David R. Mehr

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BACKGROUND Urinary tract infections (UTIs) are the most commonly treated infection among nursing home residents. Even in the absence of specific (e.g., dysuria) or non-specific (e.g., fever) signs or symptoms, residents frequently receive an antibiotic for a suspected infection. This research investigates factors associated with the use of antibiotics to(More)
BACKGROUND Accurately defining severe dementia is important for care and prognosis, but is not explicitly included in the Minimum Data Set (MDS). OBJECTIVE To define severe dementia using the MDS, we used data for nursing home residents with moderate to severe dementia. METHODS Two cross-sectional studies enrolled 175 residents; 89 residents from one US(More)
OBJECTIVE This study aimed to develop a practice guideline for a structured and consensus-based approach to relieve symptoms of pneumonia in patients with dementia in nursing homes. METHODS A five-round Delphi study involving a panel consisting of 24 experts was conducted. An initial version of the practice guideline was developed with leading(More)
BACKGROUND Currently, 24% of all deaths nationally occur in nursing homes making this an important focus of care. However, many residents are not identified as dying and thus do not receive appropriate care in the last weeks and months of life. The aim of our study was to develop and validate a predictive model of 6-month mortality risk using functional,(More)
BACKGROUND Maintaining data quality and integrity is important for research studies involving prospective data collection. Data must be entered, erroneous or missing data must be identified and corrected if possible, and an audit trail created. METHODS Using as an example a large prospective study, the Missouri Lower Respiratory Infection (LRI) Project,(More)
Effect of home telemonitoring on glycemic and blood pressure control in primary care clinic patients with diabetes. Abstract Background: Prior telemonitoring trials of blood pressure and blood glucose have shown improvements in blood pressure and glycemic targets. However, implementation of telemonitoring in primary care practices may not yield the same(More)
BACKGROUND Although lower respiratory tract infections (LRI) cause considerable morbidity and mortality among nursing home residents with dementia, the effects of care and treatment are largely unknown. Few large prospective studies have been conducted. METHODS We pooled data from two large prospective cohort studies in 61 Dutch nursing homes and 36(More)
BACKGROUND Poor adherence to medications is a common problem among heart failure (HF) patients. Inadequate adherence leads to increased HF exacerbations, reduced physical function, and higher risk for hospital admission and death. Many interventions have been tested to improve adherence to HF medications, but the overall impact of such interventions on(More)
4 Development of a practice guideline for optimal symptom relief for patients with pneumonia and dementia in nursing homes using a Delphi study 70 | Chapter 4 ABSTRACT Objective This study aimed to develop a practice guideline for a structured and consensus based approach to relieve symptoms of pneumonia in patients with dementia in nursing homes. Methods A(More)
OBJECTIVE To evaluate whether a model that was previously developed to predict 14-day mortality for nursing home residents with dementia and lower respiratory tract infection who received antibiotics could be applied to residents who were not treated with antibiotics. Specifically, in this same data set, to update the model using recalibration methods; and(More)