The Meyers Primary Care Institute (MPCI) was established in 1996, as a joint endeavor of the University of Massachusetts Medical School, Reliant Medical Group (previously Fallon Clinic), and Fallon Community Health Plan. The MPCI is committed to research across the lifespan, from childhood to advanced age. We conduct population-based research to inform policy and practice, promoting evidence-based care for the benefit of our community, and beyond. Our team is comprised of a multidisciplinary group of investigators and educators, who focus on the following topic areas: Patient safety and quality improvement; Communication in healthcare; Organization and delivery of healthcare; Healthcare policy; Epidemiology of chronic diseases; Pharmacoepidemiology and medication safety; Comparative effectiveness research.

The Meyers Primary Care Institute honors the memory of Dr. John Meyers, who served as President of Fallon Clinic from 1966-1982, and President of Fallon Community Health Plan from 1976-1985. He was an esteemed member of the faculty of the University of Massachusetts Medical School. Dr. Meyers was highly regarded as a physician leader, a caring clinician, a well-respected scholar, and an accomplished artist.

This collection showcases journal articles and other publications and presentations authored by Meyers faculty.

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Publications from 1999

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Agreement between drug treatment data and a discharge diagnosis of diabetes mellitus in the elderly., Robert J. Glynn, Mark Monane, Jerry H. Gurwitz, Igor Choodnovskiy, and Jerry Avorn

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Prehospital delay in patients hospitalized with heart attack symptoms in the United States: the REACT trial. Rapid Early Action for Coronary Treatment (REACT) Study Group, David C. Goff, Henry A. Feldman, Paul G. McGovern, Robert J. Goldberg, Denise G. Simons-Morton, Carol E. Cornell, Stavroula K. Osganian, Lawton S. Cooper, and Jerris R. Hedges

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Disseminating the results of clinical trials to community-based practitioners: is anyone listening?, Robert J. Goldberg and Jerry H. Gurwitz

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Duration of, and temporal trends (1994-1997) in, prehospital delay in patients with acute myocardial infarction: the second National Registry of Myocardial Infarction, Robert J. Goldberg, Jerry H. Gurwitz, and Joel M. Gore

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Assessing the population burden from heart failure: need for sentinel population-based surveillance systems, Robert J. Goldberg and Marvin A. Konstam

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Temporal trends in cardiogenic shock complicating acute myocardial infarction, Robert J. Goldberg, Navid A. Samad, Jorge L. Yarzebski, Jerry H. Gurwitz, Carol Bigelow, and Joel M. Gore

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Coronary Heart Disease: Epidemiology, Risk Factors, and Temporal Trends, Robert J. Goldberg and Jorge L. Yarzebski

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A two-decades (1975 to 1995) long experience in the incidence, in-hospital and long-term case-fatality rates of acute myocardial infarction: a community-wide perspective, Robert J. Goldberg, Jorge L. Yarzebski, Darleen M. Lessard, and Joel M. Gore

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Health care quality, the older patient, and the primary care physician, Jerry H. Gurwitz and Paula A. Rochon

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Knowledge, patterns of care, and outcomes of care for generalists and specialists., Leslie R. Harrold, Terry S. Field, and Jerry H. Gurwitz

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The effect of a domestic violence interclerkship on the knowledge, attitudes, and skills of third-year medical students, Julie A. Jonassen, Michele P. Pugnaire, Kathleen M. Mazor, Mary Beth Regan, E. W. Jacobson, Wendy L. Gammon, D. G. Doepel, and A. J. Cohen

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Use of a mini-grant program to stimulate generalist training at the University of Massachusetts Medical Center, Daniel H. Lasser, Alan Chuman, Emily Ferrara, and Jerry H. Gurwitz

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Formative research methods to understand patient and provider responses to heart attack symptoms, Laura Leviton, John R. Finnegan Jr., Jane G. Zapka, Hendrika Meischke, Barbara B. Estabrook, Janice Gilliland, Adriana C. Linares, Elissa R. Weitzman, James M. Raczynski, and Elaine J. Stone

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Undertreatment of hyperlipidemia in the secondary prevention of coronary artery disease., Sumit R. Majumdar, Jerry H. Gurwitz, and Stephen B. Soumerai

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The dependability of students' ratings of preceptors, Kathleen M. Mazor, B. Clauser, A. J. Cohen, Eric J. Alper, and Michele P. Pugnaire

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Variation in length of hospital stay in patients with community-acquired pneumonia: are shorter stays associated with worse medical outcomes, Danny McCormick, Michael J. Fine, Christopher M. Coley, Thomas J. Marrie, Judith R. Lave, D. Scott Obrosky, Wishwa N. Kapoor, and Daniel E. Singer

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Long-term anticoagulation therapy for atrial fibrillation in elderly patients: efficacy, risk, and current patterns of use., Danny McCormick, Jerry H. Gurwitz, Robert J. Goldberg, and Jack E. Ansell

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Use of aspirin, beta-blockers, and lipid-lowering medications before recurrent acute myocardial infarction: missed opportunities for prevention, Danny McCormick, Jerry H. Gurwitz, Darleen M. Lessard, Jorge L. Yarzebski, Joel M. Gore, and Robert J. Goldberg

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Differences in discharge medication after acute myocardial infarction in patients with HMO and fee-for-service medical insurance, Danny McCormick, Jerry H. Gurwitz, Judith A. Savageau, Jorge L. Yarzebski, Joel M. Gore, and Robert J. Goldberg

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Delayed thrombolytic treatment of older patients with acute myocardial infarction., Thomas J. McLaughlin, Jerry H. Gurwitz, Donald J. Willison, Xiaoming Gao, and Stephen B. Soumerai

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Recent aspirin use is associated with smaller myocardial infarct size and lower likelihood of Q-wave infarction, Kenneth J. Mukamal, Murray A. Mittleman, Malcolm Maclure, Jane B. Sherwood, Robert J. Goldberg, and James E. Muller

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Misclassification and under-reporting of acute myocardial infarction by elderly persons: implications for community-based observational studies and clinical trials., Christopher J. O'Donnell, Robert J. Glynn, Terry S. Field, Randy Averback, Suzanne Satterfield, Gottlieb C. Friesenger, James O. Taylor, and Charles H. Hennekens

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REACT theory-based intervention to reduce treatment-seeking delay for acute myocardial infarction. Rapid Early Action for Coronary Treatment, James M. Raczynski, John R. Finnegan Jr., Jane G. Zapka, Hendrika Meischke, Angela Meshack, Elaine J. Stone, Neil Bracht, Deborah E. Sellers, Mohamud Daya, Mark Robbins, Alfred McAlister, and Denise G. Simons-Morton

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Use of beta-blocker therapy in older patients after acute myocardial infarction in Ontario., Paula A. Rochon, Geoffrey M. Anderson, Jack V. Tu, Jocalyn P. Clark, Jerry H. Gurwitz, John Paul Szalai, and Paula Lau

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Age- and gender-related use of low-dose drug therapy: the need to manufacture low-dose therapy and evaluate the minimum effective dose., Paula A. Rochon, Geoffrey M. Anderson, Jack V. Tu, Jerry H. Gurwitz, Jocalyn P. Clark, Neil H. Shear, and Paula Lau

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Challenges of prescribing low-dose drug therapy for older people., Paula A. Rochon, Jocalyn P. Clark, and Jerry H. Gurwitz

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Prescribing for seniors: neither too much nor too little., Paula A. Rochon and Jerry H. Gurwitz

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Use of hormone replacement therapy in Washington State: is prevention being put into practice, Barry G. Saver, Thomas R. Taylor, and Nancy F. Woods

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Risk factors for a decline in upper body function following treatment for early stage breast cancer, Rebecca A. Silliman, Marianne N. Prout, Terry S. Field, Susan C. Kalish, and Theodore Colton

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Timeliness and quality of care for elderly patients with acute myocardial infarction under health maintenance organization vs fee-for-service insurance., Stephen B. Soumerai, Thomas J. McLaughlin, Jerry H. Gurwitz, Steven Pearson, Cindy L. Christiansen, Catherine Borbas, Nora Morris, Barbara McLaughlin, Xiaoming Gao, and Dennis Ross-Degnan

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Twenty year trends (1975-1995) in the incidence, in-hospital and long-term death rates associated with heart failure complicating acute myocardial infarction: a community-wide perspective, Frederick A. Spencer, Theo E. Meyer, Robert J. Goldberg, Jorge L. Yarzebski, Mark Hatton, Darleen M. Lessard, and Joel M. Gore

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Head Start: A Setting for Asthma Outreach and Prevention, Kathleen E. Walsh, Cynthia S. Kelly, and Ardythe L. Morrow

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HIV-risk practices among homeless and low-income housed mothers, Linda F. Weinreb, Robert J. Goldberg, Darleen M. Lessard, Jennifer N. Perloff, and Ellen L. Bassuk

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Health care providers' perspectives on patient delay for seeking care for symptoms of acute myocardial infarction, Jane G. Zapka, Barbara Estabrook, Janice Gilliland, Laura Leviton, Hendrika Meischke, Sharon Melville, Judy Taylor, Mohamud Daya, Brian Laing, Angela Meshack, Roy Reyna, Mark Robbins, Mary M. Hand, and John R. Finnegan Jr.

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The perceptions and practices of pediatricians: tobacco intervention, Jane G. Zapka, Kenneth E. Fletcher, Lori Pbert, Susan Druker, Judith K. Ockene, and Liping Chen

Publications from 1998

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Comparative safety evaluation of non-narcotic analgesics, Susan E. Andrade, Carlos Martinez, and Alexander M. Walker

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Lamotrigine and severe skin eruptions, James G. Donahue, Susan E. Andrade, E. M. Cain, T. A. Defor, Michael J. Goodman, Jerry H. Gurwitz, and Richard Platt

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Introducing managed care to the medical school curriculum: effect on student attitudes, Terry S. Field, Robert A. Baldor, Linda Casey, Alan Chuman, Daniel H. Lasser, Alan M. Ehrlich, and Jerry H. Gurwitz

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Age-related trends in short- and long-term survival after acute myocardial infarction: a 20-year population-based perspective (1975-1995)., Robert J. Goldberg, Danny McCormick, Jerry H. Gurwitz, Jorge L. Yarzebski, Darleen M. Lessard, and Joel M. Gore

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Impact of time to treatment with tissue plasminogen activator on morbidity and mortality following acute myocardial infarction (The second National Registry of Myocardial Infarction)., Robert J. Goldberg, Michael Mooradd, Jerry H. Gurwitz, William J. Rogers, William J. French, Hal V. Barron, and Joel M. Gore

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Sex differences in symptom presentation associated with acute myocardial infarction: a population-based perspective, Robert J. Goldberg, Caitlin O'Donnell, Jorge L. Yarzebski, Carol Bigelow, Judith A. Savageau, and Joel M. Gore

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The quality of care for treatment of early stage breast carcinoma: is it consistent with national guidelines?, Edward Guadagnoli, Charles L. Shapiro, Jane C. Weeks, Jerry H. Gurwitz, Catherine Borbas, and Stephen B. Soumerai

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Use of breast-conserving surgery for treatment of stage I and stage II breast cancer., Edward Guadagnoli, Jane C. Weeks, Charles L. Shapiro, Jerry H. Gurwitz, Catherine Borbas, and Stephen B. Soumerai

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Risk for intracranial hemorrhage after tissue plasminogen activator treatment for acute myocardial infarction. Participants in the National Registry of Myocardial Infarction 2, Jerry H. Gurwitz, Joel M. Gore, Robert J. Goldberg, Hal V. Barron, Timothy Breen, Amy Chen Rundle, Michael A. Sloan, William J. French, and William J. Rogers

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Patient noncompliance in the managed care setting. The case of medical therapy for glaucoma., Jerry H. Gurwitz, Susan M. Yeomans, Robert J. Glynn, Barbara E. Lewis, Raisa Levin, and Jerry Avorn

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Assessment of chest pain onset and out-of-hospital delay using standardized interview questions: the REACT Pilot Study. Rapid Early Action for Coronary Treatment (REACT) Study Group, Jerris R. Hedges, N.Clay Mann, Hendrika Meischke, Mark Robbins, Robert J. Goldberg, and Jane G. Zapka

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Vitamin E and vitamin C supplement use and risk of incident Alzheimer disease., Martha Clare Morris, Laurel A. Beckett, Paul A. Scherr, Liesi E. Hebert, David A. Bennett, Terry S. Field, and Denis A. Evans

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Reporting of gender-related information in clinical trials of drug therapy for myocardial infarction., Paula A. Rochon, Jocalyn P. Clark, Malcolm A. Binns, Vishal Patel, and Jerry H. Gurwitz

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Rapid early action for coronary treatment: rationale, design, and baseline characteristics. REACT Research Group, Denise G. Simons-Morton, David C. Goff, Stavroula K. Osganian, Robert J. Goldberg, James M. Raczynski, John R. Finnegan, Jane G. Zapka, Mickey S. Eisenberg, Michael A. Proschan, Henry A. Feldman, Jerris R. Hedges, and Russell V. Luepker

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Effect of local medical opinion leaders on quality of care for acute myocardial infarction: a randomized controlled trial., Stephen B. Soumerai, Thomas J. McLaughlin, Jerry H. Gurwitz, Edward Guadagnoli, Paul J. Hauptman, Catherine Borbas, Nora Morris, Barbara McLaughlin, Xiaoming Gao, Donald J. Willison, Richard Asinger, and Fredarick Gobel

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Determinants of health and service use patterns in homeless and low-income housed children, Linda F. Weinreb, Robert J. Goldberg, Ellen L. Bassuk, and Jennifer N. Perloff

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Health characteristics and medical service use patterns of sheltered homeless and low-income housed mothers, Linda F. Weinreb, Robert J. Goldberg, and Jennifer N. Perloff

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Consultation between cardiologists and generalists in the management of acute myocardial infarction: implications for quality of care., Donald J. Willison, Stephen B. Soumerai, Thomas J. McLaughlin, Jerry H. Gurwitz, Xiaoming Gao, Edward Guadagnoli, Steven Pearson, Paul J. Hauptman, and Barbara McLaughlin

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Deciding about hormone therapy: validation of a model, Nancy F. Woods, Sharon Falk, Barry G. Saver, Thomas R. Taylor, Nancy Grey Stevens, and Aileen MacLaren

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Attitudes toward menopause and hormone therapy among women with access to health care, Nancy F. Woods, Barry G. Saver, and Thomas R. Taylor

Publications from 1997

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Age-related trends (1986-1993) in the use of thrombolytic agents in patients with acute myocardial infarction. The Worcester Heart Attack Study, Harish Chandra, Jorge L. Yarzebski, Robert J. Goldberg, Judith A. Savageau, Colleen Singleton, Jerry H. Gurwitz, and Joel M. Gore

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Weight loss in people with Alzheimer's disease: a prospective population based analysis., Diane Cronin-Stubbs, Laurel A. Beckett, Paul A. Scherr, Terry S. Field, Marilyn J. Chown, David M. Pilgrim, David A. Bennett, and Denis A. Evans

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Apolipoprotein E epsilon4 and incidence of Alzheimer disease in a community population of older persons., Denis A. Evans, Laurel A. Beckett, Terry S. Field, Lin Feng, Marilyn S. Albert, David A. Bennett, Benjamin Tycko, and Richard Mayeux

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Factors Associated with Prehospital Delay and Overview of Community Trials to Reduce the Duration of Prehospital Delay in Patients with Symptoms of Acute Coronary Disease, Robert J. Goldberg and Voula Osganian

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Coronary thrombolysis for the elderly. Is clinical practice really lagging behind evidence of benefit?, Jerry H. Gurwitz and Robert J. Goldberg

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Thiazide diuretics and the initiation of anti-gout therapy., Jerry H. Gurwitz, Susan C. Kalish, Rhonda L. Bohn, Robert J. Glynn, Mark Monane, Helen Mogun, and Jerry Avorn

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Delayed hospital presentation in patients who have had acute myocardial infarction., Jerry H. Gurwitz, Thomas J. McLaughlin, Donald J. Willison, Edward Guadagnoli, Paul J. Hauptman, Xiaoming Gao, and Stephen B. Soumerai

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Atrial fibrillation and stroke prevention with warfarin in the long-term care setting., Jerry H. Gurwitz, Johanne Monette, Paula A. Rochon, Marie A. Eckler, and Jerry Avorn

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How do older persons define constipation? Implications for therapeutic management., Danielle Harari, Jerry H. Gurwitz, Jerry Avorn, Rhonda L. Bohn, and Kenneth L. Minaker

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Constipation-related symptoms and bowel program concerning individuals with spinal cord injury., Danielle Harari, M. Sarkarati, Jerry H. Gurwitz, G. McGlinchey-Berroth, and Kenneth L. Minaker

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The effect of comorbidity on use of thrombolysis or aspirin in patients with acute myocardial infarction eligible for treatment., Thomas J. McLaughlin, Stephen B. Soumerai, Donald J. Willison, Jerry H. Gurwitz, Xiaoming Gao, Catherine Borbas, and Fredarick Gobel

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The effects of initial drug choice and comorbidity on antihypertensive therapy compliance: results from a population-based study in the elderly., Mark Monane, Rhonda L. Bohn, Jerry H. Gurwitz, Robert J. Glynn, Raisa Levin, and Jerry Avorn

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The impact of thiazide diuretics on the initiation of lipid-reducing agents in older people: a population-based analysis., Mark Monane, Jerry H. Gurwitz, Rhonda L. Bohn, Robert J. Glynn, Raisa Levin, Johanne Monette, and Jerry Avorn

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Physician attitudes concerning warfarin for stroke prevention in atrial fibrillation: results of a survey of long-term care practitioners., Johanne Monette, Jerry H. Gurwitz, Paula A. Rochon, and Jerry Avorn

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Optimising drug treatment for elderly people: the prescribing cascade., Paula A. Rochon and Jerry H. Gurwitz

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Do physicians do as they say? The case of mammography, Barry G. Saver, Thomas R. Taylor, Jonathan R. Treadwell, and William G. Cole

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Toxicity of nonsteroidal anti-inflammatory drugs in the elderly: is advanced age a risk factor?, Daniel H. Solomon and Jerry H. Gurwitz

Publications from 1996

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The impact of clinical trials on the use of medications for acute myocardial infarction. Results of a community-based study., Nananda F. Col, Thomas J. McLaughlin, Stephen B. Soumerai, David W. Hosmer, Jorge L. Yarzebski, Jerry H. Gurwitz, Joel M. Gore, and Robert J. Goldberg

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Using pharmacoepidemiological findings to guide clinical practice: sulfonylureas and hypoglycemia in older adults., Jerry H. Gurwitz

The impact of ibuprofen on the efficacy of antihypertensive treatment with hydrochlorothiazide in elderly persons., Jerry H. Gurwitz, Daniel E. Everitt, Mark Monane, Robert J. Glynn, Igor Choodnovskiy, M. P. Beaudet, and Jerry Avorn

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Recent age-related trends in the use of thrombolytic therapy in patients who have had acute myocardial infarction. National Registry of Myocardial Infarction., Jerry H. Gurwitz, Joel M. Gore, Robert J. Goldberg, Michael Rubison, Nisha Chandra, and William J. Rogers

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Bowel habit in relation to age and gender. Findings from the National Health Interview Survey and clinical implications., Danielle Harari, Jerry H. Gurwitz, Jerry Avorn, Rhonda L. Bohn, and Kennethl L. Minaker

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Adherence to national guidelines for drug treatment of suspected acute myocardial infarction: evidence for undertreatment in women and the elderly., Thomas J. McLaughlin, Stephen B. Soumerai, Donald J. Willison, Jerry H. Gurwitz, Catherine Borbas, Edward Guadagnoli, Barbara McLaughlin, Nora Morris, Su Chun Cheng, Paul J. Hauptman, Elliott Antman, Linda Casey, Richard Asinger, and Fredarick Gobel

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Compliance with antihypertensive therapy among elderly Medicaid enrollees: the roles of age, gender, and race., Mark Monane, Rhonda L. Bohn, Jerry H. Gurwitz, Robert J. Glynn, Raisa Levin, and Jerry Avorn

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Geriatrics. The age of women., Paula A. Rochon and Jerry H. Gurwitz

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Aspirin use and cognitive function in the elderly., Til Sturmer, Robert J. Glynn, Terry S. Field, James O. Taylor, and Charles H. Hennekens

Publications from 1995

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Neuroleptic drug exposure and treatment of parkinsonism in the elderly: a case-control study., Jerry Avorn, Rhonda L. Bohn, Helen Mogun, Jerry H. Gurwitz, Mark Monane, Daniel E. Everitt, and Alexander M. Walker

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Drug use in the nursing home., Jerry Avorn and Jerry H. Gurwitz

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Increased incidence of levodopa therapy following metoclopramide use., Jerry Avorn, Jerry H. Gurwitz, Rhonda L. Bohn, Helen Mogun, Mark Monane, and Alexander M. Walker

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Evidence for a positive linear relation between blood pressure and mortality in elderly people., Robert J. Glynn, Terry S. Field, B. Rosner, P. R. Hebert, James O. Taylor, and Charles H. Hennekens

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Start low and go slow: dosing of antipsychotic medications in elderly patients with dementia., Jerry H. Gurwitz

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Unconventional medicine and Alzheimer's disease., Jerry H. Gurwitz

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The effect of an Rx-to-OTC switch on medication prescribing patterns and utilization of physician services: the case of vaginal antifungal products., Jerry H. Gurwitz, Thomas J. McLaughlin, and Leslie S. Fish

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Correlates of regular laxative use by frail elderly persons., Danielle Harari, Jerry H. Gurwitz, Jerry Avorn, Igor Choodnovskiy, and Kenneth L. Minaker

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Antipsychotic prescribing patterns and the treatment of extrapyramidal symptoms in older people., Susan C. Kalish, Rhonda L. Bohn, Helen Mogun, Robert J. Glynn, Jerry H. Gurwitz, and Jerry Avorn

A cost-effectiveness model of thrombolytic therapy for acute myocardial infarction., Susan C. Kalish, Jerry H. Gurwitz, Harlan M. Krumholz, and Jerry Avorn

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Practicing with the urban underserved. A qualitative analysis of motivations, incentives, and disincentives, Lawrence B. Li, Scott D. Williams, and Debra L. Scammon

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Epidemiologic and diagnostic aspects of bacteriuria: a longitudinal study in older women., Mark Monane, Jerry H. Gurwitz, Lewis A. Lipsitz, Robert J. Glynn, Igor Choodnovskiy, and Jerry Avorn

Epidemiology of adverse drug events in the nursing home setting., Johanne Monette, Jerry H. Gurwitz, and Jerry Avorn

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Drug therapy., Paula A. Rochon and Jerry H. Gurwitz

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Estimating annual charges for ambulatory care from limited utilization data, Barry G. Saver and Edward H. Wagner

Publications from 1994

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Reduction of bacteriuria and pyuria after ingestion of cranberry juice., Jerry Avorn, Mark Monane, Jerry H. Gurwitz, Robert J. Glynn, Igor Choodnovskiy, and Lewis A. Lipsitz

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Frequency of inclusion of patients with cardiogenic shock in trials of thrombolytic therapy., Nananda F. Col, Jerry H. Gurwitz, Joseph S. Alpert, and Robert J. Goldberg

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Suboptimal medication use in the elderly. The tip of the iceberg., Jerry H. Gurwitz

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Initiation of antihypertensive treatment during nonsteroidal anti-inflammatory drug therapy., Jerry H. Gurwitz, Jerry Avorn, Rhonda L. Bohn, Robert J. Glynn, Mark Monane, and Helen Mogun