Christopher M Callahan
Dados Biográficos
| ID | 5535000 |
|---|---|
| NOME | Christopher M Callahan |
| PRENOMES | Christopher M |
| SOBRENOME | Callahan |
| ASSINATURA | CALLAHAN C M |
| AFILIAÇÕES | Regenstrief Institute |
| ORCID | 0000-0002-4617-6672 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 18 |
| TOTAL DE CITAÇÕES | 17 |
| TOTAL COMO AUTOR | 18 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1994 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2024 |
| ÍNDICE H | 2 |
Building the Infrastructure to Integrate Social Care in a Safety Net Health System
A recent National Academies report recommended that health systems invest in new infrastructure to integrate social and medical care. Although many health systems routinely screen patients for social concerns, few health systems achieve the recommended model of integration. In this critical case study in an urban safety net health system, we describe the human capital, operational redesign, and financial investment needed to implement the Nationa…
Depression and Anxiety Screens as Predictors of 8-Year Incidence of Myocardial Infarction and Stroke in Primary Care Patients
OBJECTIVE: Because depression and anxiety are typically studied in isolation, our purpose was to examine the relative importance of these overlapping emotional factors in predicting incident cardiovascular disease (CVD). METHODS: We examined depression and anxiety screens, and their individual items, as predictors of incident hard CVD events, myocardial infarction, and stroke for 8 years in a diverse sample of 2041 older primary care patients ini…
Sex and Race Differences in the Relationship between Obesity and C-Reactive Protein
C-reactive protein (CRP) is a risk factor for cardiovascular disease and mortality; it is known to be positively associated with obesity but there is some evidence that this association differs by race or sex. We used nationally representative data of adults aged >50 years to investigate sex and race modifiers of the associations between obesity and CRP in non-Hispanic White males (n=3,517) and females (n=4,658), and non-Hispanic Black males (n=4…
Age Differences in the Association Between Body Mass Index Class and Annualized Medicare Expenditures
Excess Medicare expenditures related to obesity may be concentrated among severely obese young-old adults. Preventing severe obesity among middle and older aged adults may have large cost implications for society
Effect of Collaborative Care for Depression on Risk of Cardiovascular Events
OBJECTIVE: Although depression is a risk and prognostic factor for cardiovascular disease (CVD), depression trials involving cardiac patients have not observed the anticipated cardiovascular benefits. To test our hypothesis that depression treatment delivered before clinical CVD onset reduces risk of CVD events, we conducted an 8-year follow-up study of the Indiana sites of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) r…
Depressive Symptom Clusters as Predictors of Incident Coronary Artery Disease
OBJECTIVE: Because it is not known whether particular clusters of depressive symptoms are associated with a greater risk of adverse cardiac outcomes, we compared the utility of four clusters in predicting incident coronary artery disease (CAD) events during a 15-year period in a large cohort of primary care patients 60 years and older. METHODS: Participants were 2537 primary care patients 60 years or older who were screened for depression between…
Impact of Dementia on Payments for Long-term and Acute Care in an Elderly Cohort
BACKGROUND: Older people with dementia have increased risk of nursing home (NH) use and higher Medicaid payments. Dementia's impact on acute care use and Medicare payments is less well understood. OBJECTIVES: Identify trajectories of incident dementia and NH use, and compare Medicare and Medicaid payments for persons having different trajectories. RESEARCH DESIGN: Retrospective cohort of older patients who were screened for dementia in 2000-2004 …
The Meaning and Significance of Self-Management Among Socioeconomically Vulnerable Older Adults
Improved understanding of the role of social context in expectations regarding aging, and awareness of and priorities for self-management, could lead to improvements in self-management support and thus chronic care outcomes
Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9
BACKGROUND: Although effective treatment of depressed patients requires regular follow-up contacts and symptom monitoring, an efficient method for assessing treatment outcome is lacking. We investigated responsiveness to treatment, reproducibility, and minimal clinically important difference of the Patient Health Questionnaire-9 (PHQ-9), a standard instrument for diagnosing depression in primary care. METHODS: This study included 434 intervention…
Collaborative Care Management of Late-Life Depression in the Primary Care Setting
CONTEXT: Few depressed older adults receive effective treatment in primary care settings. OBJECTIVE: To determine the effectiveness of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) collaborative care management program for late-life depression. DESIGN: Randomized controlled trial with recruitment from July 1999 to August 2001. SETTING: Eighteen primary care clinics from 8 health care organizations in 5 states. PARTICIPAN…
Six-Item Screener to Identify Cognitive Impairment Among Potential Subjects for Clinical Research
OBJECTIVE: To design a brief cognitive screener with acceptable sensitivity and specificity for identifying subjects with cognitive impairment. DESIGN: Cohort one is assembled from a community-based survey coupled with a second-stage diagnostic evaluation using formal diagnostic criteria for dementia. Cohort two is assembled from referrals to a specialty clinic for dementing disorders that completed the same diagnostic evaluation. SETTING: Urban …
Improving Primary Care for Depression in Late Life
BACKGROUND: Late life depression can be successfully treated with antidepressant medications or psychotherapy, but few depressed older adults receive effective treatment. RESEARCH DESIGN: A randomized controlled trial of a disease management program for late life depression. SUBJECTS: Approximately 1,750 older adults with major depression or dysthymia are recruited from seven national study sites. INTERVENTION: Half of the subjects are randomly a…
Quality Improvement Research on Late Life Depression in Primary Care
BACKGROUND: Two million older Americans suffer from depression annually. Depression causes more functional impairment than many other common medical conditions and older adults have the highest rate of suicide in the United States. Although many of these patients fail to seek or fail to receive care for depression, the majority will be seen in primary care for the treatment of other conditions. OBJECTIVE: To review the health services research on…
Improving Quality of Care for Depression in Primary Care
From the Indiana University Center for Aging Research, Regenstrief Institute for Health Care, Indiana University School of Medicine, Indianapolis. Dr. Callahan is a Beeson Physician Faculty Scholar in Aging and is supported by a grant from the John H. Hartford Foundation, Inc. and the National Institute on Aging (grant No. 98308-G). Address correspondence to: Christopher M. Callahan, MD, Indiana University Center for Aging Research, Regenstrief I…
Accuracy of Self-Reported Health Services Use and Patterns of Care Among Urban Older Adults
BACKGROUND: Understanding older adults' volume and patterns of health service use is fundamental to efforts to improve the quality and efficiency of services. OBJECTIVE: To analyze the accuracy of older adults' self report of health services use and to determine the proportion of care obtained outside a defined urban academic health care system. RESEARCH DESIGN: Telephone survey of self-reports validated against data routinely archived in an elec…
Consistency and Change in Functional Status among Older Adults Over lime
Consistency and change between 1984 and the last reinterview (either two, four, or six years later) on 22 individual functional status markers and the five summary scales that they form are examined among the 5,986 members of the Longitudinal Study on Aging who were reinterviewed at least once. At baseline, at least three-fifths of the respondents are without limitations on any individual marker. At the last reinterview, at least 43.4% of the res…
Predicting Hospital Costs Among Older Decedents Over Time
To explain the variation in total real hospital costs among elderly patients who died between 1984 and 1991, a cohort analytic study of the nationally representative sample of elderly subjects included in the Longitudinal Study on Aging (N = 7,527) was carried out. The cohort comprised the subset of 1,778 community-dwelling Americans who were age 70 years and older in 1984, had one or more subsequent hospital episodes, and died by 1991. Hospital …
The Effect of Gender and Race on the Measurement Properties of the CES-D in Older Adults
Having observed a three-fold difference in the prevalence of significant symptoms of depression among four race-gender groups of elderly adults attending an urban primary care practice, we investigated the extent to which these differences might be explained by variability in the measurement properties of the Centers for Epidemiologic Studies depression scale (CES-D). Although the internal consistency of the CES-D was acceptable for all groups, 5…
Consistency and Change in Functional Status among Older Adults Over lime
Consistency and change between 1984 and the last reinterview (either two, four, or six years later) on 22 individual functional status markers and the five summary scales that they form are examined among the 5,986 members of the Longitudinal Study on Aging who were reinterviewed at least once. At baseline, at least three-fifths of the respondents are without limitations on any individual marker. At the last reinterview, at least 43.4% of the res…
The Meaning and Significance of Self-Management Among Socioeconomically Vulnerable Older Adults
Improved understanding of the role of social context in expectations regarding aging, and awareness of and priorities for self-management, could lead to improvements in self-management support and thus chronic care outcomes
The Effect of Gender and Race on the Measurement Properties of the CES-D in Older Adults
Having observed a three-fold difference in the prevalence of significant symptoms of depression among four race-gender groups of elderly adults attending an urban primary care practice, we investigated the extent to which these differences might be explained by variability in the measurement properties of the Centers for Epidemiologic Studies depression scale (CES-D). Although the internal consistency of the CES-D was acceptable for all groups, 5…
Predicting Hospital Costs Among Older Decedents Over Time
To explain the variation in total real hospital costs among elderly patients who died between 1984 and 1991, a cohort analytic study of the nationally representative sample of elderly subjects included in the Longitudinal Study on Aging (N = 7,527) was carried out. The cohort comprised the subset of 1,778 community-dwelling Americans who were age 70 years and older in 1984, had one or more subsequent hospital episodes, and died by 1991. Hospital …
Consistency and Change in Functional Status among Older Adults Over lime
Consistency and change between 1984 and the last reinterview (either two, four, or six years later) on 22 individual functional status markers and the five summary scales that they form are examined among the 5,986 members of the Longitudinal Study on Aging who were reinterviewed at least once. At baseline, at least three-fifths of the respondents are without limitations on any individual marker. At the last reinterview, at least 43.4% of the res…
Accuracy of Self-Reported Health Services Use and Patterns of Care Among Urban Older Adults
BACKGROUND: Understanding older adults' volume and patterns of health service use is fundamental to efforts to improve the quality and efficiency of services. OBJECTIVE: To analyze the accuracy of older adults' self report of health services use and to determine the proportion of care obtained outside a defined urban academic health care system. RESEARCH DESIGN: Telephone survey of self-reports validated against data routinely archived in an elec…
Improving Quality of Care for Depression in Primary Care
From the Indiana University Center for Aging Research, Regenstrief Institute for Health Care, Indiana University School of Medicine, Indianapolis. Dr. Callahan is a Beeson Physician Faculty Scholar in Aging and is supported by a grant from the John H. Hartford Foundation, Inc. and the National Institute on Aging (grant No. 98308-G). Address correspondence to: Christopher M. Callahan, MD, Indiana University Center for Aging Research, Regenstrief I…
Improving Primary Care for Depression in Late Life
BACKGROUND: Late life depression can be successfully treated with antidepressant medications or psychotherapy, but few depressed older adults receive effective treatment. RESEARCH DESIGN: A randomized controlled trial of a disease management program for late life depression. SUBJECTS: Approximately 1,750 older adults with major depression or dysthymia are recruited from seven national study sites. INTERVENTION: Half of the subjects are randomly a…
Quality Improvement Research on Late Life Depression in Primary Care
BACKGROUND: Two million older Americans suffer from depression annually. Depression causes more functional impairment than many other common medical conditions and older adults have the highest rate of suicide in the United States. Although many of these patients fail to seek or fail to receive care for depression, the majority will be seen in primary care for the treatment of other conditions. OBJECTIVE: To review the health services research on…
Collaborative Care Management of Late-Life Depression in the Primary Care Setting
CONTEXT: Few depressed older adults receive effective treatment in primary care settings. OBJECTIVE: To determine the effectiveness of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) collaborative care management program for late-life depression. DESIGN: Randomized controlled trial with recruitment from July 1999 to August 2001. SETTING: Eighteen primary care clinics from 8 health care organizations in 5 states. PARTICIPAN…
Six-Item Screener to Identify Cognitive Impairment Among Potential Subjects for Clinical Research
OBJECTIVE: To design a brief cognitive screener with acceptable sensitivity and specificity for identifying subjects with cognitive impairment. DESIGN: Cohort one is assembled from a community-based survey coupled with a second-stage diagnostic evaluation using formal diagnostic criteria for dementia. Cohort two is assembled from referrals to a specialty clinic for dementing disorders that completed the same diagnostic evaluation. SETTING: Urban …
Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9
BACKGROUND: Although effective treatment of depressed patients requires regular follow-up contacts and symptom monitoring, an efficient method for assessing treatment outcome is lacking. We investigated responsiveness to treatment, reproducibility, and minimal clinically important difference of the Patient Health Questionnaire-9 (PHQ-9), a standard instrument for diagnosing depression in primary care. METHODS: This study included 434 intervention…
The Meaning and Significance of Self-Management Among Socioeconomically Vulnerable Older Adults
Improved understanding of the role of social context in expectations regarding aging, and awareness of and priorities for self-management, could lead to improvements in self-management support and thus chronic care outcomes
Impact of Dementia on Payments for Long-term and Acute Care in an Elderly Cohort
BACKGROUND: Older people with dementia have increased risk of nursing home (NH) use and higher Medicaid payments. Dementia's impact on acute care use and Medicare payments is less well understood. OBJECTIVES: Identify trajectories of incident dementia and NH use, and compare Medicare and Medicaid payments for persons having different trajectories. RESEARCH DESIGN: Retrospective cohort of older patients who were screened for dementia in 2000-2004 …
Effect of Collaborative Care for Depression on Risk of Cardiovascular Events
OBJECTIVE: Although depression is a risk and prognostic factor for cardiovascular disease (CVD), depression trials involving cardiac patients have not observed the anticipated cardiovascular benefits. To test our hypothesis that depression treatment delivered before clinical CVD onset reduces risk of CVD events, we conducted an 8-year follow-up study of the Indiana sites of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) r…
Depressive Symptom Clusters as Predictors of Incident Coronary Artery Disease
OBJECTIVE: Because it is not known whether particular clusters of depressive symptoms are associated with a greater risk of adverse cardiac outcomes, we compared the utility of four clusters in predicting incident coronary artery disease (CAD) events during a 15-year period in a large cohort of primary care patients 60 years and older. METHODS: Participants were 2537 primary care patients 60 years or older who were screened for depression between…
Age Differences in the Association Between Body Mass Index Class and Annualized Medicare Expenditures
Excess Medicare expenditures related to obesity may be concentrated among severely obese young-old adults. Preventing severe obesity among middle and older aged adults may have large cost implications for society
Depression and Anxiety Screens as Predictors of 8-Year Incidence of Myocardial Infarction and Stroke in Primary Care Patients
OBJECTIVE: Because depression and anxiety are typically studied in isolation, our purpose was to examine the relative importance of these overlapping emotional factors in predicting incident cardiovascular disease (CVD). METHODS: We examined depression and anxiety screens, and their individual items, as predictors of incident hard CVD events, myocardial infarction, and stroke for 8 years in a diverse sample of 2041 older primary care patients ini…
Sex and Race Differences in the Relationship between Obesity and C-Reactive Protein
C-reactive protein (CRP) is a risk factor for cardiovascular disease and mortality; it is known to be positively associated with obesity but there is some evidence that this association differs by race or sex. We used nationally representative data of adults aged >50 years to investigate sex and race modifiers of the associations between obesity and CRP in non-Hispanic White males (n=3,517) and females (n=4,658), and non-Hispanic Black males (n=4…
Building the Infrastructure to Integrate Social Care in a Safety Net Health System
A recent National Academies report recommended that health systems invest in new infrastructure to integrate social and medical care. Although many health systems routinely screen patients for social concerns, few health systems achieve the recommended model of integration. In this critical case study in an urban safety net health system, we describe the human capital, operational redesign, and financial investment needed to implement the Nationa…
Medicine (18 obras) · Internal Medicine (10 obras) · Gerontology (9 obras) · Internal Medicine (9 obras) · Psychiatry (9 obras) · Health care (8 obras) · Depression (economics) (6 obras) · Gerontology (6 obras) · Nursing (6 obras) · Demography (5 obras)