health - Abstract
BackgroundInformation about the prevalence and correlates of self-reported medication nonadherence using multiple measures in older adults with chronic cardiovascular conditions is needed.ObjectiveTo examine the prevalence and correlates of self-reported medication nonadherence among community-dwelling elders with chronic cardiovascular conditions.MethodsParticipants (n = 897) included members from the Health, Aging and Body Composition Study with coronary heart disease, diabetes mellitus, and/or hypertension at Year 10. Self-reported nonadherence was measured by the 4-item Morisky Medication Adherence Scale (MMAS-4) and 2-item cost-related nonadherence (CRN-2) scale at Year 11. Factors (demographic, health status, and access to care) were examined for association with the MMAS-4 and then for association with the CRN-2 scale.ResultsNonadherence per the MMAS-4 and CRN-2 scale was reported by 40.7% and 7.7% of participants, respectively, with little overlap (3.7%). Multivariable logistic regression analyses found that black race was significantly associated with nonadherence per the MMAS-4 (P = 0.002) and the CRN-2 scale (P = 0.005). Other correlates of nonadherence per the MMAS-4 (with independent associations) included having cancer (P = 0.04), a history of falls (P = 0.02), sleep disturbances (P = 0.04) and having a hospitalization in the previous 6 months (P = 0.005). Conversely, being unmarried (P = 0.049), having worse self-reported health (P = 0.04) and needs being poorly met by income (P = 0.02) showed significant independent associations with nonadherence per the CRN-2 scale.ConclusionsSelf-reported medication nonadherence was common in older adults with chronic cardiovascular conditions and only one factor - race - was associated with both types. The research implication of this finding is that it highlights the need to measure both types of self-reported nonadherence in older adults. Moreover, the administration of these quick measures in the clinical setting should help identify specific actions such as patient education or greater use of generic medications or pill boxes that may address barriers to medication nonadherence.
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- 2013
21. Racial differences in antilipemic use and lipid control in high-risk older adults: Post–Medicare Part D
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Hanlon, Joseph T, Boudreau, Robert M, Perera, Subashan, Strotmeyer, Elsa S, Newman, Anne B, Simonsick, Eleanor M, Shorr, Ronald I, Bauer, Douglas C, and Donohue, Julie M
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Heart Disease ,Clinical Research ,Aging ,Cardiovascular ,Black or African American ,Aged ,Coronary Disease ,Drug Costs ,Humans ,Hypolipidemic Agents ,Lipids ,Medicare Part D ,United States ,White People ,Cardiorespiratory Medicine and Haematology ,Public Health and Health Services ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
BackgroundOlder blacks are less likely to receive guideline-recommended antilipemic therapy and achieve lipid control than older whites because, in part, of out-of-pocket costs. We sought to determine whether racial differences in antilipemic use and lipid control narrowed after Medicare Part D's implementation.MethodsThis before-after study included 1,091 black and white adults 70 years or older with coronary heart disease and/or diabetes mellitus from the Health Aging and Body Composition Study. Primary outcomes were antilipemic use and low-density lipoprotein cholesterol control. Key independent variables were race, time (pre-Part D vs post-Part D), and their interaction.ResultsBefore Part D, fewer blacks than whites reported taking an antilipemic (32.70% vs 49.35%), and this difference was sustained after Part D (blacks 48.30% vs whites 64.57%). Multivariable generalized estimating equations confirmed no post-Part D change in racial differences in antilipemic use (adjusted ratio of the odds ratio 1.07, 95% CI 0.79-1.45). Compared with whites, more blacks had poor lipid control both before Part D (24.30% vs 12.36%, respectively) and after Part D (24.46% vs 13.72%, respectively), with no post-Part D change in racial differences in lipid control (adjusted ratio of the odds ratio 0.82, 95% CI 0.51-1.33).ConclusionAlthough antilipemic use increased after Medicare Part D for both races, this policy change was associated with a change neither in lipid control for either racial group nor in the racial differences in antilipemic use or lipid control.
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- 2013
22. The Improving Outcomes of UTI Management in Long-Term Care Project (IOU) Consensus Guidelines for the Diagnosis of Uncomplicated Cystitis in Nursing Home Residents
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Nace, David A., Perera, Subashan K., Hanlon, Joseph T., Saracco, Stacey, Anderson, Gulsum, Schweon, Steven J., Klein-Fedyshin, Michele, Wessel, Charles B., Mulligan, Mary, Drinka, Paul J., and Crnich, Christopher J.
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- 2018
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23. Changes in Cholesterol-Lowering Medications Use Over a Decade in Community-Dwelling Older Adults
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Lo-Ciganic, Wei-Hsuan, Boudreau, Robert M, Gray, Shelly L, Zgibor, Janice C, Donohue, Julie M, Perera, Subashan, Newman, Anne B, Simonsick, Eleanor M, Bauer, Douglas C, Satterfield, Suzanne, and Hanlon, Joseph T
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Aging ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Age Factors ,Aged ,Cholesterol ,Female ,Follow-Up Studies ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Hypercholesterolemia ,Male ,Practice Guidelines as Topic ,Prospective Studies ,Residence Characteristics ,Time Factors ,Pharmacology and Pharmaceutical Sciences ,Pharmacology & Pharmacy ,Clinical sciences ,Pharmacology and pharmaceutical sciences - Abstract
BackgroundThe impact of evidence-based guidelines and controlled trial data on use of cholesterol-lowering medications in older adults is unclear.ObjectiveTo examine whether utilization patterns of cholesterol-lowering medications in community-dwelling older adults changed following the release of the National Cholesterol Education Program Adult Treatment Panel III guidelines and results from the Prospective Study of Pravastatin in the Elderly at Risk in 2002.MethodsCommunity-dwelling elderly individuals who were enrolled in the Health, Aging and Body Composition Study in 1997-1998 were followed for up to 11 years. An interrupted time series analysis with multivariable generalized estimating equations (GEEs) was used to examine changes in level and trend in cholesterol-lowering medication use before and after 2002, adjusting for sociodemographics, health-related behaviors, and health status.ResultsCholesterol-lowering medication use increased nearly 3-fold from 14.9% in 1997-1998 to 42.6% in 2007-2008, with statins representing the most common class used (87-94%). Multivariable GEE results revealed no significant difference in the level of cholesterol-lowering medication use after 2002 (adjusted OR 0.95; 95% CI 0.89-1.02). Multivariable GEE results revealed that trend changes in the rate of increase in cholesterol-lowering medication declined after 2002 (adjusted ratio of ORs 0.92; 95% CI 0.89-0.95).ConclusionsThe use of cholesterol-lowering medication increased substantially over a decade in community-dwelling elderly individuals but was not related to a change in level or trend following the release of the guidelines and evidence-based data.
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- 2013
24. Antihypertensive Drug Class Use and Differential Risk of Urinary Incontinence in Community-Dwelling Older Women
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Peron, Emily P, Zheng, Yan, Perera, Subashan, Newman, Anne B, Resnick, Neil M, Shorr, Ronald I, Bauer, Douglas C, Simonsick, Eleanor M, Gray, Shelly L, Hanlon, Joseph T, and Ruby, Christine M
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Aging ,Cardiovascular ,Urologic Diseases ,5.1 Pharmaceuticals ,Development of treatments and therapeutic interventions ,Aged ,Aged ,80 and over ,Antihypertensive Agents ,Dose-Response Relationship ,Drug ,Female ,Humans ,Logistic Models ,Risk Assessment ,Urinary Incontinence ,Clinical Sciences ,Gerontology - Published
- 2012
25. Cognitive Impairment and Medication Complexity in Community-Living Older Adults: The Health, Aging and Body Composition Study
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Lee, David Sh, De Rekeneire, Nathalie, Hanlon, Joseph T, Gill, Thomas M, Bauer, Douglas C, Meibohm, Bernd, Harris, Tamara B, and Jeffery, Sean M
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Pharmacology and Pharmaceutical Sciences ,Biomedical and Clinical Sciences ,Clinical Research ,Aging ,Brain Disorders ,Behavioral and Social Science ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Mental health ,Good Health and Well Being ,Pharmacology & Pharmacy ,Pharmacology and pharmaceutical sciences - Abstract
BackgroundMedication complexity is a large determinant of adherence. Few studies have explored the relationship between cognitive impairment and medication complexity.ObjectiveTo evaluate whether cognitive impairment is associated with medication complexity for prescription and over-the-counter (OTC) medications.MethodsIn this cross-sectional analysis, we studied the association between cognitive impairment and the complexity of prescription and OTC drug regimens. Baseline participants were from the Health, Aging and Body Composition study, consisting of 3075 well-functioning 70- to 79-year-old black and white men and women. Cognitive impairment was defined by having a Modified Mini-Mental State Examination score
- Published
- 2012
26. Polypharmacy in Older Adults Hospitalized for Heart Failure
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Unlu, Ozan, Levitan, Emily B., Reshetnyak, Evgeniya, Kneifati-Hayek, Jerard, Diaz, Ivan, Archambault, Alexi, Chen, Ligong, Hanlon, Joseph T., Maurer, Mathew S., Safford, Monika M., Lachs, Mark S., and Goyal, Parag
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- 2020
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27. Inappropriate Medications and Risk of Falls in Older Adults
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Naples, Jennifer Greene, Hanlon, Joseph T., Ruby, Christine M., Greenspan, Susan L., Huang, Allen R., editor, and Mallet, Louise, editor
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- 2016
- Full Text
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28. Impact of Inappropriate Drug Use on Mortality and Functional Status in Representative Community Dwelling Elders
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Hanlon, Joseph T., Fillenbaum, Gerda G., Kuchibhatla, Maggie, Artz, Margaret B., Boult, Chad, Gross, Cynthia R., Garrard, Judith, and Schmader, Kenneth E.
- Published
- 2002
29. Drug-Related Problems and Pharmaceutical Care: What Are They, Do They Matter, and What's Next?
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Hanlon, Joseph T. and Artz, Margaret B.
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- 2001
30. Benzodiazepine Use and Physical Disability in Community‐Dwelling Older Adults
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Gray, Shelly L, LaCroix, Andrea Z, Hanlon, Joseph T, Penninx, Brenda WJH, Blough, David K, Leveille, Suzanne G, Artz, Margaret B, Guralnik, Jack M, and Buchner, Dave M
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Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Health Sciences ,Rehabilitation ,Aging ,Clinical Research ,Activities of Daily Living ,Aged ,Anxiety ,Benzodiazepines ,Disabled Persons ,Female ,Follow-Up Studies ,Humans ,Incidence ,Male ,Population Surveillance ,Prospective Studies ,Surveys and Questionnaires ,Time Factors ,Treatment Outcome ,United States ,Medical and Health Sciences ,Geriatrics ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
ObjectivesTo determine whether benzodiazepine use is associated with incident disability in mobility and activities of daily living (ADLs) in older individuals.DesignA prospective cohort study.SettingFour sites of the Established Populations for Epidemiologic Studies of the Elderly.ParticipantsThis study included 9,093 subjects (aged > or =65) who were not disabled in mobility or ADLs at baseline.MeasurementsMobility disability was defined as inability to walk half a mile or climb one flight of stairs. ADL disability was defined as inability to perform one or more basic ADLs (bathing, eating, dressing, transferring from a bed to a chair, using the toilet, or walking across a small room). Trained interviewers assessed outcomes annually.ResultsAt baseline, 5.5% of subjects reported benzodiazepine use. In multivariable models, benzodiazepine users were 1.23 times as likely as nonusers (95% confidence interval (CI) = 1.09-1.39) to develop mobility disability and 1.28 times as likely (95% CI = 1.09-1.52) to develop ADL disability. Risk for incident mobility was increased with short- (hazard ratio (HR) = 1.27, 95% CI = 1.08-1.50) and long-acting benzodiazepines (HR = 1.20, 95% CI = 1.03-1.39) and no use. Risk for ADL disability was greater with short- (HR = 1.58, 95% CI = 1.25-2.01) but not long-acting (HR = 1.11, 95% CI = 0.89-1.39) agents than for no use.ConclusionOlder adults taking benzodiazepines have a greater risk for incident mobility and ADL disability. Use of short-acting agents does not appear to confer any safety benefits over long-acting agents.
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- 2006
31. Factors Associated With Potentially Inappropriate Phosphodiesterase-5 Inhibitor Use for Pulmonary Hypertension in the United States, 2006 to 2015
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Gillmeyer, Kari R., Rinne, Seppo T., Glickman, Mark E., Lee, Kyung Min, Shao, Qing, Qian, Shirley X., Klings, Elizabeth S., Maron, Bradley A., Hanlon, Joseph T., Miller, Donald R., and Wiener, Renda Soylemez
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- 2020
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32. Non-tricyclic and Non-selective Serotonin Reuptake Inhibitor Antidepressants and Recurrent Falls in Frail Older Women
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Naples, Jennifer G., Kotlarczyk, Mary P., Perera, Subashan, Greenspan, Susan L., and Hanlon, Joseph T.
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- 2016
- Full Text
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33. Central nervous system active medications and risk for fractures in older women.
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Ensrud, Kristine E, Blackwell, Terri, Mangione, Carol M, Bowman, Paula J, Bauer, Douglas C, Schwartz, Ann, Hanlon, Joseph T, Nevitt, Michael C, Whooley, Mary A, and Study of Osteoporotic Fractures Research Group
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Study of Osteoporotic Fractures Research Group ,Humans ,Benzodiazepines ,Anticonvulsants ,Narcotics ,Antidepressive Agents ,Multivariate Analysis ,Proportional Hazards Models ,Odds Ratio ,Risk Factors ,Cohort Studies ,Accidental Falls ,Aged ,Women's Health ,United States ,Female ,Fractures ,Bone ,Surveys and Questionnaires ,Aging ,Neurosciences ,Physical Injury - Accidents and Adverse Effects ,Osteoporosis ,Injuries and accidents ,Medical and Health Sciences ,General & Internal Medicine - Abstract
BackgroundUse of central nervous system (CNS) active medications may increase the risk for fractures. Prior studies are limited by incomplete control of confounders.MethodsTo determine whether use of CNS active medications, including benzodiazepines, antidepressants, anticonvulsants, and narcotics, increases fracture risk in elderly, community-dwelling women, we examined use of these 4 categories of medications in a cohort of 8127 older women and followed the participants prospectively for incident nonspine fractures, including hip fractures. Current use of CNS active medications was assessed by interview with verification of use from containers between 1992 and 1994 and between 1995 and 1996. Use was coded as a time-dependent variable. Incident nonspine fractures occurring after the initial medication assessment until May 31, 1999, were confirmed by radiographic reports.ResultsDuring an average follow-up of 4.8 years, 1256 women (15%) experienced at least one nonspine fracture, including 288 (4%) with first hip fractures. Compared with nonusers, women taking narcotics (multivariate hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.06-1.83) and those taking antidepressants (multivariate HR, 1.25; 95% CI, 0.99-1.58) had increases in the risks for any nonspine fractures. Women taking tricyclic antidepressants and those using selective serotonin reuptake inhibitors (SSRIs) had similar fracture rates. There were no independent associations between benzodiazepine use or anticonvulsant use and risk for nonspine fracture. Women taking antidepressants compared with nonusers had a 1.7-fold increase in the risk for hip fracture (multivariate HR, 1.65; 95% CI, 1.05-2.57). We did not observe independent associations between use of any of the other 3 classes of CNS active medications and risk of hip fracture.ConclusionsCommunity-dwelling older women taking narcotics have an increased risk for any nonspine fracture, and those taking antidepressants have a greater risk for nonspine fractures, including hip fracture. Rates of fracture were similar in women taking tricyclic antidepressants and those using SSRIs. Benzodiazepine use and anticonvulsant use were not independently associated with an increased risk of nonspine fractures, including hip fracture.
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- 2003
34. Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia
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Thorpe, Carolyn T., Gellad, Walid F., Mor, Maria K., Cashy, John P., Pleis, John R., Houtven, Courtney H. Van, Schleiden, Loren J., Hanlon, Joseph T., Niznik, Joshua D., Carico Jr., Ronald L., Good, Chester B., and Thorpe, Joshua M.
- Subjects
Dementia -- Care and treatment ,Medicare Part D -- Analysis ,Business ,Health care industry - Abstract
Objective. To evaluate the effect of dual use of VA/Medicare Part D drug benefits on antihypertensive medication supply in older Veterans with dementia.Data Sources/Study Setting. National, linked 2007-2010 Veterans Affairs (VA) and Medicare utilization and prescription records for 50,763 dementia patients with hypertension.Study Design. We used inverse probability of treatment (IPT)-weighted multinomial logistic regression to examine the association of dual prescription use with undersupply and oversupply of antihypertensives.Data Collection/Extraction Methods. Veterans Affairs and Part D prescription records were used to classify patients as VA-only, Part D-only, or dual VA/Part D users of antihypertensives and summarize their antihypertensive medication supply in 2010: (1) appropriate supply of all prescribed antihypertensive classes, (2) undersupply of [greater than or equal to]1 class with no oversupply of another class, (3) oversupply of [greater than or equal to]1 class with no undersupply, or (4) both undersupply and oversupply.Principal Findings. Dual prescription users were more likely than VA-only users to have undersupply only (aOR = 1.28; 95 percent CI = 1.18-1.39), oversupply only (aOR = 2.38; 95 percent CI = 2.15-2.64), and concurrent under- and oversupply (aOR = 2.89; 95 percent CI = 2.53-3.29), versus appropriate supply of all classes.Conclusions. Obtaining antihypertensives through both VA and Part D was associated with increased antihypertensive under- and oversupply. Efforts to understand how best to coordinate dual-system prescription use are critically needed.Key Words. Dementia, hypertension, medication use, Veterans, Medicare Part D, Millions of Veterans who obtain health care from the U.S. Department of Veterans Affairs (VA) also seek care from non-VA sources (U.S. Department of Veterans Affairs 2016). Veterans aged 65 [...]
- Published
- 2018
- Full Text
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35. Low blood pressure levels for fall injuries in older adults: the Health, Aging and Body Composition Study
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Sagawa, Naoko, Marcum, Zachary A., Boudreau, Robert M., Hanlon, Joseph T., Albert, Steven M., O’Hare, Celia, Satterfield, Suzanne, Schwartz, Ann V., Vinik, Aaron I., Cauley, Jane A., Harris, Tamara B., Newman, Anne B., Strotmeyer, Elsa S., and for the Health Aging Body Composition Study
- Published
- 2018
- Full Text
- View/download PDF
36. Central nervous system-active medications and risk for falls in older women.
- Author
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Ensrud, Kristine E, Blackwell, Terri L, Mangione, Carol M, Bowman, Paula J, Whooley, Mary A, Bauer, Douglas C, Schwartz, Ann V, Hanlon, Joseph T, Nevitt, Michael C, and Study of Osteoporotic Fractures Research Group
- Subjects
Study of Osteoporotic Fractures Research Group ,Humans ,Benzodiazepines ,Central Nervous System Agents ,Anticonvulsants ,Narcotics ,Anti-Anxiety Agents ,Antidepressive Agents ,Odds Ratio ,Risk ,Prospective Studies ,Accidental Falls ,Health Status ,Aged ,Female ,Neurosciences ,Clinical Research ,Aging ,Prevention ,accidental falls ,older people ,medications ,Medical and Health Sciences ,Geriatrics - Abstract
ObjectivesTo determine whether current use of central nervous system (CNS)-active medications, including benzodiazepines, antidepressants, anticonvulsants, and narcotics, increases the risk for subsequent falls.DesignProspective cohort study.SettingFour clinical centers in Baltimore, Maryland; Portland, Oregon; Minneapolis, Minnesota; and the Monongahela Valley, Pennsylvania.ParticipantsEight thousand one hundred twenty-seven women aged 65 and older participating in the fourth examination of the Study of Osteoporotic Fractures between 1992 and 1994.MeasurementsCurrent use of CNS-active medications was assessed with an interviewer-administered questionnaire with verification of use from medication containers. A computerized dictionary was used to categorize type of medication from product brand and generic names. Incident falls were reported every 4 months for 1 year after the fourth examination.ResultsDuring an average follow-up of 12 months, 2,241 women (28%) reported falling at least once, including 917 women (11%) who experienced two or more (frequent) falls. Compared with nonusers, women using benzodiazepines (multivariate odds ratio (MOR) = 1.51, 95% confidence interval (CI) = 1.14-2.01), those taking antidepressants (MOR = 1.54, 95% CI = 1.14-2.07), and those using anticonvulsants (MOR = 2.56, 95% CI = 1.49-4.41) were at increased risk of experiencing frequent falls during the subsequent year. We found no evidence of an independent association between narcotic use and falls (MOR = 0.99 for frequent falling, 95% CI = 0.68-1.43). Among benzodiazepine users, both women using short-acting benzodiazepines (MOR = 1.42, 95% CI = 0.98-2.04) and those using long-acting benzodiazepines (MOR = 1.56, 95% CI = 1.00-2.43) appeared to be at greater risk of frequent falls than nonusers, although the CIs overlapped 1.0. We found no evidence to suggest that women using selective serotonin-reuptake inhibitors (MOR = 3.45, 95% CI = 1.89-6.30) had a lower risk of frequent falls than those using tricyclic antidepressants (MOR 1.28, 95% CI = 0.90-1.84).ConclusionsCommunity-dwelling older women taking CNS-active medications, including those taking benzodiazepines, antidepressants, and anticonvulsants, are at increased risk of frequent falls. Minimizing use of these CNS-active medications may decrease risk of future falls. Our results suggest that fall risk in women taking benzodiazepines is at best marginally decreased by use of short-acting preparations. Similarly, our findings indicate that preferential use of selective serotonin-reuptake inhibitors is unlikely to reduce fall risk in older women taking antidepressants.
- Published
- 2002
37. Anticholinergic Prescribing in Medicare Part D Beneficiaries Residing in Nursing Homes: Results from a Retrospective Cross-Sectional Analysis of Medicare Data
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Niznik, Joshua, Zhao, Xinhua, Jiang, Tao, Hanlon, Joseph T., Aspinall, Sherrie L., Thorpe, Joshua, and Thorpe, Carolyn
- Published
- 2017
- Full Text
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38. No Difference in Average Interdialytic Weight Gain Observed in a Randomized Trial With a Technology-Supported Behavioral Intervention to Reduce Dietary Sodium Intake in Adults Undergoing Maintenance Hemodialysis in the United States: Primary Outcomes of the BalanceWise Study
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Sevick, Mary Ann, Piraino, Beth M., St-Jules, David E., Hough, Linda J., Hanlon, Joseph T., Marcum, Zachary A., Zickmund, Susan L., Snetselaar, Linda G., Steenkiste, Ann R., and Stone, Roslyn A.
- Published
- 2016
- Full Text
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39. Use of new STOPP/START criteria in the care of older adults.
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Hanlon, Joseph T. and Schmader, Kenneth E.
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- *
GERIATRICS , *INAPPROPRIATE prescribing (Medicine) , *DRUG prescribing , *PHYSICIAN practice patterns , *ADVERSE health care events , *PATIENT safety , *OLD age - Abstract
This article comments on the article by Rochon et al. in this issue. [ABSTRACT FROM AUTHOR]
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- 2024
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40. Who Gets Testosterone? Patient Characteristics Associated with Testosterone Prescribing in the Veteran Affairs System: a Cross-Sectional Study
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Jasuja, Guneet K., Bhasin, Shalender, Reisman, Joel I., Hanlon, Joseph T., Miller, Donald R., Morreale, Anthony P., Pogach, Leonard M., Cunningham, Francesca E., Park, Angela, Berlowitz, Dan R., and Rose, Adam J.
- Published
- 2017
- Full Text
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41. Improving Medication Adherence and Health Outcomes in Older Adults: An Evidence-Based Review of Randomized Controlled Trials
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Marcum, Zachary A., Hanlon, Joseph T., and Murray, Michael D.
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- 2017
- Full Text
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42. Inappropriate Medication Use and Medication Errors in the Elderly
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Marcum, Zachary A., Hanlon, Joseph T., and Wehling, Martin, editor
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- 2013
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43. Medication Use in Older Adults
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Marcum, Zachary A., Peron, Emily P., Hanlon, Joseph T., Newman, Anne B., editor, and Cauley, Jane A., editor
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- 2012
- Full Text
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44. Drug Interactions With Non–Vitamin K Oral Anticoagulants
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Linnebur, Sunny A. and Hanlon, Joseph T.
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- 2018
- Full Text
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45. Meta‐analysis of Interventions to Reduce Adverse Drug Reactions in Older Adults
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Gray, Shelly L., Hart, Laura A., Perera, Subashan, Semla, Todd P., Schmader, Kenneth E., and Hanlon, Joseph T.
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- 2018
- Full Text
- View/download PDF
46. Impact of Dual Use of Department of Veterans Affairs and Medicare Part D Drug Benefits on Potentially Unsafe Opioid Use
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Gellad, Walid F, Thorpe, Joshua M, Zhao, Xinhua, Thorpe, Carolyn T, Sileanu, Florentina E, Cashy, John P, Hale, Jennifer A, Mor, Maria K, Radomski, Thomas R, Hausmann, Leslie R. M, Donohue, Julie M, Gordon, Adam J, Suda, Katie J, Stroupe, Kevin T, Hanlon, Joseph T, Cunningham, Francesca E, Good, Chester B, and Fine, Michael J
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- 2018
- Full Text
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47. Effect of Deintensifying Diabetes Medications on Negative Events in Older Veteran Nursing Home Residents
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Niznik, Joshua D., primary, Zhao, Xinhua, additional, Slieanu, Florentina, additional, Mor, Maria K., additional, Aspinall, Sherrie L., additional, Gellad, Walid F., additional, Ersek, Mary, additional, Hickson, Ryan P., additional, Springer, Sydney P., additional, Schleiden, Loren J., additional, Hanlon, Joseph T., additional, Thorpe, Joshua M., additional, and Thorpe, Carolyn T., additional
- Published
- 2022
- Full Text
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48. Effect of De-intensifying Diabetes Medications on Negative Events in Older Veteran Nursing Home Residents
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Niznik, Joshua D., primary, Zhao, Xinhua, primary, Slieanu, Florentina, primary, Mor, Maria K., primary, Aspinall, Sherrie L., primary, Gellad, Walid F., primary, Ersek, Mary, primary, Hickson, Ryan P., primary, Springer, Sydney P., primary, Schleiden, Loren J., primary, Hanlon, Joseph T., primary, Thorpe, Joshua M., primary, and Thorpe, Carolyn T., primary
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- 2022
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49. Deprescribing trials: A focus on adverse drug withdrawal events
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Hanlon, Joseph T., primary and Gray, Shelly L., additional
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- 2022
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50. Use of Antipsychotics Among Older Residents in VA Nursing Homes
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Gellad, Walid F., Aspinall, Sherrie L., Handler, Steven M., Stone, Roslyn A., Castle, Nicholas, Semla, Todd P., Good, Chester B., Fine, Michael J., Dysken, Maurice, and Hanlon, Joseph T.
- Published
- 2012
- Full Text
- View/download PDF
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