Background: Addressing the needs of the geriatric population is critical, as “baby boomers” comprise a larger proportion of hospitalized patients. Hospitalists increasingly care for these complex geriatric patients. The “BEERS Criteria” are evidence-based guidelines that encourage medication safety by describing potentially inappropriate and harmful medications (PIMS) among geriatric patients. BEERS guidelines recommend that with a [...]

Background: Central nervous system medication (CNS med) use among older adults is associated with high morbidity and mortality. This study described patterns of CNS medication use, and identified people most likely to have CNS medications initiated or deprescribed around hospitalization. Methods: Retrospective cohort study using electronic health record data from 3-hospitals. Patients aged 65 years [...]

Background: Proton pump inhibitors (PPIs) have been associated with adverse events and increased mortality in patients diagnosed with cirrhosis (1). PPIs are commonly prescribed to patients with cirrhosis who present to the hospital with gastrointestinal bleeds (2). However, guidelines do not suggest routine usage of PPI in patients with cirrhosis without gastroesophageal reflux disease (GERD) [...]

Background: The volume of opioid prescriptions in the US has increased dramatically over the last two decades, and strong evidence suggests that this has perpetuated opioid misuse, addiction, overdose, and drug-related deaths. We aimed to learn if there are differences in opioid prescribing among generalist physicians, NPs, and PAs to Medicare beneficiaries. Methods: We performed [...]

Background: Acute otitis media (AOM) is a commonly overtreated pediatric diagnosis. Since 2014, the American Academy of Pediatrics (AAP) has recommended a ‘wait-and-see’ strategy and shorter antibiotic courses for mild or moderate AOM in qualifying patients. While this strategy has been successfully implemented in some pediatric emergency units (EUs), studies have shown that 30-90% of [...]

Background: Prescription opioids have come under increasing scrutiny in recent years due to the rise in use and misuse which has resulted in significant morbidity and mortality. There have been several efforts by government agencies to address this such as the FDA issuing a Risk Evaluation Mitigation Strategy (REMS) for extended release/long acting (ERLAs) opioids [...]

Background: Choice of agent for venous thromboembolism prophylaxis (VTEP) after joint arthroplasty is a complex decision, the difficulty of which has been compounded by divergent guidelines. Specifically, the adequacy of aspirin monotherapy (ASA) for VTEP has long been debated between the American Academy of Orthopaedic Surgeons (AAOS) and the American College of Chest Physicians (ACCP). [...]

Background: Patients, physicians and health technology developers are increasingly interested in mobile health applications. However, there are few examples of partnerships between hospitalists and the private companies to test novel health technologies in the inpatient setting.   Purpose: To test the feasibility and uptake of a Hospital-Medicine based program for prescribing mobile health applications to hospitalized [...]

Background: In an effort to combat the national opioid crisis, our state legislation passed House Bill 451 effective July 1, 2019. It addresses medication overprescribing to decrease morbidity and mortality from opioid misuse, abuse, and overdose. The law has several requirements including discussion of non-opioid treatment alternatives, review of the Prescription Monitoring Drug Program (PDMP) [...]

Background: Electronic prescribing (eRx) at discharge enhances safety and quality of care transitions. It results in improved medication adherence and a decreased chance of readmission. Stage 3 Meaningful Use goals include discharge eRx rates of greater than 25%. As of September 2017, our large academic medical center had a year-to-date discharge eRx rate of 18.3%, [...]