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  1. Artikel ; Online: The value of triggered geriatrics and palliative care consults in hospital medicine during the COVID-19 response.

    Prsic, Elizabeth H / Ouellet, Jennifer A / Lai, James M

    Annals of palliative medicine

    2021  Band 10, Heft 2, Seite(n) 970–972

    Mesh-Begriff(e) COVID-19 ; Geriatrics/trends ; Hospital Medicine/trends ; Humans ; Palliative Care/trends
    Sprache Englisch
    Erscheinungsdatum 2021-02-16
    Erscheinungsland China
    Dokumenttyp Journal Article
    ZDB-ID 2828544-X
    ISSN 2224-5839 ; 2224-5839
    ISSN (online) 2224-5839
    ISSN 2224-5839
    DOI 10.21037/apm-20-2297
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: A qualitative study of coaching patient priorities-aligned decision-making through virtual case-based discussions.

    Ouellet, Jennifer A / Kiwak, Eliza / Tinetti, Mary E / Hashmi, Ardeshir / Ng, Henry / Esterson, Jessica / Davenport, Claire

    Journal of the American Geriatrics Society

    2023  Band 71, Heft 12, Seite(n) E34–E37

    Mesh-Begriff(e) Humans ; Mentoring ; Decision Making ; Qualitative Research
    Sprache Englisch
    Erscheinungsdatum 2023-10-03
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.18609
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Hip Fracture: Can We Do Better?

    Ouellet, Jennifer A / Cooney, Leo M

    Journal of the American Geriatrics Society

    2016  Band 65, Heft 1, Seite(n) 22–24

    Mesh-Begriff(e) Hip Fractures ; Humans
    Sprache Englisch
    Erscheinungsdatum 2016-11-14
    Erscheinungsland United States
    Dokumenttyp Editorial ; Comment
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.14686
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel: Principle of rational prescribing and deprescribing in older adults with multiple chronic conditions.

    Ouellet, Gregory M / Ouellet, Jennifer A / Tinetti, Mary E

    Therapeutic advances in drug safety

    2018  Band 9, Heft 11, Seite(n) 639–652

    Abstract: Although the majority of older adults in the developed world live with multiple chronic conditions (MCCs), the task of selecting optimal treatment regimens is still fraught with difficulty. Older adults with MCCs may derive less benefit from prescribed ... ...

    Abstract Although the majority of older adults in the developed world live with multiple chronic conditions (MCCs), the task of selecting optimal treatment regimens is still fraught with difficulty. Older adults with MCCs may derive less benefit from prescribed medications than healthier patients as a result of the competing risk of several possible outcomes including, but not limited to, death before a benefit can be accrued. In addition, these patients may be at increased risk of medication-related harms in the form of adverse effects and significant burdens of treatment. At present, the balance of these benefits and harms is often uncertain, given that older adults with MCCs are often excluded from clinical trials. In this review, we propose a framework to consider patients' own priorities to achieve optimal treatment regimens. To begin, the practicing clinician needs information on the patient's goals, what the patient is willing and able to do to achieve these goals, an estimate of the patient's clinical trajectory, and what the patient is actually taking. We then describe how to integrate this information to understand what matters most to the patient in the context of an array of potential tradeoffs. Finally, we propose conducting serial therapeutic trials of prescribing and deprescribing, with success measured as progress towards the patient's own health outcome goals. The process described in this manuscript is truly an iterative process, which should be repeated regularly to account for changes in the patient's priorities and clinical status. With this process, we aim to achieve optimal prescribing, that is, treatment regimens that maximize benefits that matter to the patient and minimize burdens and potential harms.
    Sprache Englisch
    Erscheinungsdatum 2018-08-09
    Erscheinungsland England
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2583589-0
    ISSN 2042-0994 ; 2042-0986
    ISSN (online) 2042-0994
    ISSN 2042-0986
    DOI 10.1177/2042098618791371
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Emergency department clinician satisfaction with an APRN-led geriatric emergency medicine service consult team.

    Moreines, Laura T / Gettel, Cameron J / Hajduk, Alexandra M / Kukulka, Shannon / Lai, James M / Ouellet, Jennifer A

    Journal of the American Geriatrics Society

    2022  Band 71, Heft 3, Seite(n) 991–994

    Mesh-Begriff(e) Humans ; Aged ; Advanced Practice Nursing ; Emergency Medical Services ; Emergency Service, Hospital ; Personal Satisfaction ; Emergency Medicine
    Sprache Englisch
    Erscheinungsdatum 2022-11-24
    Erscheinungsland United States
    Dokumenttyp Letter ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.18133
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: An observational case series of targeted virtual geriatric medicine and palliative care consults for hospitalized older adults with COVID-19.

    Ouellet, Jennifer A / Prsic, Elizabeth H / Spear, Rebecca A / Blatt, Leslie / Kukulka, Shannon / Cronin-Ozyck, Rosemary / Kapo, Jennifer M / Lai, James M

    Annals of palliative medicine

    2021  Band 10, Heft 6, Seite(n) 6297–6306

    Abstract: Background: COVID-19 presents unique challenges to the care of hospitalized older adults, including fractured lines of communication and uncertainty surrounding long term trajectories in cognition and function. Geriatric medicine and palliative care ... ...

    Abstract Background: COVID-19 presents unique challenges to the care of hospitalized older adults, including fractured lines of communication and uncertainty surrounding long term trajectories in cognition and function. Geriatric medicine and palliative care clinicians bring specialized training in facilitating communication in the face of uncertainty. Insurance expansion of virtual visits enabled inpatient virtual consultation, which can preserve personal protective equipment and minimize exposure to clinicians. We examined changes in goals of care and code status following an inpatient virtual consultation with geriatric medicine and palliative care clinicians.
    Methods: This was an observational case series study performed at a large tertiary Academic Hospital. The study population included 78 patients aged 65 years and older, hospitalized with COVID-19 who had an inpatient consultation completed by geriatric medicine or palliative care clinicians between April 9, 2020 through May 9, 2020. The intervention was targeted, virtual geriatric medicine or palliative care consultation. All patients admitted to a medical floor with COVID-19 were screened four days a week and if a patient was over the age of 65, the medical team was offered a consultation by geriatric medicine (ages 80 and above) or palliative care (ages 65-79). Consultation included medical record review, telephone conversations with clinicians and nurses, telephone or video conversations with patients and/or surrogate decision-makers and collaborative case review on daily virtual huddles with an interprofessional team of geriatric medicine and palliative care clinicians. Descriptive statistics were applied to categorize outcomes after chart abstraction.
    Results: Following consultation, 24 patients (31%) patients changed their code status to less invasive interventions. Of patients who were FULL CODE at the time of consultation (n=42), 2 (4.8%) transitioned to DNR only and 16 (38.1%) transitioned to DNR/DNI after consultation. While 8 patients (10.3%) utilized intensive care unit (ICU) level of care prior to consultation, 6 (7.6%) patients utilized ICU after consultation. After consultation, 11 (14.1%) patients were referred to hospice.
    Conclusions: Given uncertain trajectories in older adults hospitalized with COVID-19 and variability in patient preferences, virtual goals of care geriatric medicine and palliative care consultations should be considered as a key component of COVID-19 hospital protocols.
    Sprache Englisch
    Erscheinungsdatum 2021-06-18
    Erscheinungsland China
    Dokumenttyp Journal Article
    ZDB-ID 2828544-X
    ISSN 2224-5839 ; 2224-5839
    ISSN (online) 2224-5839
    ISSN 2224-5839
    DOI 10.21037/apm-21-117
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Education outcomes of a multisite, virtual, interprofessional training in patient priorities aligned care.

    Ouellet, Jennifer A / Mecca, Marcia C / Tinetti, Mary E / Dindo, Lilian / Kiefer, Lea / Nguyen, Aaron C / Omer, Zehra B / Naik, Aanand D / Catic, Angela G

    Journal of the American Geriatrics Society

    2021  Band 70, Heft 1, Seite(n) E5–E7

    Mesh-Begriff(e) Education, Continuing/organization & administration ; Fellowships and Scholarships ; Geriatrics/education ; Humans ; Multiple Chronic Conditions/therapy ; Qualitative Research
    Sprache Englisch
    Erscheinungsdatum 2021-11-06
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.17544
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  8. Artikel ; Online: Functional Outcomes After Hip Fracture in Independent Community-Dwelling Patients.

    Ouellet, Jennifer A / Ouellet, Gregory M / Romegialli, Alison M / Hirsch, Marilyn / Berardi, Lisa / Ramsey, Christine M / Cooney, Leo M / Walke, Lisa M

    Journal of the American Geriatrics Society

    2019  Band 67, Heft 7, Seite(n) 1386–1392

    Abstract: Objectives: To determine predictors of new activities of daily living (ADLs) disability and worsened mobility disability and secondarily increased daily care hours received, in previously independent hip fracture patients.: Design: Retrospective ... ...

    Abstract Objectives: To determine predictors of new activities of daily living (ADLs) disability and worsened mobility disability and secondarily increased daily care hours received, in previously independent hip fracture patients.
    Design: Retrospective cohort study.
    Setting: Academic hospital with ambulatory follow-up.
    Participants: Community-dwelling adults 65 years or older independent in ADLs undergoing hip fracture surgery in 2015 (n = 184).
    Measurements: Baseline, 3- and 6-month ADLs, mobility, and daily care hours received were ascertained by telephone survey and chart review. Comorbidities, medications, and characteristics of hospitalization were extracted from patient charts. Models for each outcome used logistic regression with a backward elimination strategy, adjusting a priori for age, sex, and race.
    Results: Predictors of new ADL disability at 3 months were dementia (odds ratio [OR] = 11.81; P = .001) and in-hospital delirium (OR = 4.20; P = .002), and at 6 months were age (OR = 1.04; P = .014), dementia (OR = 9.91; P = .001), in-hospital delirium (OR = 3.00; P = .031) and preadmission opiates (OR = 7.72; P = .003). Predictors of worsened mobility at 3 months were in-hospital delirium (OR = 4.48; P = .001) and number of medications (OR = 1.13; P = .003), and at 6 months were age (OR = 1.06; P = .001), preadmission opiates (OR = 7.23; P = .005), in-hospital delirium (OR = 3.10; P = .019), and number of medications (OR = 1.13; P = .013). Predictors of increased daily care hours received at 3 and 6 months were age (3 months: OR = 1.07; P = .014; 6 months: OR = 1.06; P = .017) and number of medications (3 months: OR = 1.13; P = .004; 6 months: OR = 1.22; P = .013). The proportion of patients with ADL disability and care hours received did not change from 3 to 6 months, yet there were significant improvements in mobility.
    Conclusion: Age, dementia, in-hospital delirium, number of medications, and preadmission opiate use were predictors of poor outcomes in independent older adults following hip fracture. Further investigation is needed to identify factors associated with improved mobility measures from 3 to 6 months to ultimately optimize recovery.
    Mesh-Begriff(e) Activities of Daily Living ; Aged ; Disability Evaluation ; Female ; Hip Fractures/surgery ; Humans ; Independent Living ; Male ; Recovery of Function ; Retrospective Studies
    Sprache Englisch
    Erscheinungsdatum 2019-04-09
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.15870
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