Andy Russell, MD/MPH

UMich Integrated Fellow in Geriatrics & Palliative Medicine

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC Since sedation regimens were allowed to follow usual practice in both arms, it would be interesting to look at what those usual practices are & how they are determined.

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC Interesting finding consideration the study population was mostly AD, esp since Hwang et. al. (Neurology, 2021) showed higher concomitant antipsychotic use & 365d-mortality in PD pts on pimavanserin. Makes this a more appealing option for AD pts if $ weren't a concern

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC The utility of this intervention is esp. appealing during the pandemic. Given that the between-group differences were only significant for completed cases, would want to add extra measures to promote adherence... could then follow w/ a repeat intention-to-treat analysis!

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC Concerned about weight loss methylphenidate might cause. 14 in the drug arm vs. 8 in placebo lost weight w/ 10 vs. 6 having >7% loss. Notably no between-group differences in BMI at baseline or eating patterns at follow up based on the NPI scale. Would need to monitor closely

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC Good to know these interventions can improve physical performance in research setting months after discharge. Unfortunately limited in practice give current level of resources, but something to strive for.

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC Those on a BB 3yrs post-discharge have >25% higher rates of also being on RAAS blocker and/or statin suggesting an all-or-nothing approach in post-MI prescribing trends. Doesn't have to be this way, esp. given the little difference in long-term events between groups

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC The %pts treated w/ abx course was notably less for UTIs than for LRIs in both the intervention & control groups. Authors speculate that this was due to previous efforts to reduce UTI abx overuse. Perhaps similar interventions can help reduce overtreatment of LRIs

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC This study demonstrates the correlation between scores for different subtests across the BDST and CERAD-Plus despite how differently they are administered, providing evidence for the construct validity that these tests are measuring their purported cognitive domains

[Andy Russell, MD/MPH @ARussell065]

@GeriatricsJC The authors point out that out-of-pocket costs weren't included, which is especially important given the longer length of treatment among HaH pts. One study had found increased caregiver stress on admission... perhaps more information on financial burden can help address this?

[Kahli Zietlow @KahliGoBlue]

Meet our first year integrated @UMIntMed #geriatrics and #palliativecare fellow @ARussell065 who is working towards improved palliative and geriatric coordinated care in the outpatient setting.

We are so glad we could make you feel at home - even virtually!