Mary Tinetti
· Gladys Phillips Crofoot Professor of Medicine (Geriatrics) and Professor in the Institution for Social and Policy StudiesYale University · Geriatrics and Palliative Medicine
Active 2013–2023
About
Mary Tinetti, MD, is the Gladys Phillips Crofoot Professor of Medicine (Geriatrics) and a professor at the Institution for Social and Policy Studies. Her current research and clinical focus is on clinical decision-making for older adults in the face of multiple health conditions, measuring the net benefit and harms of commonly used medications, and the importance of cross-disease universal health outcomes. She is leading a national effort, Patient Priorities Care, to develop and test an approach to health care that aligns clinical care and decision-making with the specific health priorities of older adults with multiple conditions. This initiative involves helping older adults identify their health goals and guiding clinicians to translate these goals and preferences into care decisions. She is evaluating the feasibility of this approach in clinical practice and its effect on patient-reported outcomes and healthcare utilization. Dr. Tinetti’s work is funded by the NIH and several foundations, and she has published over 250 peer-reviewed articles. Her research includes assessment, management, and prevention of multifactorial geriatric health conditions such as falls, immobility, and dizziness, conducted across various settings including home, hospital, nursing home, and outpatient clinics. Her projects are interdisciplinary, involving nursing, rehabilitation, epidemiology, biostatistics, and medicine, among others. She also chairs a group of advisors helping health systems become Age-Friendly and has served on several national advisory committees, including the FDA, NCQA, and NQF. Dr. Tinetti is a member of the National Academy of Medicine and a recipient of a MacArthur Foundation fellowship.
Research topics
- Medicine
- Gerontology
- Psychiatry
- Family medicine
- Internal medicine
Selected publications
Annals of Emergency Medicine · 2023 · 1 citations
- Medicine
- Gerontology
- Family medicine
JAMA Network Open · 2021 · 18 citations
- Political Science
- Medicine
- Gerontology
This cross-sectional study assesses how patient-identified top health priorities can be incorporated into the care of older adults with multiple chronic conditions while facilitating decision-making that aligns with these priorities.
Journal of the American Heart Association · 2021 · 24 citations
- Medicine
- Internal medicine
<0.02), compared with the >12.5% to 25% dose group. The mortality in the full-dose group was not significantly higher (hazard ratio, 1.196; 95% CI, 0.687-2.083). In subgroup analyses, only history of congestive heart failure demonstrated significant interaction with beta-blocker effects on survival. Conclusions This analysis suggests that patients treated with >12.5% to 25% of the target dose used in prior randomized clinical trials beyond 1 year after MI may have enhanced survival compared with no beta-blocker and other beta-blocker doses. A new paradigm for post-MI beta-blocker therapy is needed that addresses which patients should be treated, for how long, and at what dose.
Journal of the American Geriatrics Society · 2021 · 9 citations
- Medicine
- Gerontology
- Psychiatry
Feasibility of Clinicians Aligning Health Care with Patient Priorities in Geriatrics Ambulatory Care
Journal of the American Geriatrics Society · 2020 · 47 citations
- Medicine
- Family medicine
- Emergency medicine
BACKGROUND/OBJECTIVES: Aligning healthcare decisions with patients' priorities may improve care for older adults with multiple chronic conditions (MCCs). We conducted a pilot study to assess the feasibility of identifying patient priorities in routine geriatrics care and to compare clinicians' recommendations for patients who did or did not have their priorities identified. DESIGN: Retrospective chart review. SETTING: Veterans Administration Medical Center Geriatrics Clinic. PARTICIPANTS: Older adults with MCCs receiving Patient Priorities Care (PPC; n = 35) were matched with patients receiving usual care (UC; n = 35). Both PPC and UC patients were cared for by three primary care providers (PCPs) in an ambulatory geriatric clinic. INTERVENTION: In the PPC group, a clinician facilitator met with each patient to identify their healthcare priorities and transmitted patients' priorities in the electronic health record (EHR). Trained PCPs then sought to align healthcare decisions with patients' priorities. In the UC group, patients received usual care from the same PCPs. MEASUREMENTS: We matched patients by clinician seen, patient's age, number of active conditions, medications, hospitalizations, functional status, and prior hospitalizations. EHRs were reviewed to identify care decisions including medications added or stopped, referrals and consults added or avoided, referrals to community services and supports, self-management activities added or avoided, and total number of changes to care. Mean differences in recommended care between PPC and UC patients from the same PCPs were examined. RESULTS: Clinician facilitators could identify patient priorities during routine clinic encounters. Compared with patients in the UC group, those in the PPC group had, on average, fewer medications added (P = .05), more referrals to community services and supports (P = .03), and more priorities-aligned self-management tasks added (P = .005). CONCLUSION: These findings support the feasibility of identifying and documenting patient priorities during routine encounters. Results also suggest that clinicians use patient priorities in recommending care.
Frequent coauthors
- 20 shared
Yolanda Davis
Advisory Board Company (United States)
- 20 shared
Joshua Lampinen
- 20 shared
Larry Bryant
International Rescue Committee
- 20 shared
Daniel Degroot
Faculty of Media
- 20 shared
Monica Smith
Dell Children's Medical Center of Central Texas
- 20 shared
James Madara
St. Louis County Missouri
- 20 shared
Maria Kowalkowski
- 20 shared
David Antoš
Washington University in St. Louis
Awards & honors
- Member of the National Academy of Medicine
- MacArthur Foundation fellowship
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