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Jan Busby-Whitehead, M.D. - UNC-Chapel Hill. Raleigh-Durham, NC, US

Jan Busby-Whitehead, M.D. Jan Busby-Whitehead, M.D.

Professor & Chief, Division of Geriatric Medicine | UNC-Chapel Hill

Raleigh-Durham, NC, UNITED STATES

Dr. Jan Busby-Whitehead is professor & chief in the division of geriatric medicine and the director of the Center for Aging and Health.

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Jan Busby-Whitehead, M.D. Publication Jan Busby-Whitehead, M.D. Publication

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Biography

Dr. Jan Busby-Whitehead, MD, received her medical degree from the University of Texas Medical Branch at Galveston in 1977. She was the first fellow in Geriatric Medicine at the VAMC/University of Florida (1980-1982) and was a Medical Staff Fellow at the NIA (1985-1987). Dr. Busby-Whitehead is currently a Professor of Medicine, Chief of the Division of Geriatric Medicine, Department of Medicine and Director of the School of Medicine Center for Aging and Health. She is also Director of the HRSA-funded Geriatric Education Center and the Hartford Center of Excellence in Geriatric Medicine and Training.

Dr. Jan Busby-Whitehead's current research projects include assessment of racial disparities regarding treatment of urinary incontinence in Southeastern United States nursing homes and developing and testing a treatment program for fecal incontinence in frail elders.

Her clinical interests include geriatric syndromes including urinary and fecal incontinence, memory disorders, falls, functional decline, and polypharmacy.

Industry Expertise (4)

Education/Learning Research Medical/Dental Practice Health Care - Providers

Areas of Expertise (6)

Geriatric Care Higher Education Elder Care Memory Disorders Epidemiology Public Health

Education (5)

National Institute on Aging: Fellowship, Laboratory of Clinical Physiology 1987

Veterans Administration Medical Center: Fellowship, Geriatric Medicine 1982

John Sealy Hospital: Internship and Residency, Department of Medicine 1980

University of Texas Medical Branch: M.D., Medicine 1977

Baylor University: B.A., History 1973

Magna cum laude

Affiliations (1)

  • Hartford Center of Excellence in Geriatric Medicine : Director

Media Appearances (3)

New Healthinaging.org Website Offers Health Information Unique to Older Adults

Senior Journal  online

2012-09-14

"American Geriatrics Society Foundation launches website to help seniors and caregivers manage complex health issues, decisions."

Dr. Jan Busby-Whitehead is featured in this article.

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Falls are fifth-leading cause of death for people over 65

WRAL.com  online

2011-09-28

"When most people slip and fall, they're able to get up again. However, accidental falls are the fifth-leading cause of death for people over 65 in the U.S. One in three people in that age group will experience a fall every year, according to health experts."

Dr. Jan Busby-Whitehead is featured in this article for WRAL.com.

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Watching a loved one sink into Alzheimer's, dementia can be harrowing

USA Today  online

2008-02-01

"Barbara Center has raised four children, but now, at 59, she's helping care for her mother, who has Alzheimer's.
She's also dealing with two elderly aunts in nearby institutions. Both have Alzheimer's, and one is in the final stage of the disease."

Dr. Jan Busby-Whitehead is featured in this article for USA Today.

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Event Appearances (1)

36th Annual International Medicine Conference

Geriatrics Panel  Chapel Hill, North Carolina

2012-03-15

Articles (5)

Translation of The Otago Exercise Program for Adoption and Implementation in the United States Frontiers in public health

April 27, 2015

BACKGROUND: The Otago Exercise Program (OEP) is an evidence-based fall prevention program developed, evaluated, and disseminated in New Zealand. The program was designed for delivery in the home by physical therapists (PTs). It was not known if American PTs would require additional training and resources to adopt the OEP. This article describes the process of translating the OEP for dissemination in the US. Processes included reviewing and piloting the New Zealand training materials to identify implementation challenges, updating training materials to be consistent with American physical therapy practices, piloting the updated training materials in an online format, and determining if the online format reached the target PT audience.

METHODS: The New Zealand manual was reviewed by expert American PTs and a training webinar was piloted with 56 American PTs. Feedback suggested that the program itself was understood by PTs, but training materials required modification related to documentation and reimbursement policies. Additional content was developed and integrated into an online training module. The online training was piloted and then deemed adequate by seven PT subject matter experts. The online training was launched in March 2013. Demographic and practice data were collected to characterize the PTs attending the online training as well as perceived barriers and facilitators to implementation (n = 522). Perceived facilitators include the effectiveness of the OEP to facilitate adoption, but the lack of agency support, billing and reimbursement challenges pose a significant barrier to OEP implementation.

CONCLUSION: The OEP required additional information to facilitate adoption by American PTs. Online training that specifically targets PTs appears to effectively reach the target audience and be well received by participants. More research is required to determine the impact of online training on a PT’s adoption and implementation of this material into their practice.

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A Feasibility Study for a Posthospital Intervention for Lower Urinary Tract Symptoms in Adults With Heart Failure Journal of Wound Ostomy & Continence Nursing

2015

PURPOSE: To test the feasibility of a self-management intervention for lower urinary tract symptoms (LUTS) in adults with heart failure (HF) discharged from hospital.

DESIGN: Single blinded randomized controlled trial.

SUBJECTS AND SETTING: Thirty-one adults, aged 50 years and older, with an HF diagnosis and 1 or more LUTS were recruited during their hospitalization after passing a cognitive screen. Subjects received the intervention and completed postintervention measures in their own homes.

METHODS: During hospitalization, subjects were recruited, enrolled, and consented, and then completed baseline questionnaires and 24-hour pad test. After discharge, both groups received educational sessions on different topics by telephone in 4-weekly sessions. The specific aims were to determine: (1) subject recruitment and retention rates, (2) subjects' adherence to baseline and postintervention measures, and (3) subjects' and nurse interventionist's adherence to the protocol. The LUTS intervention effects on specific clinical outcomes were explored.

RESULTS: Potential subjects were recruited over 5 months at an enrollment ratio of 4.7:1. Approximately 68% completed the study. Average age was 66.3 ± 9.8 years (mean ± SD). The majority were female (54.8%) and white (51.6%). Most subjects had urinary incontinence (UI) (74.2%) and 77.4% rated their health as either fair or poor. The study was underpowered to determine statistical significance at P < .05 level. Thirty-three percent of the LUTS intervention group reported improved UI frequency postintervention, compared to 25% of the attention control group.

CONCLUSION: Adults with HF experience LUTS, but little is known about how best to manage and treat it. This study showed that it is possible to recruit and retain adults who have HF and rate their health as fair or poor into a 4-week intervention study, although oversampling is needed due to attrition.

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A Randomized Trial Exploring the Effect of a Telephone Call Follow-up on Care Plan Compliance Among Older Adults Discharged Home From the Emergency Department Academic Emergency Medicine

February 10, 2014

OBJECTIVES: Older patients discharged from the emergency department (ED) have difficulty comprehending discharge plans and are at high risk of adverse outcomes. The authors investigated whether a postdischarge telephone call–mediated intervention by a nurse would improve discharge care plan adherence, specifically by expediting post–ED visit physician follow-up appointments and/or compliance with medication changes. The second objectives were to determine if this telephone call intervention would reduce return ED visits and/or hospitalizations within 35 days of the index ED visit and to determine potential cost savings of this intervention.

METHODS: This was a 10-week randomized, controlled trial among patients aged 65 and older discharged to home from an academic ED. At 1 to 3 days after each patient's index ED visit, a trained nurse called intervention group patients to review discharge instructions and assist with discharge plan compliance; placebo call group patients received a patient satisfaction survey call, while the control group patients were not called. Data collection calls occurred at 5 to 8 days and 30 to 35 days after the index ED visits for all three groups. Chi-square or Fisher's exact tests were performed for categorical data and the Kruskal-Wallis test examined group differences in time to follow-up.

RESULTS: A total of 120 patients completed the study. Patients were 60% female and 72% white, with a mean age of 75 years (standard deviation [SD] ± 7.58 years). Intervention patients were more likely to follow up with medical providers within 5 days of their ED visits than either the placebo or the control group patients (54, 20, and 37%, respectively; p = 0.04). [...]

CONCLUSIONS: Telephone call follow-up of older patients discharged from the ED resulted in expedited follow-up for patients with their primary care physicians. Further study is warranted to determine if these results translate into improved patient outcomes, decreased return ED visits or hospital admissions, and cost savings resulting from this intervention.

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Growth Hormone and Sex Steroid Administration in Healthy Aged Women and Men JAMA

2002

CONTEXT: Hormone administration to elderly individuals can increase lean body mass (LBM) and decrease fat, but interactive effects of growth hormone (GH) and sex steroids and their influence on strength and endurance are unknown.

OBJECTIVE: To evaluate the effects of recombinant human GH and/or sex steroids on body composition, strength, endurance, and adverse outcomes in aged persons.

DESIGN, SETTINGS, AND PARTICIPANTS: A 26-week randomized, double-blind, placebo-controlled parallel-group trial in healthy, ambulatory, community-dwelling US women (n = 57) and men (n = 74) aged 65 to 88 years recruited between June 1992 and July 1998.

INTERVENTIONS: Participants were randomized to receive GH (starting dose, 30 µg/kg, reduced to 20 µg/kg, subcutaneously 3 times/wk) + sex steroids (women: transdermal estradiol, 100 µg/d, plus oral medroxyprogesterone acetate, 10 mg/d, during the last 10 days of each 28-day cycle [HRT]; men: testosterone enanthate, biweekly intramuscular injections of 100 mg) (n = 35); GH + placebo sex steroid (n = 30); sex steroid + placebo GH (n = 35); or placebo GH + placebo sex steroid (n = 31) in a 2 × 2 factorial design.

MAIN OUTCOME MEASURES: Lean body mass, fat mass, muscle strength, maximum oxygen uptake (O2max) during treadmill test, and adverse effects.

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Inadequate nutrient intakes among homebound elderly and their correlation with individual characteristics and health-related factors The American Journal of Clinical Nutrition

2002

BACKGROUND: The prevalence of inadequate nutrient intakes among the homebound elderly and their correlation with individual characteristics and health-related factors remain poorly understood.

OBJECTIVE: We assessed the extent of inadequate dietary intakes of key nutrients among the homebound elderly by using the newly released dietary reference intakes and examined the associations of individual characteristics and health-related factors with low nutrient intakes.

DESIGN: This was a cross-sectional examination of data collected during the baseline assessment of a prospective study of nutrition and function among a randomly recruited sample of cognitively eligible recipients of home-delivered meals who completed a home visit and three 24-h dietary recalls (n = 345). Nutrient analysis was performed with the NUTRITION DATA SYSTEM software, and associations were identified through multiple regression models.

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