Richard W. Grant

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OBJECTIVE To assess the ability to identify potential association(s) of diabetes medications with myocardial infarction using usual care clinical data obtained from the electronic medical record. RESEARCH DESIGN AND METHODS We defined a retrospective cohort of patients (n = 34,253) treated with a sulfonylurea, metformin, rosiglitazone, or pioglitazone in a(More)
W ith the exception of rare mono-genic disorders, most type 2 diabetes results from the interaction of genetic variation at multiple different chromosomal sites with environmental exposures experienced throughout the lifespan (1). This complex genetic architecture has important consequences for understanding the pathophysiology of type 2 diabetes, both for(More)
BACKGROUND Prevention of diabetes and coronary heart disease (CHD) is possible but identification of at-risk patients for targeting interventions is a challenge in primary care. METHODS We analyzed electronic health record (EHR) data for 122,715 patients from 12 primary care practices. We defined patients with risk factor clustering using metabolic(More)
OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no(More)
Electronic health records (EHRs) and EHR-connected patient portals offer patient-provider collaboration tools for visit-based care. During a randomized controlled trial, primary care patients completed pre-visit electronic journals (eJournals) containing EHR-based medication, allergies, and diabetes (study arm 1) or health maintenance, personal history, and(More)
OBJECTIVE To determine the effects of a personal health record (PHR)-linked medications module on medication accuracy and safety. DESIGN From September 2005 to March 2007, we conducted an on-treatment sub-study within a cluster-randomized trial involving 11 primary care practices that used the same PHR. Intervention practices received access to a(More)
Advances in genetic epidemiology have increased understanding of common, polygenic preventable diseases such as type 2 diabetes. As genetic risk testing based on this knowledge moves into clinical practice, we propose that genetic counselors will need to expand their roles and adapt traditional counseling techniques for this new patient set. In this paper,(More)
Increasing patient demands for convenient access to their own health care information has led to the development of "patient portals" that allow limited patient access to ambulatory electronic health records (EHR). Little is known about clinicians attitudes towards this new model of health care. In our study, we collected baseline information about primary(More)