MOUNT SINAI MEDICAL CENTER
Claude D. Pepper Older Americans Independence Center

Albert L. Siu, M.D.
Principal Investigator		   212-241-4290   albert.siu@mssm.edu
R. Sean Morrison, MD
Co-Principle Investigator		   212-241-1466   sean.morrison@mssm.edu
Deborah Watman
Program Administrator		   212-241-1856   Deborah.watman@mssm.edu
     
CENTER DESCRIPTION

The overarching goal of the Mount Sinai OAIC is to improve independence for older adults with serious illness and to consolidate the substantial progress made in the first eight years of the OAIC at the Icahn School of Medicine at Mount Sinai (ISMMS).  The OAIC supports research in seriously ill older adults (geriatric palliative care research) with the overall goal of creating the needed evidence base that, in the words of Claude D. Pepper, will  “…lighten the burden of those who suffer.” Our specific aims are:

1.    To expand a transdisciplinary research program focused on: a) improving quality of life and  independence and b) healthcare delivery models that improve care for seriously ill older adults and their families.

2.    To identify, recruit, and train leaders in aging and palliative care research through: a) mentoring relationships with successful investigators; b) strengthening and expanding Mount Sinai’s existing research training programs in aging and palliative care; and c) support for pilot projects, statistical and analytic consultation, use of population-based data, and instrument development and measurement.

3.    To expand research infrastructure that will support new and ongoing research in the care of seriously ill older adults by a) providing expertise in research design, measurement, and analysis, b) developing and applying innovative research designs, analytic techniques, and measures to OAIC and externally supported projects, c) applying to aging research relevant methods not currently in widespread use (e.g. item response theory, propensity score methods, latent class growth analyses), d) supporting innovative research employing newly available population-based data; and e) supporting two new cross-cutting themes focused on dementia and implantation science.

4.    To expand ongoing collaborations with other OAICs and National Palliative Care Research Center (NPCRC) and create new collaborations with NIA’s ADRCs,  RCMARs, and others

5.    To develop a research center that bridges geriatrics and palliative care and that will serve as a model for research that has not been well addressed previously by these two transdisciplinary specialties.

The OAIC consists of the following cores:  1) Leadership and Administrative Core (LAC), 2) Research Education Component (REC), 3) Pilot Exploratory Studies Core (PESC), 4) Measurement, Methods, and Analyses Core (RC-MMA), 5) Population Research and Methods Core (RC-PRM), and 6) Population Data Use and Management Core (RC-PDM).    Through the REC, we are providing junior faculty with educational activities and training experiences in improving the care of older adults with serious illness. These young investigators will have opportunities to participate in research through the PESC and external projects linked to the OAIC.  They and research supported in the OAIC are supported by three resource cores.  Our RC-MMA core provides statistical, methodological and programming expertise to investigators, as well as mentoring in those areas. The RC-MMA provides our investigators with access to measurement support including measures developed through item response theory.  The new RC-PDM core was developed to assist investigators with database management, sampling procedures, and analytic techniques needed for the increasing numbers of population-based datasets (e.g., NIA”s Health and Retirement Study [HRS] and National Health and Aging Trends Study [NHATS]).  All these cores are coordinated and integrated by the LAC In sum, our aim is to ensure that all health care professionals have the knowledge and evidence base necessary, and that our institutions have the necessary clinical models to provide high quality geriatric palliative care to the rapidly increasing numbers of older adults living with serious illness and their families.

CORES
Leadership and Administrative Core (LAC)
Leader 1:    Albert Siu, MD, MSPH   albert.siu@mssm.edu
Leader 2:    R. Sean Morrison, MD   sean.morrison@mssm.edu
The Leadership and Administrative Core is housed in the offices of the Chairman of the Mount Sinai Department of Geriatrics. Core staff consists of: Center Primary Investigator and Core Leader: Albert L. Siu, MD The Leaders of the Research Education Component: Nathan Goldstein, MD, R. Sean Morrison, MD, and Juan Wisnivesky, MD, PhD; Pilot and Exploratory Studies Core leaders: Kenneth Boockvar, MD; Population Research and Effectiveness Core leaders: Melissa Aldridge, PhD; Measurement and Data Management Core: Jeanne Teresi, PhD Vice Chair for Education of the Department of Geriatrics and Palliative Medicine: Rosanne Leipzig, MD, PhD Director of the Center to Advance Palliative Care: Diane Meier, MD Three standing committees advise the Center regarding policy and conduct of its programs: An OAIC Executive Committee (OAIC EC or EC) of OAIC core leaders and institutional leadership A Research Advisory Committee (RAC) of senior investigators not currently involved in the OAIC as investigators or mentors

Research Education Component (REC)
Leader 1:    Nathan Goldstein, MD   nathan.goldstein@mssm.edu
Leader 2:    Juan Wisnivesky, MD, PhD   juan.wisnivesky@mountsinai.org
The OAIC’s Research Education Component (REC) at the Icahn School of Medicine reinforces junior faculty’s interest in improving the care of seriously ill, older adults with educational activities and training experiences while promoting the development of future research leaders. The REC’s specific objectives are to: Recruit talented faculty from different disciplines who are committed to academic careers improving the care of older adults with serious illness Provide advanced training in research methodologies needed to conduct high quality, ethical, and multidisciplinary palliative care research for seriously ill older adults Provide multidisciplinary mentorship and individually tailored career development plans Support trainees in conducting and disseminating research studies to assess questions related to the health and independence of older adults or related palliative care issues Facilitate attainment of academic and life skills to sustain long-term success as independent investigators and future leaders in geriatric and palliative care medicine Prepare and assist trainees in obtaining external funding to continue an academic research career.

Pilot and Exploratory Studies Core (PESC)
Leader 1:    William Hung, MD   william.hung@mssm.edu
Leader 2:    Barbara Vickrey, MD, MPH   barbara.vickrey@mssm.edu
The Pilot and Exploratory Studies Core (PESC), builds upon a 15-year foundation of research in palliative care, disability, and function at Mount Sinai; an established record of successful mentorship by the OAIC senior investigators; and a strong and consistent track record in conducting collaborative and interdisciplinary research that will accomplish the following specific aims: Facilitate pilot and exploratory studies that will examine the relationship of pain and other distressing symptoms to independence, function, and disability; develop interventions directed at the treatment of pain and other distressing symptoms in older adults; and explore interventions to improve quality of life and promote function and independence for older adults living with serious and chronic illness Encourage the development of junior faculty by providing a mechanism to obtain mentored, hands-on research training and develop preliminary data in aging and palliative care that will lead to the development of larger federally or foundation-funded research projects and career development awards focused on improving care and promoting independence for older adults with advanced illness Support senior and mid-level faculty who are conducting studies in palliative care and aging who are embarking on new research projects requiring pilot data; palliative care research in younger populations who would like to expand or shift their research into aging; and aging research unrelated to palliative care who would like to refocus their work to fit within our OAIC theme Foster collaborative research among investigators from different disciplines, specialties, and institutions

Measurement, Methods and Analysis Core (RC-MMA)
Leader 1:    Jeanne Teresi, PhD   teresimeas@aol.com
Leader 2:    Mildred Ramirez, PhD   milramirez@aol.com
The goal of the proposed RC-MMA is to improve independence for older adults with serious illness through research and leadership training in geriatric palliative care methods. RC-MMA will support this effort by providing measurement consultation, evaluation and analyses for selected core projects.

Population Data Use and Management Core (RC-PDM)
Leader 1:    Carolyn Zhu, PhD   carolyn.zhu@mssm.edu
Leader 2:    Claire Ankuda, MD, MPH, MSc   claire.ankuda@mssm.edu
The Population Data Use and Management (RC-PDM) Core has pursued its objectives of leveraging existing national survey, administrative and health system data to support OAIC research on geriatric palliative care. As a newly established Core, this core has been highly productive in providing data management and operational support to OAIC investigators working with existing data sources through close partnership with RC-PRM and RC-MMA.

Population Research and Methods Core (RC-PRM)
Leader 1:    Melissa Aldridge, PhD   melissa.aldridge@mssm.edu
Leader 2:    Lihua Li, PhD   lihua.li@mssm.edu
The Population Research and Effectiveness (PRE) Core contributes to the goals of the OAIC by providing statistical, methodological, and programming expertise, as well as mentoring in those areas, to investigators in the School’s OAIC. This core has been highly productive in providing consultations and support for numerous OAIC investigators confronted with methodological and analytic issues that occur in the study of older adults with serious illness. Our Core’s consultants have a broad range of knowledge regarding research methods to serve as potential consults to OAIC investigators. Resources and expertise are provided in a variety of ways and throughout all phases of the research process—from design to interpretation and presentation of findings to: To provide sophisticated, cutting edge methodological, statistical, and programming support to OAIC investigators. To apply advanced research and statistical methodology (e.g., propensity scores, instrumental variable estimation, competing risk analysis) used in other fields but not commonly applied to aging-related research. To collaborate closely with the RCDC and RCDSC to ensure that junior faculty obtain research methods training to advance their current knowledge and expertise. To develop the infrastructure for population based research by hiring and training data analysts who will conduct data management and programming functions and provide statistical expertise in cutting edge research methods.

CAREER DEVELOPMENT
REC Scholar, Research & Grants Funded During Pepper Supported Time Years /
Publications
 
Rebecca Rodin
MD, MS / Assistant Professor
Dementia and the Opioid Epidemic: The Impact of the 2016 CDC Opioid Guidelines on Disparities in Pain Management
Aim 1: Identify the association of opioid prescribing and the publication of the 2016 CDC guidelines among community-dwelling older adults with and without dementia who have a pain-associated, opioid-responsive condition (either cancer or traumatic hip/pelvic fracture) H1: Opioid prescribing after 2016 will decrease to a greater extent for PWD than for PWoD Aim 2: Examine and compare racial/ethnic disparities in opioid prescribing after the publication of the 2016 CDC guidelines among community-dwelling older adults with and without dementia who experience a pain-associated, opioid-responsive condition (cancer or traumatic hip/pelvic fracture)
 2022-2025 /
8 (total)
5 (1st/Sr)
 
Past Scholars
Lili Chan, Mount Sinai Division of Nephrology (2019-2020)
Raj G. Kumar, Mount Sinai Department of Rehabilitation and Human Performance (2020-2021)
Rita C Crooms, Mount Sinai Department of Neurology (2020-2022)
Leah Blank, Mount Sinai Department of Neurology (2020-2022)
Aaron Baum, Mount Sinai Division of General Internal Medicine (2020-2021)
Julia L. Frydman, Mount Sinai Department of Geriatrics & Palliative Medicine (2020-2022)
Matthew R Augustine, Mount Sinai Division of General Internal Medicine (2020-2021)
Zainab Toteh Osakwe, College of Nursing and Public Health, Adelphi University (2021-2022)

PILOT/EXPLORATORY PROJECTS (8 Pilot Projects Listed)
1. Project Title: Geriatric Surgery Co-Management Program: A New Model to Optimize Pre-Operative Care For Frail Older Adults
  Leader: Stephanie Chow, MD, MPH; Fred Ko, MD, MSCR
 

ABSTRACT: Frail older adults undergoing surgery encounter higher rates of adverse post-operative outcomes as compared to non-frail older adults. Currently, much of geriatric surgery co-management takes place in the inpatient setting, as a collaboration primarily between surgeons and geriatricians, and without deliberate social work guidance on the social determinants of health. This Pepper Center pilot study proposes to explore Geriatric Surgery CO-Management (SCOM) in the ambulatory setting as a pre-emptive approach to optimizing comprehensive geriatric medical and social work care in the frail older patient. It aims to characterize patients referred to and enrolled in SCOM and evaluate their relevant clinical outcomes, examine the feasibility of delivering SCOM program elements in real-world clinical settings, and identify facilitators and barriers to SCOM implementation. This knowledge will provide the foundation to inform future grant proposals and definitive effectiveness trials that aim to study the post-surgical benefits of a pre-operative, collaborative interprofessional co-management intervention in frail older patients in the Mount Sinai Health System.
 
2. Project Title: Developing Training for MyChart Use for Older Persons with Mild Cognitive Impairment: A pilot study
  Leader: Maria Loizos, PhD
 

There is an increasing number of patients who utilize technology to promote a healthy lifestyle. Various forms of telehealth services, including text messaging, email, patient portals, videoconferencing visits, and evisits are becoming increasingly available. In fact, patients are increasingly utilizing electronic personal health records (PHR), which include the most up to date information about a patient’s health care. At the Icahn School of Medicine at Mount Sinai, patients can use MyChart, which is linked to EPIC (electronic medical record). Utilizing PHR allows patients the ability to more easily manage their health, increase their independence, increase access to care, and reduce health disparities among rural and underserved populations. However, older adults, and especially older adults with Mild Cognitive Impairment (MCI) overwhelmingly underutilize PHR. Not having access to and being able to use technology may put older adults with MCI at a disadvantage in terms of their ability to live independently. Additionally, many older adults with MCI depend on spouses or other family members to assist with telehealth visits, and these are often also older frail individuals. Rapidly changing technology does not allow for patient ease of use, and many older adults with MCI become agitated and more symptomatic trying to adapt to it. Presently, there exists a need to assist older persons with MCI with utilizing PHR to manage their health and maintain their independence. To address the issue of older adults with MCI underutilizing PHR, we will develop a training module which will utilize feedback from patients and caregivers both familiar and unfamiliar with MyChart. Utilizing direct patient feedback allows the training module to be tailored specifically to patient need and will allow the inclusion of language and verbiage that older patients are familiar with. The proposed project is supported by the fact that while these patient portal systems are not intuitive for older adults with MCI, they can be trained to utilize these systems by incorporating their preferred learning method. Thus, it is hypothesized that older individuals with MCI can identify what makes it difficult for them to use MyChart and can inform a training module to improve their utilization. The potential increase in use of patient portals will promote independence in managing health care which is particularly important for older adults. The specific aims of this project are: 1) Understand nature of user difficulties and knowledge needs with regard to MyChart use and determine preferred training method for older adults with MCI and their caregivers with and without MyChart experience. This includes multiple focus groups with older adults with MCI consumers of MyChart and novice older adults with MCI users and their caregivers. Focus groups will be carried out by a clinical psychologist. Feedback generated from these focus groups will provide the basis for the development of the training module. 2) Develop a MyChart training module based on identified knowledge needs. The training module will be created utilizing direct feedback regarding the way older adult consumers with MCI and their caregivers prefer to receive information and training regarding technology (e.g., video, written materials, or live instruction). Identified difficulties gleamed from prior focus groups will be reviewed and verbiage that older adult consumers with MCI and their caregivers have identified will be utilized. 3) Assess the feasibility of providing training to improve use of MyChart amongst older adults with MCI. This includes utilizing multiple focus groups with older adults unfamiliar with MyChart and ascertaining participant satisfaction via questionnaire as well as participant’s ability to carry out health tasks via MyChart. It is hypothesized that older individuals can identify what makes it difficult for them to use MyChart and can inform a training module to improve their utilization. Results will demonstrate the feasibility of providing a training module to improve MyChart usage amongst older adults as well as determine the preferred learning method of older adults with MCI. The goal of this proposed pilot project is to identify the causes of low use of MyChart among older adults and assess the feasibility of using a training module based on patient feedback and experience regarding the use of MyChart.
 
3. Project Title: Understanding discordance between goals of care and admission to the emergency department at the end of life (2.0)
  Leader: Bevin Cohen PhD, MPH, MS, RN, Associate Professor; Kimberly Souffront, PhD, RN, FNP-BC, Assistant Professor
  The purpose of this mixed methods study is to characterize the patient, family, provider, and system level processes and factors that lead to ED admissions near the end of life when this is inconsistent with patients’ documented advance directives and goals of care (DADGOC). The specific aims are: 1. To describe the prevalence and characteristics of patients with advanced serious illness who are admitted to the ED at the end of life, and within this cohort: a. Describe the differences in characteristics between patients who have DADGOC that are inconsistent with admission to the ED versus those who do not; b. Describe the proportion and characteristics of DADGOC that contain inconsistent, contradictory, outdated, or vague statements regarding goals of care. 2. To qualitatively explore the factors that contribute to discordance between DADGOC and admission to the ED at the end of life by interviewing patients, family members, and healthcare workers. 3. To characterize the factors that contribute to discordance between DADGOC and admission to the ED using a process mapping approach.
 
4. Project Title: Home Health Aide Continuity Among Home-based Long-Term Care Clients and Its Relationship with Health Outcomes
  Leader: Jennifer M. Reckrey, MD Associate Professor Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai
  Due to both individual and family preference as well as growing evidence that community-based long-term services and supports (LTSS) can be cost effective, the locus of long-term care is shifting from institutions into the community. Concerns about safety in congregate settings like nursing homes during the COVID-19 pandemic may accelerate this trend. While paid caregivers (e.g., home health aides, personal care attendants, and other direct care workers in the home) play an important role making sure older adults receive needed assistance, few studies have examined how paid caregivers themselves or the characteristics of the services they provide shapes health outcomes for care recipients. Consistency in the paid caregiver(s) providing care to an individual with long-term care needs may make it possible for paid caregivers to establish trust, support, and familiarity with their client’s personal care and health needs. This in turn may enable paid caregivers to meaningfully contribute to the health outcomes of their clients. A large body of health services research suggests that consistency in the individual providing healthcare services (e.g., doctors, nurses, physical therapists) is important for patient outcomes; this is known as “provider continuity”. However, limited research has empirically explored continuity of paid caregivers such as home health aides (i.e., “home health aide continuity”) in the home-based long-term care setting. Previous work on this topic has largely been qualitative, conducted outside of the U.S., or focused on paid caregivers providing short-term post-acute home-based care. The impact of home health aide continuity on home-based long-term care clients has not been studied. Given the integral but often underappreciated role that paid caregivers play in the health care team, information about home health aide continuity is essential to both guide paid caregiver workforce development and to maximize the potentially positive impact of paid caregivers on those for whom they care. Existing data from the Visiting Nurse Service of New York (VNSNY) provides a unique opportunity to simultaneously explore long-term care client health outcomes (using Medicaid Managed Long-Term Care records) and patterns of continuity among the home health aides who care for them (using Licensed Home Care Service Agency records). We propose to conduct a retrospective cohort study using secondary analysis of these data in order to: Aim 1. Describe home health aide continuity (i.e., number of home health aides providing care to a given client over time) among a population of older adults receiving Medicaid-funded, home-based long term care. Aim 2: Identify client factors associated with greater home health aide continuity. H2: Those with greater service needs will experience greater discontinuity of home health aides. Aim 3: Determine the association between home health aide continuity and client health outcomes across multiple domains (i.e., quality of life, safety, psychosocial well-being, and healthcare utilization). H3: Greater home health aide continuity will be associated with better health outcomes
 
5. Project Title: “TIER PALLIATIVE CARE: A palliative care delivery model to match palliative care services for community-based patients with heart failure or cancer”
  Leader: Laura P. Gelfman, MD, MPH: Associate Professor Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai
  Older adults with serious illness suffer from poor symptom control, decreased quality of life (QoL) and poor communication with their healthcare providers, especially with regards to goals of care discussions (GOCD). Palliative care, when offered alongside disease management, offers the benefits of improved symptom control, QoL and communication (increased prognostic awareness, GOCDs, goal concordant care). Due to a limited specialty-trained palliative care workforce, patients often cannot access these benefits, particularly outside of the hospital. These needs are particularly acute in advanced cancer and HF, which are the two leading causes of death in the US and the prototypical examples of the most common illness trajectories. Indeed the dynamic nature of these two illnesses present distinct symptom patterns and change in functional status that can create challenges with regard to the optimal delivery of palliative care. To improve the quality of care for these two populations, new models are needed to deliver community-based palliative care tailored to patient’s illness trajectory and changing needs. TIER-PALLIATIVE CARE (TIER-PC) is an innovative and adaptive model of delivering palliative care that provides the right level of care to the right patients at the right time. TIER-PC increases the number and intensity of disciplines added to the patient’s care team as their symptoms worsen and function declines. In Tier 1, patients who are able to care for themselves and no/mild symptoms receive a community health worker (CHW) trained to elicit illness understanding in a culturally competent way. In Tier 2, for patients with poorer function and mild symptoms, a social worker (SW), trained in serious illness communication, joins the CHW to further elicit patients’ goals and prognostic understanding while communicating symptom needs to their primary clinician. In Tier 3, as function decreases and symptoms increase, an advance practice nurse (APN) joins the CHW+SW to manage complex symptoms. Finally, in Tier 4, for those older adults with the poorest function and most complex symptoms, a physician joins the team to assure that the most complex needs (e.g., end-of-life treatment preferences and multifaceted symptom control) are met. The CHW follows patients longitudinally across all tiers and re-allocates them to the appropriate tier based on their evolving needs. We will adapt an existing model and refine TIER-PC (SA1), and evaluate the efficacy of TIER-PC in a single-site, two-arm randomized controlled trial (RCT) of TIER-PC vs. usual care in a population of community-based older adults with advanced cancer or HF (SA2). We will enroll and randomize 40 older adults to receive TIER-PC or a CHW-delivered augmented control and follow patients for 6 months. Patients with either advanced cancer or HF will receive regular assessments by the TIER-PC team to: address their specific symptom and psychosocial needs; improve illness/prognostic understanding; prescribe medications; and address goals of care. As a result of this work, we will have pilot data (symptom control; QoL) for an R01 efficacy trial. Our model has the potential to improve care for older adults with cancer or HF and match demand to the limited specialty-trained palliative care workforce.
 
6. Project Title: Understanding Discharge Destination Decisions from Patient and Caregiver Perspectives in the Context of Self-Efficacy and Social Determinants of Health
  Leader: Shira Winter, PhD, RN, FNP-BC
  This study aims to advise future efforts to discharge patients from hospital to home safely with appropriate services rather than discharge to a facility), accounting for both patient and caregiver preferences as well as for social determinants of health. The findings from this pilot study will: 1) help elucidate the phenomena surrounding the complexity of discharge destination decisions beyond medical and functional status, and 2) provide insight on ways to design evidence-based methods that will help hospital teams determine when discharges to home with rehabilitation services are likely to yield optimal medical and psychosocial outcomes for patients and caregivers. The overall objective of this project is to understand the interplay between self-efficacy and social determinants of health in the context of determinations of discharge destination.
 
7. Project Title: Defining a cohort of chronically ill patients with repeated hospitalizations for future research on segregation of care
  Leader: Louisa Holoday, MD, MHS
  Racial disparities in healthcare outcomes persist despite decades of research and interventions. One reason for these ongoing racial disparities may be segregation in care. Hospital care in the United States is de facto racially segregated, with Black and Hispanic patients generally cared for in different hospitals than White patients. Hospitals that serve primarily Black patients have lower quality measures, receive less revenue, and have lower profits. Individuals with serious illness may be more vulnerable to poor outcomes from low quality hospital care. Despite this, relatively few studies have demonstrated that the hospital used for care is an explanatory variable for observed racial disparities among seriously ill older adults. However, whether site of care mediates racial health disparities among older adults with serious illness is unknown. Further, examining segregation of care as a driver of poor outcomes is understudied. Research on the segregation of care has been limited in part due to unreliable race and ethnicity data in administrative datasets, which may be overcome with novel methods. Recently published work has identified significant racial and ethnic segregation of Medicare patients among Asian, Black, and Hispanic patients in the New York City metropolitan region. This paper also found hospitals primarily serving minoritized individuals had lower quality measures and poorer performance overall. Thus, segregation of care may indeed drive racial health disparities, and deserve further study as potentially modifiable drivers of racial health disparities. In order to study the effects of receipt of care in segregated hospitals on health outcomes, we propose identifying a cohort of chronically ill patients using data from the Medicare Current Beneficiary Survey. We will also characterize hospitals used by chronically ill, high utilization patients.
 
8. Project Title: Improving Psychological Adjustment and Care Quality for Men on Active Surveillance (ImPACt)
  Leader: Nihal E. Mohamed, MD
  Active surveillance (AS) is an evidence-based observation strategy to manage men with low-risk prostate cancer (PCa) to prevent a decrease in men’s quality of life typically associated with definitive treatment (e.g., surgery, radiation therapies). In spite of the benefits of AS, 90% of eligible patients opt for treatment and 25% of patients discontinue the AS protocol within the first 2 years without clinical evidence of PCa progression. We have developed an educational intervention to improve patients’ adherence to AS. In this study, we aim to enhance the intervention by including an 8-session on cognitive-behavioral skills to reduce distress.
 
DEVELOPMENT PROJECTS (0 Development Projects Listed)
  No development projects.
RESEARCH (0 Projects Listed)
PUBLICATIONS
2024
 
2023
  1. Comparison of the Pathway to Hospice Enrollment Between Medicare Advantage and Traditional Medicare.
    Ankuda CK, Belanger E, Bunker J, Gozalo P, Keohane L, Meyers D, Trivedi A, Teno JM
    JAMA Health Forum, 2023 Feb 3, 4(2): e225457
    https://doi.org/10.1001/jamahealthforum.2022.5457 | PMID: 36800194 | PMCID: PMC9938424
    Citations: 1 | AltScore: NA
  2. The devil's in the details: Variation in estimates of late-life activity limitations across national cohort studies.
    Ankuda CK, Covinsky K, Freedman VA, Langa K, Aldridge MD, Yee C, Kelley AS
    J Am Geriatr Soc, 2023 Mar, 71(3): 858-868
    https://doi.org/10.1111/jgs.18158 | PMID: 36511646 | PMCID: PMC10023348
    Citations: NA | AltScore: 17.3
  3. Defining a taxonomy of Medicare-funded home-based clinical care using claims data.
    Ankuda CK, Ornstein KA, Leff B, Rajagopalan S, Kinosian B, Brody AA, Ritchie CS
    BMC Health Serv Res, 2023 Feb 6, 23(1): 120
    https://doi.org/10.1186/s12913-023-09081-8 | PMID: 36747175 | PMCID: PMC9900204
    Citations: NA | AltScore: NA
  4. Building a Cardiac Palliative Care Program: A Qualitative Study of the Experiences of Ten Program Leaders From Across the United States.
    Blum M, Beasley A, Ikejiani D, Goldstein NE, Bakitas MA, Kavalieratos D, Gelfman LP
    J Pain Symptom Manage, 2023 Jul, 66(1): 62-69.e5
    https://doi.org/10.1016/j.jpainsymman.2023.03.009 | PMID: 36972857 | PMCID: PMC10330149
    Citations: 1 | AltScore: 14.2
  5. Visualizing Multimorbidity in Chronically Ill Populations Using UpSet Plots.
    Blum M, Gelfman LP
    J Pain Symptom Manage, 2023 Apr, 65(4): e397-e398
    https://doi.org/10.1016/j.jpainsymman.2022.12.003 | PMID: 36526250 | PMCID: PMC10240179
    Citations: NA | AltScore: NA
  6. Using Latent Class Analysis to Identify Different Clinical Profiles Among Patients With Advanced Heart Failure.
    Blum M, McKendrick K, Gelfman LP, Pinney SP, Goldstein NE
    J Pain Symptom Manage, 2023 Feb, 65(2): 111-119
    https://doi.org/10.1016/j.jpainsymman.2022.10.011 | PMID: 36911500 | PMCID: PMC9994448
    Citations: NA | AltScore: NA
  7. Using Functional Status at the Time of Palliative Care Consult to Identify Opportunities for Earlier Referral.
    Blum M, Zeng L, Chai E, Morrison RS, Gelfman LP
    J Palliat Med, 2023 Oct, 26(10): 1398-1400
    https://doi.org/10.1089/jpm.2023.0265 | PMID: 37440176 | PMCID: PMC10541928
    Citations: NA | AltScore: NA
  8. An Update: National Institutes of Health Research Funding for Palliative Medicine 2016-2020.
    Buehler NJ, Frydman JL, Morrison RS, Gelfman LP
    J Palliat Med, 2023 Apr, 26(4): 509-516
    https://doi.org/10.1089/jpm.2022.0316 | PMID: 36306522 | PMCID: PMC10066773
    Citations: 1 | AltScore: 7.55
  9. Palliative care referral across the disease trajectory in high-grade glioma.
    Crooms RC, Taylor JW, Jette N, Morgenstern R, Agarwal P, Goldstein NE, Vickrey BG
    J Neurooncol, 2023 May, 163(1): 249-259
    https://doi.org/10.1007/s11060-023-04338-y | PMID: 37209290 | PMCID: PMC10546385
    Citations: NA | AltScore: NA
  10. Beyond the Fight: Why President Biden's Cancer Moonshot Must Include Palliative Care.
    Daubman BR, Rosenberg LB, Meier DE
    J Clin Oncol, 2023 Feb 20, 41(6): 1189-1192
    https://doi.org/10.1200/JCO.22.00838 | PMID: 36103638 | PMCID: PMC9940938
    Citations: NA | AltScore: 33.5
  11. Techniques for Clinical Practice: Communication Strategies for Black Patients with Serious Illness.
    Frydman JL, Arnold RM, Gelfman LP, Smith CB
    J Pain Symptom Manage, 2023 Jan, 65(1): e105-e107
    https://doi.org/10.1016/j.jpainsymman.2022.09.007 | PMID: 36182009 | PMCID: PMC9979277
    Citations: NA | AltScore: 2
  12. \Dose\" of Palliative Care Matters: Let's Figure Out How to Measure It Nationally."
    Frydman JL, Gelfman LP
    J Palliat Med, 2023 Aug, 26(8): 1040-1041
    https://doi.org/10.1089/jpm.2023.0325 | PMID: 37579233
    Citations: NA | AltScore: NA
  13. Health care utilization and costs in the years preceding dementia identification.
    Kumar RG, Lund EB, Ornstein KA, Li J, Covinsky KE, Kelley AS
    Alzheimers Dement, 2023 Sep 18
    https://doi.org/10.1002/alz.13476 | PMID: 37718630
    Citations: NA | AltScore: NA
  14. Evaluating memory testing to distinguish dementia severity among White, Black, and Spanish-speaking individuals in the Uniform Data Set (UDS).
    Loizos M, Zhu CW, Akrivos J, Sewell M, Li C, Neugroschl J, Melnick J, Ljekocevic M, Martin J, Grossman H, Aloysi A, Schimming C, Sano M
    Alzheimers Dement, 2023 Feb 25, 19(8): 3625-3634
    https://doi.org/10.1002/alz.13002 | PMID: 36840724 | PMCID: PMC10440216
    Citations: NA | AltScore: 7
  15. Lessons Learned from an Embedded Palliative Care Model in the Medical Intensive Care Unit.
    Mehta A, Krishnasamy P, Chai E, Acquah S, Lasseigne J, Newman A, Zeng L, Gelfman LP
    J Pain Symptom Manage, 2023 Apr, 65(4): e321-e327
    https://doi.org/10.1016/j.jpainsymman.2022.12.011 | PMID: 36584736 | PMCID: PMC10258731
    Citations: NA | AltScore: 21.4
  16. Palliative Care and Neurology Needs in Patients With and Without COVID-19.
    Ng M, Crooms RC, Ankuda C
    Am J Hosp Palliat Care, 2023 Feb, 40(2): 244-249
    https://doi.org/10.1177/10499091221102554 | PMID: 35574974 | PMCID: PMC9111909
    Citations: NA | AltScore: NA
  17. Role of Home Health for Community-Dwelling Older Adults Near the End of Life: A Resource Beyond Hospice?
    Oh A, Hunt LJ, Ritchie CS, Ornstein KA, Kelley AS, Rajagopalan S, Ankuda CK
    J Palliat Med, 2023 Mar, 26(3): 385-392
    https://doi.org/10.1089/jpm.2022.0272 | PMID: 36137095 | PMCID: PMC9986009
    Citations: NA | AltScore: 9
  18. Academic-Clinical Collaborations to Build Undergraduate Nursing Education in Hospice and Palliative Care.
    Osakwe ZT, Horton JR, Ottah J, Eisner J, Atairu M, Stefancic A
    J Gerontol Nurs, 2023 Jun, 49(6): 13-18
    https://doi.org/10.3928/00989134-20230515-01 | PMID: 37256758 | PMCID: PMC10445232
    Citations: NA | AltScore: NA
  19. The role of restrictive scope-of-practice regulations on the delivery of nurse practitioner-delivered home-based primary care.
    Osakwe ZT, Liu B, Ankuda CK, Ritchie CS, Leff B, Ornstein KA
    J Am Geriatr Soc, 2023 Feb 28, 71(7): 2256-2263
    https://doi.org/10.1111/jgs.18300 | PMID: 36855242 | PMCID: PMC10363209
    Citations: NA | AltScore: NA
  20. Patterns of Healthcare Utilization and Spending Among Homebound Older Adults in the USA: an Observational Study.
    Oseroff BH, Ankuda CK, Bollens-Lund E, Garrido MM, Ornstein KA
    J Gen Intern Med, 2023 Mar, 38(4): 1001-1007
    https://doi.org/10.1007/s11606-022-07742-8 | PMID: 35945471 | PMCID: PMC9362988
    Citations: 1 | AltScore: 39.2
  21. Unexpected lucidity in dementia: application of qualitative methods to develop an informant-reported lucidity measure.
    Ramirez M, Teresi JA, Ellis J, Gonzalez-Lopez P, Silver S, Rutigliano M, Vidal-Manzano J, Boratgis G, Devanand DP, van Meer I, Bhatti I, Bhatti U, Luchsinger JA
    Aging Ment Health, 2023 May 5, 27(12): 2395-2402
    https://doi.org/10.1080/13607863.2023.2207167 | PMID: 37145967
    Citations: NA | AltScore: NA
  22. Caring for aging parents in the last years of life.
    Roberts HL, Bollens-Lund E, Ornstein KA, Kelley AS
    J Am Geriatr Soc, 2023 May 24, 71(9): 2871-2877
    https://doi.org/10.1111/jgs.18415 | PMID: 37224430 | PMCID: PMC10524882
    Citations: NA | AltScore: NA
  23. Clinician Perspectives on Palliative Care for People with Hepatocellular Carcinoma: Facilitators of and Barriers to Referral.
    Woodrell CD, Mulholland CN, Goldstein NE, Hutchinson CL, Schiano TD, Hansen L
    Cancers (Basel), 2023 Jul 14, 15(14):
    https://doi.org/10.3390/cancers15143617 | PMID: 37509278 | PMCID: PMC10377573
    Citations: NA | AltScore: NA


EXTERNAL ADVISORY BOARD MEMBERS

Christine Ritchie
UCSF
Serving since 2011 (13 years)

Jay Magaziner
University of Maryland
Serving since 2011 (13 years)

Vincent Mor
Brown University
Serving since 2011 (13 years)

Ken Langa
University of Michigan
Serving since 2017 (7 years)

RECOGNITION AND AWARDS (2023-2024)

Recognition and Awards not specified.

MINORITY RESEARCH

General Brief Description of Minority Activities:

No minority trainee information specified.

No minority grant information specified.