Cumulative Anticholinergic Exposure and Change in Gait Speed and Grip Strength in Older Adults.

Importance: Anticholinergics have been associated with functional decline in older adults. Past studies have assumed constant effects over time and have not considered the etiologically relevant exposure window.

Objective: To examine the association of anticholinergic exposure with gait speed and grip strength assuming constant and time-varying effects of daily exposure.

Associations of Pain Characteristics With Physical Capacity Trajectories Among Older Adults in the United States.

Objective: To investigate the associations of pain characteristics with trajectories of physical capacity in older adults and determined if bothersome and activity-limiting pain modified the association between the number of chronic conditions and trajectories of physical capacity.

Methods: We performed a cohort study with 6783 community-dwelling adults ≥65 years old who participated in the National Health and Aging Trends Study from 2011 to 2016. We assessed baseline pain characteristics and the number of self-reported chronic conditions (0 to 12) at baseline.

Brain metastases and mortality in patients with ALK + metastatic non-small cell lung cancer treated with second-generation ALK tyrosine kinase inhibitors as first-line targeted therapies: An observational cohort study.

Background: Brain metastases (BM) are common in patients with ALK + metastatic non-small cell lung cancer (mNSCLC). Limited contemporary real-world evidence exists on the burden of BM in these patients. This study estimated the cumulative incidence of BM in patients with ALK + mNSCLC treated with second-generation ALK tyrosine kinase inhibitors (TKI) as first-line (1L) targeted therapies and assessed the association between BM and mortality.

Pharmacy Integrated Transitions (PIT) trial: a protocol for a pragmatic cluster-randomised crossover trial.

Introduction: Ineffective coordination during care transitions from hospitals to skilled nursing facilities (SNFs) costs Medicare US$2.8-US$3.4 billion annually and results in avoidable adverse events.

Economic burden of cardiorespiratory hospitalizations associated with respiratory syncytial virus among United States adults in 2017-2019.

Morbidity and mortality caused by respiratory syncytial virus (RSV) in older adults and those with underlying health conditions can be potentially alleviated through vaccination. To assist vaccine policy decision-makers and payers, we estimated the annual economic burden of RSV-associated cardiorespiratory hospitalizations among insured US adults aged ≥18 y in the Merative MarketScan claims database from September through August of 2017-2018 and 2018-2019. Negative binomial regression models were used to estimate the number of RSV-associated cardiorespiratory hospitalizations using MarketScan-identified cardiorespiratory diagnosis codes in the presence or absence of RSV circulation per weekly laboratory test positivity percentages from the Centers for Disease Control and Prevention.

Association between Opioid-Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries.

Concurrent opioid (OPI) and benzodiazepine (BZD) use may exacerbate injurious fall risk (e.g., falls and fractures) compared to no use or use alone.

Incidence of Herpes Zoster and Postherpetic Neuralgia and Herpes Zoster Vaccination Uptake in a US Administrative Claims Database.

Background: The objective of this study was to estimate the annual incidence rates of herpes zoster (HZ) and postherpetic neuralgia (PHN) among individuals aged ≥19 years and the proportion who received HZ vaccination among those aged ≥50 years.

Methods: This observational cohort study was conducted with administrative claims data from HealthVerity and included insured individuals across the US. Crude and US age- and sex-standardized incidence rates of HZ and PHN were calculated from 1 January 2019 to 31 May 2022 by calendar year in persons aged ≥19 years.

Prevalence of Genital Herpes and Antiviral Treatment.

Background: Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus. Contemporary US population-based epidemiologic data on genital herpes are limited. This study aimed to provide nationally representative estimates of genital herpes prevalence and treatment using a large US health insurance claims database.

Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents.

Importance: Limited evidence exists on the association between initiation of antihypertensive medication and risk of fractures in older long-term nursing home residents.

Objective: To assess the association between antihypertensive medication initiation and risk of fracture.

Design, Setting, And Participants: This was a retrospective cohort study using target trial emulation for data derived from 29 648 older long-term care nursing home residents in the Veterans Health Administration (VA) from January 1, 2006, to October 31, 2019.

Temporal effect of imatinib adherence on time to remission in chronic myeloid leukemia patients.

Introduction: Adherence to imatinib in chronic myeloid leukemia (CML) patients is estimated to be as low as 70% despite its clinical benefit, and our understanding of the impact of nonadherence in this population is limited. This study presents a novel application of the Alternating Conditional Estimation (ACE) algorithm in newly diagnosed CML patients to map the full dose-response curve (DRC) and determine how the strength of this curve varies over time.

Methods: We applied the ACE algorithm alongside a backward elimination procedure to detect the presence of time dependence and nonlinearity in the relationship between imatinib adherence and time-to-remission.

Year-by-Year Blood Pressure Variability From Midlife to Death and Lifetime Dementia Risk.

Importance: High visit-to-visit blood pressure variability (BPV) in late life may reflect increased dementia risk better than mean systolic blood pressure (SBP). Evidence from midlife to late life could be crucial to understanding this association.

Objective: To determine whether visit-to-visit BPV at different ages was differentially associated with lifetime incident dementia risk in community-dwelling individuals.

Cognitive Impairment in Sexual and Gender Minority Groups: A Scoping Review of the Literature.

The purpose of this review was to synthesize evidence on differences in cognitive impairment by sexual orientation/gender identity (SOGI) status. A scoping review of the literature was conducted. Five databases (PubMed/Medline, Cumulated Index to Nursing and Allied Health Literature, Web of Science, PsycInfo, and Embase) were searched for primary articles comparing incidence or prevalence of cognitive impairment among sexual and gender minority (SGM) groups versus non-SGM groups.

New Users of Angiotensin II Receptor Blocker-Versus Angiotensin-Converting Enzyme Inhibitor-Based Antihypertensive Medication Regimens and Cardiovascular Disease Events: A Secondary Analysis of ACCORD-BP and SPRINT.

BACKGROUND Angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) block distinct components of the renin-angiotensin system. Whether this translates into differential effects on cardiovascular disease events remains unclear. METHODS AND RESULTS We used the ACCORD-BP (Action to Control Cardiovascular Risk in Diabetes-Blood Pressure) trial and the SPRINT (Systolic Blood Pressure Intervention Trial) to emulate target trials of new users of ARBs versus ACEIs on cardiovascular disease events (primary outcome) and death (secondary outcome).

Identifying Patients for Intensive Blood Pressure Treatment Based on Cognitive Benefit: A Secondary Analysis of the SPRINT Randomized Clinical Trial.

Importance: Intensive vs standard treatment to lower systolic blood pressure (SBP) reduces risk of mild cognitive impairment (MCI) or dementia; however, the magnitude of cognitive benefit likely varies among patients.

Objective: To estimate the magnitude of cognitive benefit of intensive vs standard systolic BP (SBP) treatment.

Design, Setting, And Participants: In this ad hoc secondary analysis of the Systolic Blood Pressure Intervention Trial (SPRINT), 9361 randomized clinical trial participants 50 years or older with high cardiovascular risk but without a history of diabetes, stroke, or dementia were followed up.

Community pharmacist intervention to optimize statin adherence in diabetes care: The GuIDE-S study.

Background: Statin use in people with type 2 diabetes (T2D) reduces cardiovascular events, yet adherence remains suboptimal.

Objective: This study evaluated the impact of a community pharmacist intervention on statin adherence in new users with T2D.

Methods: As part of a quasi-experimental study, community pharmacy staff proactively identified adult patients with T2D who were not prescribed a statin.

Provider knowledge, beliefs, and self-efficacy to deprescribe opioids and sedative-hypnotics.

Background: While many studies have assessed and measured patient attitudes toward deprescribing, less quantitative research has addressed the provider perspective. We thus sought to describe provider knowledge, beliefs, and self-efficacy to deprescribe, with a focus on opioids and sedative-hypnotics.

Methods: An electronic anonymous survey was distributed to primary care providers at Kaiser Permanente Washington.

Toward a broader concept of societal value: family spillovers in Alzheimer's disease.

Recognizing that the "healthcare sector perspective" can be too limited in some situations, the National Institute of Health and Care Excellence (NICE), Institute for Clinical and Economic Review (ICER), and the U.S. Second Panel on Cost-Effectiveness in Health and Medicine all recommend a "societal" perspective in "reference case" cost-effectiveness analyses (CEAs).

Community pharmacist intervention to close statin gaps in diabetes care: The GuIDE-S study.

Background: Statin therapy is recommended for people with type 2 diabetes (T2D) to lower cardiovascular risk; however, evidence suggests that significant gaps in statin therapy exist.

Objective: To evaluate (1) the impact of a community pharmacist-led model for initiating statin therapy in people with type 2 diabetes (T2D) on statin initiation and (2) pharmacists' self-reported perceptions of the intervention feasibility and fidelity to the intervention.

Methods: This was a type 1 hybrid effectiveness-implementation study of 9 intervention and 18 control pharmacies within a community pharmacy chain.

Risk of Mild Cognitive Impairment or Probable Dementia in New Users of Angiotensin II Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors: A Secondary Analysis of Data From the Systolic Blood Pressure Intervention Trial (SPRINT).

Importance: The cardiovascular and renal outcomes of angiotensin-II receptor blocker (ARB) and angiotensin-converting enzyme inhibitor (ACEI) treatment are well-known; however, few studies have evaluated initiation of these agents and cognitive impairment.

Objective: To emulate a target trial to evaluate the cognitive outcomes of initiating an ARB- vs ACEI-based antihypertensive regimen in individuals at risk for mild cognitive impairment (MCI) and probable dementia (PD).

Design, Setting, And Participants: Active comparator, new-user observational cohort study design using data from the Systolic Blood Pressure Intervention Trial (SPRINT), conducted November 2010 through July 2018.