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Article ; Online: Basal Insulin/GLP-1 RA Fixed-Ratio Combinations as an Option for Advancement of Basal Insulin Therapy in Older Adults With Type 2 Diabetes.

Corriere, Mark / Burtch, Brian / Pandya, Naushira

2023 Volume 72, Issue 1 Suppl, Page(s) 1

Abstract: The prevalence of type 2 diabetes (T2D) is increasing, and owing to the aging population, the number of older adults with T2D is growing rapidly. By virtue of their age, older adults are likely to have been living with the disease longer than their ... ...

Abstract	The prevalence of type 2 diabetes (T2D) is increasing, and owing to the aging population, the number of older adults with T2D is growing rapidly. By virtue of their age, older adults are likely to have been living with the disease longer than their younger counterparts. This, coupled with differences in T2D pathophysiology between younger and older patients, means that older adults often require advancement of treatment from basal insulin. However, older adults with T2D represent a heterogeneous population, for whom the goals of treatment are complex, and overtreatment can increase the risk of complications. These factors highlight the need for individualized glycemic targets and therapeutic strategies. In this roundtable, the authors discuss the management of older adults with T2D--a large patient population who often require treatment simplification.
MeSH term(s)	Humans ; Aged ; Diabetes Mellitus, Type 2/drug therapy ; Hypoglycemic Agents/therapeutic use ; Insulin/therapeutic use ; Glucagon-Like Peptide 1 ; Glucagon-Like Peptide-1 Receptor/therapeutic use
Chemical Substances	Hypoglycemic Agents ; Insulin ; Glucagon-Like Peptide 1 (89750-14-1) ; Glucagon-Like Peptide-1 Receptor
Language	English
Publishing date	2023-02-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	197883-4
ISSN	1533-7294 ; 0094-3509
ISSN (online)	1533-7294
ISSN	0094-3509
DOI	10.12788/jfp.0515
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Article ; Online: Individualizing Diabetes Care in Older Persons With Multimorbidity.

Sloane, Philip D / Pandya, Naushira

Journal of the American Medical Directors Association

2021 Volume 22, Issue 9, Page(s) 1884–1888

MeSH term(s)	Aged ; Aged, 80 and over ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/therapy ; Humans ; Multimorbidity
Language	English
Publishing date	2021-09-08
Publishing country	United States
Document type	Editorial
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2021.07.019
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Article ; Online: Supporting Vulnerable Older Adults With Telehealth Through Wellness Calls and Tablet Distribution During COVID-19: Quality Improvement Project.

Tewary, Sweta / Cook, Nicole / Dezine, Marie / Shnayder, Oksana / Pandya, Naushira

JMIR formative research

2023 Volume 7, Page(s) e46002

Abstract: Background: Loneliness, social isolation, and lack of technical literacy are associated with poorer health outcomes. To help improve social connection during the COVID-19 pandemic, Nova Southeastern University's South Florida Geriatric Workforce ... ...

Abstract	Background: Loneliness, social isolation, and lack of technical literacy are associated with poorer health outcomes. To help improve social connection during the COVID-19 pandemic, Nova Southeastern University's South Florida Geriatric Workforce Enhancement Program partnered with a community-based organization to provide educational resources to promote telehealth services. Objective: This study aimed to provide educational resources to older adults with limited resources and promote the use of telehealth services in this population. Methods: Through this pilot project, we contacted 66 vulnerable older adults who expressed interest in telehealth support through wellness calls, with 44 participants moving on to participate in tablet usage. All tablets were preloaded with educational information on using the device, COVID-19 resources, and accessing telehealth services for patients, caregivers, and families. Results: Feedback from wellness assessments suggested a significant need for telehealth support. Participants used the tablets mainly for telehealth (n=6, 15%), to connect with friends and family (n=10, 26%), and to connect with faith communities (n=3, 8%). Conclusions: The findings from the pilot project suggest that wellness calls and telehealth education are beneficial to support telehealth usage among older adults.
Language	English
Publishing date	2023-09-11
Publishing country	Canada
Document type	Journal Article
ISSN	2561-326X
ISSN (online)	2561-326X
DOI	10.2196/46002
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Article ; Online: Integrating 4Ms Assessment through Medicare Annual Wellness Visits: Comparison of Quality Improvement Strategies in Primary Care Clinics.

Tewary, Sweta / Cook, Nicole / Simon, Desiree / Philippe, Elizabeth / Shnayder, Oksana / Pandya, Naushira

Geriatrics (Basel, Switzerland)

2023 Volume 8, Issue 4

Abstract: The Medicare Annual Wellness Visit (AWV), which includes comprehensive preventative assessments and screenings, is associated with improved preventative services, including vaccination and cancer screenings. However, the AWV alone does not promote whole- ... ...

Abstract	The Medicare Annual Wellness Visit (AWV), which includes comprehensive preventative assessments and screenings, is associated with improved preventative services, including vaccination and cancer screenings. However, the AWV alone does not promote whole-person care. Integrating the AWV within an Age-Friendly Health System (AFHS) contextualizes AWV services within a comprehensive geriatric care framework that integrates the "4Ms" (mentation, medication, mobility, and what matters). This study describes and evaluates quality improvement initiatives to improve the completion of AWV within two different AFHS-recognized health systems (an academic university clinic and a Federally Qualified Health Center). The results from this evaluation present opportunities that other health systems can consider for leveraging electronic health records (EHRs) and enabling services to complete AWVs within a 4Ms framework. The implementation results also suggest an adaptation of the 4Ms assessment schedule for patients with complex chronic conditions who may suffer from multiple comorbidities and cognitive impairment.
Language	English
Publishing date	2023-06-28
Publishing country	Switzerland
Document type	Journal Article
ISSN	2308-3417
ISSN (online)	2308-3417
DOI	10.3390/geriatrics8040070
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Article ; Online: Medication Prescribing for Type 2 Diabetes in the US Long-Term Care Setting: Observational Study.

Pandya, Naushira / Jung, Molly / Norfolk, Aaron / Goldblatt, Claudia / Trenery, Alyssa / Sieradzan, Ray

Journal of the American Medical Directors Association

2023 Volume 24, Issue 6, Page(s) 790–797.e4

Abstract: Objectives: To characterize prescribing of glucose-lowering medication annually and to quantify the annual frequency of hypoglycemia among residents in long-term care (LTC) facilities with type 2 diabetes mellitus (T2DM).: Design: Serial cross- ... ...

Abstract	Objectives: To characterize prescribing of glucose-lowering medication annually and to quantify the annual frequency of hypoglycemia among residents in long-term care (LTC) facilities with type 2 diabetes mellitus (T2DM). Design: Serial cross-sectional study using a deidentified real-world database comprising electronic health records from LTC facilities. Setting and participants: Individuals eligible for this study were ≥65 years old with T2DM and recorded stay of ≥100 days at an LTC facility in the United States in any of 5 study years (2016-2020), excluding individuals receiving palliative or hospice care. Methods: Drug orders (prescriptions) for glucose-lowering medications for each LTC resident with T2DM in each calendar year were summarized by administration route (oral or injectable) and by drug class as ever-prescribed (ie, multiple prescriptions were included once), overall and stratified by age subgroup, <3 vs ≥3 comorbidities, and obesity status. We calculated the annual percentage of patients ever prescribed glucose-lowering medication each year, overall and by medication category, who experienced ≥1 hypoglycemic events. Results: Among 71,200 to 120,861 LTC residents with T2DM included each year from 2016 to 2020, 68% to 73% (depending on the year) were prescribed ≥1 glucose-lowering medications, among them oral agents for 59% to 62% and injectable agents for 70% to 71%. Metformin was the most commonly prescribed oral agent, followed by sulfonylureas and dipeptidyl peptidase 4 inhibitors; basal plus prandial insulin was the most commonly prescribed injectable regimen. Prescribing patterns remained relatively consistent from 2016 to 2020, both overall and by patient subgroup. During each study year, 35% of LTC residents with T2DM experienced level 1 hypoglycemia (glucose ≥54 to <70 mg/dL), including 10% to 12% of those prescribed only oral agents and ≥44% of those prescribed injectable agents. Overall, 24% to 25% experienced level 2 hypoglycemia (glucose concentration <54 mg/dL). Conclusions and implications: Study findings suggest that opportunities exist for improving diabetes management for LTC residents with T2DM.
MeSH term(s)	Humans ; United States ; Aged ; Diabetes Mellitus, Type 2/drug therapy ; Long-Term Care ; Cross-Sectional Studies ; Hypoglycemic Agents/therapeutic use ; Hypoglycemia ; Glucose/therapeutic use
Chemical Substances	Hypoglycemic Agents ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2023-04-21
Publishing country	United States
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2023.03.020
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Article ; Online: Glucose targets in older adults with diabetes: an evolving landscape.

Pandya, Naushira

Journal of the American Medical Directors Association

2013 Volume 14, Issue 2, Page(s) 143–144

MeSH term(s)	Diabetes Mellitus/therapy ; Geriatrics ; Humans
Language	English
Publishing date	2013-02
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2012.10.005
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Article ; Online: Time to Strategically Position Nursing Homes to Effectively Manage Emerging Infections.

Mayi, Bindu / Cook, Nicole / Pandya, Naushira

Journal of the American Medical Directors Association

2020 Volume 21, Issue 11, Page(s) 1578–1579

MeSH term(s)	Aged ; Homes for the Aged ; Humans ; Nursing Homes
Keywords	covid19
Language	English
Publishing date	2020-08-15
Publishing country	United States
Document type	Letter
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2020.07.004
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Article ; Online: Using the 4M framework of the Age-Friendly Health System to improve MIPS documentation in primary care clinics: A quality improvement study.

Tewary, Sweta / Cook, Nicole / Pandya, Naushira / Damier, Sashah / Shnayder, Oksana / Dezine, Marie

Gerontology & geriatrics education

2022 Volume 44, Issue 4, Page(s) 631–640

Abstract: Age-Friendly Health Systems (AFHS) commit to providing evidence-based, low-risk, coordinated care centered on what matters most to older adults, their families, and caregivers. Nova Southeastern University's South Florida Geriatric Workforce Enhancement ... ...

Abstract	Age-Friendly Health Systems (AFHS) commit to providing evidence-based, low-risk, coordinated care centered on what matters most to older adults, their families, and caregivers. Nova Southeastern University's South Florida Geriatric Workforce Enhancement Program (NSU SFGWEP) has partnered with primary care clinics to provide AFHS training and support to promote AFHS transformation in Broward and Miami-Dade Counties. NSU SFGWEP provides face-to-face and virtual training for AFHS and Electronic Health Record (EHR) documentation as part of the initiative. This project focuses on a group of primary care clinics in Broward County, Florida. In this paper, we evaluate the progress of AFHS transformation through six e-clinical measures that collectively provide indicators of the 4 M framework of AFHS (What Matters, Medication, Mentation, and Mobility). We used provider feedback and e-clinical measures aligned with the Center for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS) to measure clinic outcomes. From Jan 1- Dec 31, 2019, to Jan 1-Dec 31, 2020, the clinics improved high-risk medication management (0-3.71%), advanced care planning (6.79%-20.74%), and fall risk assessment (no data- 46.72%). Results demonstrate some success and ongoing opportunities to continue and expand AFHS interventions for sustainability.
MeSH term(s)	Humans ; United States ; Aged ; Medicare ; Quality Improvement ; Motivation ; Geriatrics/education ; Documentation ; Primary Health Care
Language	English
Publishing date	2022-09-05
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	605726-3
ISSN	1545-3847 ; 0270-1960
ISSN (online)	1545-3847
ISSN	0270-1960
DOI	10.1080/02701960.2022.2117171
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Article: Challenges of Diabetes Care in Older People With Type 2 Diabetes and the Role of Basal Insulin.

Cersosimo, Eugenio / Lee, Pearl G / Pandya, Naushira

Clinical diabetes : a publication of the American Diabetes Association

2019 Volume 37, Issue 4, Page(s) 357–367

Abstract: ... IN ... ...

Abstract	IN BRIEF
Language	English
Publishing date	2019-10-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1025953-3
ISSN	0891-8929
ISSN	0891-8929
DOI	10.2337/cd18-0074
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Article ; Online: Hypoglycemia upon hospital admission from long-term care: health care resource use.

Pandya, Naushira / Trenery, Alyssa / Sieradzan, Ray / Gabai, Claudia / Ermakova, Anastasia / Xiong, Yan

The American journal of managed care

2021 Volume 27, Issue 10, Page(s) e349–e354

Abstract: Objectives: Residents with diabetes in long-term care (LTC) settings often have recognized risk factors for developing hypoglycemia, including advanced age, dementia, and polypharmacy; however, data regarding hypoglycemia in LTC and associated ... ...

Abstract	Objectives: Residents with diabetes in long-term care (LTC) settings often have recognized risk factors for developing hypoglycemia, including advanced age, dementia, and polypharmacy; however, data regarding hypoglycemia in LTC and associated hospitalizations are lacking. Our aim was to describe health care resource use and costs for patients with diabetes and hypoglycemia upon hospital admission. Study design: Retrospective, descriptive study using a US hospital billing database, October 2015 through September 2019. Methods: Eligible patients were those 18 years and older with type 1 or 2 diabetes who (1) were hospitalized with hypoglycemia upon admission from LTC or from home and (2) received insulin during hospitalization. We described the percentages of patients admitted from LTC or from home with hypoglycemia and their characteristics, length of hospitalization, and hospital costs (2019 US$). Results: Of 106,602 patients with diabetes admitted from LTC and 4,315,571 from home, 6609 (6%) and 182,756 (4%), respectively, presented with hypoglycemia on hospital admission. Mean ages of patients admitted with hypoglycemia from LTC and home were 73 and 66 years, respectively. The percentages of patients in LTC and home cohorts with dementia were 34% and 12%, respectively; with renal disease, 60% and 52%; and with type 2 diabetes, 95% and 89%. Mean hospital stays were 8.0 days for patients admitted from LTC and 6.7 days for those admitted from home; mean total hospital costs were $19,800 and $16,800, respectively. Conclusions: These findings highlight the importance of providing optimal diabetes management for patients in LTC settings to prevent hypoglycemia and potential hospitalizations and costs.
MeSH term(s)	Delivery of Health Care ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Hospitalization ; Hospitals ; Humans ; Hypoglycemia/epidemiology ; Long-Term Care ; Retrospective Studies
Language	English
Publishing date	2021-10-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2035781-3
ISSN	1936-2692 ; 1088-0224 ; 1096-1860
ISSN (online)	1936-2692
ISSN	1088-0224 ; 1096-1860
DOI	10.37765/ajmc.2021.88765
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