Jerry H Gurwitz
Datos Biográficos
| ID | 5534396 |
|---|---|
| NOMBRE | Jerry H Gurwitz |
| NOMBRES | Jerry H |
| APELLIDO | Gurwitz |
| FIRMA | GURWITZ J H |
| AFILIACIONES | University of Massachusetts Chan Medical School |
| ORCID | 0000-0003-1630-8213 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 18 |
| TOTAL DE CITAS | 16 |
| TOTAL COMO AUTOR | 18 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1993 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2023 |
| ÍNDICE H | 2 |
Approach to Multimorbidity Burden Classification and Outcomes in Older Adults With Heart Failure
BACKGROUND: The optimal approach to classifying multimorbidity burden in assessing treatment-associated outcomes using real-world data remains uncertain. We assessed whether 2 measurement approaches to characterize multimorbidity influenced observed associations of β-blocker use with outcomes in adults with heart failure (HF). METHODS: We conducted a retrospective study on adults with HF from 4 integrated health care delivery systems. Multimorbid…
Affordability of Medical Care Among Medicare Enrollees
The findings of this study suggest that unaffordability of medical care is common among Medicare enrollees, especially those with lower incomes, or worse health, or who qualify for Medicare based on disability. Policy reforms, such as caps on patient spending, are needed to reduce Medical cost burdens on the most vulnerable enrollees
Cost-related Medication Nonadherence and Its Risk Factors Among Medicare Beneficiaries
BACKGROUND: Unaffordability of medications is a barrier to effective treatment. Cost-related nonadherence (CRN) is a crucial, widely used measure of medications access. OBJECTIVES: Our study examines the current national prevalence of and risk factors for CRN (eg, not filling, skipping or reducing doses) and companion measures in the US Medicare population. RESEARCH DESIGN: Survey-weighted analyses included logistic regression and trends 2006-201…
The Exclusion of Older People from Participation in Cardiovascular Trials
Persistent Medication Affordability Problems Among Disabled Medicare Beneficiaries After Part D, 2006–2011
BACKGROUND: Disabled Americans who qualify for Medicare coverage typically have multiple chronic conditions, are highly dependent on effective drug therapy, and have limited financial resources, putting them at risk for cost-related medication nonadherence (CRN). Since 2006, the Part D benefit has helped Medicare beneficiaries afford medications. OBJECTIVE: To investigate recent national trends in medication affordability among this vulnerable po…
Antipsychotic Use in Nursing Homes Varies by Psychiatric Consultant
BACKGROUND: The relationship between psychiatric consultation and antipsychotic prescribing in nursing homes (NH) is unknown. OBJECTIVE: To identify the association between psychiatric consultant groups and NH-level antipsychotic prescribing after adjustment for resident case-mix and facility characteristics. RESEARCH DESIGN AND SUBJECTS: Nested cross-sectional study of 60 NHs in a cluster randomized trial. We linked facility leadership surveys t…
Medicare Part D and Changes in Prescription Drug Use and Cost Burden
CONTEXT: The full effect of Medicare Part D, after the initial policy transition period and across the United States Medicare population, remains unclear. OBJECTIVE: To estimate nationally representative changes in prescription drug use and out-of-pocket drug costs 2 years after implementation of Part D. DESIGN, SETTING, AND PARTICIPANTS: We examined study outcomes over 8 years (2000 to 2007) and estimated changes after Part D, accounting for ear…
Out-of-Pocket Burden of Health Care Spending and the Adequacy of the Medicare Part D Low-Income Subsidy
BACKGROUND: Evaluating the adequacy of Medicare prescription drug program (Part D) and its low-income subsidy (LIS) requires a comprehensive understanding of drug spending in relation to household resources. OBJECTIVE: : To estimate out-of-pocket health care costs in the year before Part D, in context of total household spending, health status, and LIS eligibility. RESEARCH DESIGN: Nationally representative cross-sectional study. SUBJECTS: Two th…
Reliability of New Measures of Cost-Related Medication Nonadherence
BACKGROUND: Although several national studies have attempted to measure medication nonadherence due to cost in cross-sectional studies of the elderly and disabled, little information exists on the psychometric properties of these measures over time. OBJECTIVES: Examine the test-retest reliability of several recently published measures of cost-related medication nonadherence, among elderly community. METHODS: We developed a questionnaire and teste…
Cluster Randomized Trials
BACKGROUND: Cluster randomized trials (CRTs) offer unique advantages over standard randomized controlled clinical trials (RCTs) and observational methodologies, and may provide a cost-efficient alternative for answering questions about the best treatments for common conditions. OBJECTIVES: To describe health plan leaders' views on CRTs, identify barriers to conducting CRTs, and solicit recommendations for increasing the acceptability of CRTs. RES…
The Costs Associated With Adverse Drug Events Among Older Adults in the Ambulatory Setting
BACKGROUND: Reducing the rate of adverse drug events in the ambulatory setting may require large investments in quality improvement efforts and technologic innovations. Little evidence is available on the potential resulting savings. OBJECTIVE: The objective of this study was to estimate the costs associated with adverse drug events among older adults in the ambulatory setting. RESEARCH DESIGN: This study consisted of a 1-year retrospective cohor…
The Relationship Among Physicians’ Specialty, Perceptions of the Risks and Benefits of Adjuvant Tamoxifen Therapy, and Its Recommendation in Older Patients With Breast Cancer
OBJECTIVES: The objectives of this study were to determine whether tamoxifen recommendation differs by physician specialty, to determine whether perception affects tamoxifen recommendation, and to investigate the association between the physician's specialty and the perception of risks and benefits of tamoxifen. METHODS: We enrolled a cohort of geographically diverse women aged 65 and older with stage I through IIIa breast cancer in a prospective…
The Treating Physician as Active Gatekeeper in the Recruitment of Research Subjects
BACKGROUND: Institutional Review Boards vary in regard to the conditions imposed on investigators concerning contacting potential subjects to participate in health-services research studies. OBJECTIVE: The impact of more active involvement of the treating physician was examined in the approval process for recruiting study subjects. DESIGN: In recruiting subjects for a Massachusetts-based, multihospital (n = 17), health-services research study of …
Evaluation of a Formulary Switch From Conjugated to Esterified Estrogens in a Managed Care Setting
BACKGROUND: Formulary switches between agents in the same therapeutic class have become commonplace in the managed care setting as a strategy to reduce costs. OBJECTIVES: We evaluated the impact of a formulary switch from conjugated to esterified estrogen tablets at the Fallon Community Health Plan, a mixed-model health maintenance organization. DESIGN: A retrospective study was conducted with the use of the automated database of the health plan.…
The Effect of an Rx-to-OTC Switch on Medication Prescribing Patterns and Utilization of Physician Services
BACKGROUND: Prescription medications are being switched to over-the-counter (OTC) status with increasing frequency. Information is limited regarding the impact of OTC availability on the use of prescription forms of those products and on the utilization of health care services. OBJECTIVES: To determine the impact of OTC availability of H2-receptor antagonists on medication prescribing patterns and utilization of physician services among a populat…
Patient Noncompliance in the Managed Care Setting
OBJECTIVES: The authors identify demographic and clinical characteristics associated with noncompliance in patients beginning medical therapy for the treatment of glaucoma in a managed care setting. METHODS: The authors describe a retrospective cohort study in a group-model health maintenance organization in Massachusetts. Patients were members of the health maintenance organization who were newly initiated on topical drug therapy to treat open-a…
Compliance with antihypertensive therapy among elderly Medicaid enrollees
OBJECTIVES: This study measured compliance and related demographic factors in a retrospective cohort of 4068 elderly outpatients newly starting antihypertensive therapy from 1982 through 1988. METHODS: Logistic regression modeling of data from the New Jersey Medicaid program was used. RESULTS: These patients filled antihypertensive prescriptions covering an average of only 179 days in the 365-day follow-up period (49%) Good compliance (> or = 80%…
Treatment for glaucoma
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Compliance with antihypertensive therapy among elderly Medicaid enrollees
OBJECTIVES: This study measured compliance and related demographic factors in a retrospective cohort of 4068 elderly outpatients newly starting antihypertensive therapy from 1982 through 1988. METHODS: Logistic regression modeling of data from the New Jersey Medicaid program was used. RESULTS: These patients filled antihypertensive prescriptions covering an average of only 179 days in the 365-day follow-up period (49%) Good compliance (> or = 80%…
Treatment for glaucoma
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Treatment for glaucoma
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Compliance with antihypertensive therapy among elderly Medicaid enrollees
OBJECTIVES: This study measured compliance and related demographic factors in a retrospective cohort of 4068 elderly outpatients newly starting antihypertensive therapy from 1982 through 1988. METHODS: Logistic regression modeling of data from the New Jersey Medicaid program was used. RESULTS: These patients filled antihypertensive prescriptions covering an average of only 179 days in the 365-day follow-up period (49%) Good compliance (> or = 80%…
Patient Noncompliance in the Managed Care Setting
OBJECTIVES: The authors identify demographic and clinical characteristics associated with noncompliance in patients beginning medical therapy for the treatment of glaucoma in a managed care setting. METHODS: The authors describe a retrospective cohort study in a group-model health maintenance organization in Massachusetts. Patients were members of the health maintenance organization who were newly initiated on topical drug therapy to treat open-a…
The Effect of an Rx-to-OTC Switch on Medication Prescribing Patterns and Utilization of Physician Services
BACKGROUND: Prescription medications are being switched to over-the-counter (OTC) status with increasing frequency. Information is limited regarding the impact of OTC availability on the use of prescription forms of those products and on the utilization of health care services. OBJECTIVES: To determine the impact of OTC availability of H2-receptor antagonists on medication prescribing patterns and utilization of physician services among a populat…
Evaluation of a Formulary Switch From Conjugated to Esterified Estrogens in a Managed Care Setting
BACKGROUND: Formulary switches between agents in the same therapeutic class have become commonplace in the managed care setting as a strategy to reduce costs. OBJECTIVES: We evaluated the impact of a formulary switch from conjugated to esterified estrogen tablets at the Fallon Community Health Plan, a mixed-model health maintenance organization. DESIGN: A retrospective study was conducted with the use of the automated database of the health plan.…
The Treating Physician as Active Gatekeeper in the Recruitment of Research Subjects
BACKGROUND: Institutional Review Boards vary in regard to the conditions imposed on investigators concerning contacting potential subjects to participate in health-services research studies. OBJECTIVE: The impact of more active involvement of the treating physician was examined in the approval process for recruiting study subjects. DESIGN: In recruiting subjects for a Massachusetts-based, multihospital (n = 17), health-services research study of …
The Relationship Among Physicians’ Specialty, Perceptions of the Risks and Benefits of Adjuvant Tamoxifen Therapy, and Its Recommendation in Older Patients With Breast Cancer
OBJECTIVES: The objectives of this study were to determine whether tamoxifen recommendation differs by physician specialty, to determine whether perception affects tamoxifen recommendation, and to investigate the association between the physician's specialty and the perception of risks and benefits of tamoxifen. METHODS: We enrolled a cohort of geographically diverse women aged 65 and older with stage I through IIIa breast cancer in a prospective…
The Costs Associated With Adverse Drug Events Among Older Adults in the Ambulatory Setting
BACKGROUND: Reducing the rate of adverse drug events in the ambulatory setting may require large investments in quality improvement efforts and technologic innovations. Little evidence is available on the potential resulting savings. OBJECTIVE: The objective of this study was to estimate the costs associated with adverse drug events among older adults in the ambulatory setting. RESEARCH DESIGN: This study consisted of a 1-year retrospective cohor…
Cluster Randomized Trials
BACKGROUND: Cluster randomized trials (CRTs) offer unique advantages over standard randomized controlled clinical trials (RCTs) and observational methodologies, and may provide a cost-efficient alternative for answering questions about the best treatments for common conditions. OBJECTIVES: To describe health plan leaders' views on CRTs, identify barriers to conducting CRTs, and solicit recommendations for increasing the acceptability of CRTs. RES…
Reliability of New Measures of Cost-Related Medication Nonadherence
BACKGROUND: Although several national studies have attempted to measure medication nonadherence due to cost in cross-sectional studies of the elderly and disabled, little information exists on the psychometric properties of these measures over time. OBJECTIVES: Examine the test-retest reliability of several recently published measures of cost-related medication nonadherence, among elderly community. METHODS: We developed a questionnaire and teste…
Out-of-Pocket Burden of Health Care Spending and the Adequacy of the Medicare Part D Low-Income Subsidy
BACKGROUND: Evaluating the adequacy of Medicare prescription drug program (Part D) and its low-income subsidy (LIS) requires a comprehensive understanding of drug spending in relation to household resources. OBJECTIVE: : To estimate out-of-pocket health care costs in the year before Part D, in context of total household spending, health status, and LIS eligibility. RESEARCH DESIGN: Nationally representative cross-sectional study. SUBJECTS: Two th…
Medicare Part D and Changes in Prescription Drug Use and Cost Burden
CONTEXT: The full effect of Medicare Part D, after the initial policy transition period and across the United States Medicare population, remains unclear. OBJECTIVE: To estimate nationally representative changes in prescription drug use and out-of-pocket drug costs 2 years after implementation of Part D. DESIGN, SETTING, AND PARTICIPANTS: We examined study outcomes over 8 years (2000 to 2007) and estimated changes after Part D, accounting for ear…
The Exclusion of Older People from Participation in Cardiovascular Trials
Persistent Medication Affordability Problems Among Disabled Medicare Beneficiaries After Part D, 2006–2011
BACKGROUND: Disabled Americans who qualify for Medicare coverage typically have multiple chronic conditions, are highly dependent on effective drug therapy, and have limited financial resources, putting them at risk for cost-related medication nonadherence (CRN). Since 2006, the Part D benefit has helped Medicare beneficiaries afford medications. OBJECTIVE: To investigate recent national trends in medication affordability among this vulnerable po…
Antipsychotic Use in Nursing Homes Varies by Psychiatric Consultant
BACKGROUND: The relationship between psychiatric consultation and antipsychotic prescribing in nursing homes (NH) is unknown. OBJECTIVE: To identify the association between psychiatric consultant groups and NH-level antipsychotic prescribing after adjustment for resident case-mix and facility characteristics. RESEARCH DESIGN AND SUBJECTS: Nested cross-sectional study of 60 NHs in a cluster randomized trial. We linked facility leadership surveys t…
Affordability of Medical Care Among Medicare Enrollees
The findings of this study suggest that unaffordability of medical care is common among Medicare enrollees, especially those with lower incomes, or worse health, or who qualify for Medicare based on disability. Policy reforms, such as caps on patient spending, are needed to reduce Medical cost burdens on the most vulnerable enrollees
Cost-related Medication Nonadherence and Its Risk Factors Among Medicare Beneficiaries
BACKGROUND: Unaffordability of medications is a barrier to effective treatment. Cost-related nonadherence (CRN) is a crucial, widely used measure of medications access. OBJECTIVES: Our study examines the current national prevalence of and risk factors for CRN (eg, not filling, skipping or reducing doses) and companion measures in the US Medicare population. RESEARCH DESIGN: Survey-weighted analyses included logistic regression and trends 2006-201…
Approach to Multimorbidity Burden Classification and Outcomes in Older Adults With Heart Failure
BACKGROUND: The optimal approach to classifying multimorbidity burden in assessing treatment-associated outcomes using real-world data remains uncertain. We assessed whether 2 measurement approaches to characterize multimorbidity influenced observed associations of β-blocker use with outcomes in adults with heart failure (HF). METHODS: We conducted a retrospective study on adults with HF from 4 integrated health care delivery systems. Multimorbid…
Medicine (18 obras) · Internal Medicine (13 obras) · Internal Medicine (13 obras) · Health care (9 obras) · Medical prescription (9 obras) · Medication Adherence and Compliance (8 obras) · Environmental health (7 obras) · Family medicine (7 obras) · Population (7 obras) · Nursing (6 obras)