Scholars@Duke
Cara L. McDermott

Cara L. McDermott

Assistant Professor in Medicine
Medicine, Geriatrics and Palliative Care

Selected Publications

Characterizing Intervention Components and Complexity of Nonpharmacologic Healthcare Interventions to Manage Distress Behaviors in Older Adults.

Journal Article J Appl Gerontol · April 28, 2025 Distress behaviors are common in residential care settings and contribute to staff burnout and poor quality of life for older adults. While nonpharmacologic interventions reduce distress behaviors, implementation in routine care remains challenging. Our st ... Full text Link to item Cite

Opioids and benzodiazepines in oncology: Perspectives on coprescribing and mitigating risks.

Journal Article J Geriatr Oncol · March 2025 INTRODUCTION: Opioids and benzodiazepines are commonly prescribed for cancer symptoms. In combination, they can increase the risk of adverse events, particularly for older adults with multimorbidity, who represent most patients with cancer. We aimed to und ... Full text Link to item Cite

LIVING WITH MULTIMORBIDITY AND FINANCIAL TOXICITY: A PATIENT- AND CLINICIAN-INFORMED FRAMEWORK

Conference Innovation in Aging · December 31, 2024 AbstractMost older adults in the US have multimorbidity (2+ serious illnesses). Living with multimorbidity impacts patient quality of life, specifically managing the symptoms of multiple diseases and accompa ... Full text Cite

Utilization and patient characteristics for the trastuzumab reference and biosimilars, and other human epidermal growth factor receptor 2 inhibitors in the United States.

Journal Article J Manag Care Spec Pharm · October 2024 BACKGROUND: Trastuzumab is an antihuman epidermal growth factor receptor 2 monoclonal antibody used to treat breast and other cancers. Trastuzumab biosimilars were approved in the United States beginning in 2017. Utilization information on these biosimilar ... Full text Link to item Cite

Criteria for Enrollment of Patients With COPD in Palliative Care Trials: A Systematic Review.

Journal Article J Pain Symptom Manage · June 2024 CONTEXT: Use of palliative care interventions in chronic obstructive pulmonary disease (COPD) has increased in recent years and inclusion criteria used to identify patients with COPD appropriate for palliative care vary widely. We evaluated the inclusion c ... Full text Link to item Cite

Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis.

Journal Article J Pain Symptom Manage · June 2024 CONTEXT: Driven by concerns about care quality, patient experience, and national metrics, health systems are increasingly focusing on identifying risk factors for patients who are hospitalized in the last month of life. OBJECTIVE: To evaluate patient facto ... Full text Link to item Cite

Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults: A Review.

Journal Article JAMA · April 23, 2024 IMPORTANCE: Falls are reported by more than 14 million US adults aged 65 years or older annually and can result in substantial morbidity, mortality, and health care expenditures. OBSERVATIONS: Falls result from age-related physiologic changes compounded by ... Full text Link to item Cite

Health Care Team Interventions to Reduce Distress Behaviors in Older Adults: A Systematic Review.

Journal Article Clin Gerontol · 2024 OBJECTIVES: This review examines health care team-focused interventions on managing persistent or recurrent distress behaviors among older adults in long-term residential or inpatient health care settings. METHODS: We searched interventions addressing heal ... Full text Link to item Cite

Patient-Informed Framework to Address Financial Toxicity in Multimorbidity

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · 2024 Cite

Factors Associated with Hospital Admission in the Last Month of Life

Conference JOURNAL OF PAIN AND SYMPTOM MANAGEMENT · 2024 Cite

Fall Risk and Medication Use Near End of Life Among Adults With Chronic Obstructive Pulmonary Disease

Journal Article Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation · 2024 Full text Cite

Targets and study design for symptom-focused trials aimed at patients with cirrhosis: An expert consensus.

Journal Article Hepatol Commun · June 1, 2023 BACKGROUND: Symptom-focused trials are critically needed for patients with cirrhosis. However, this work would benefit from standard processes and validated measures. METHODS: A writing group was formed among hepatologists, nurses, palliative care provider ... Full text Open Access Link to item Cite

Effect of the COVID-19 Pandemic on Place of Death Among Medicaid and Commercially Insured Patients With Cancer in Washington State.

Journal Article J Clin Oncol · March 10, 2023 PURPOSE: The COVID-19 pandemic-related disruptions in health care delivery might have affected end-of-life care in patients with cancer. We examined changes in place of death and hospice support for Medicaid and commercially insured patients during the pan ... Full text Link to item Cite

Identification of cancer chemotherapy regimens and patient cohorts in administrative claims: challenges, opportunities, and a proposed algorithm.

Journal Article J Med Econ · 2023 BACKGROUND: Real-world evidence is a valuable source of information in healthcare. This study describes the challenges and successes during algorithm development to identify cancer cohorts and multi-agent chemotherapy regimens from claims data to perform a ... Full text Link to item Cite

Polypharmacy, chemotherapy receipt, and medication-related out-of-pocket costs at end of life among commercially insured adults with advanced cancer.

Journal Article J Oncol Pharm Pract · June 2022 BACKGROUND: Polypharmacy raises the risk of drug-drug interactions and adverse events among patients with cancer. Most polypharmacy research has focused on adults age 65 or older enrolled in Medicare insurance. To better inform pharmacy practice and cancer ... Full text Link to item Cite

The Association of Advance Care Planning Documentation and End-of-Life Healthcare Use Among Patients With Multimorbidity.

Journal Article Am J Hosp Palliat Care · August 2021 PURPOSE: Multimorbidity is associated with increased intensity of end-of-life healthcare. This association has been examined by number but not type of conditions. Our purpose was to understand how intensity of care is influenced by multimorbidity within sp ... Full text Link to item Cite

Patient Characteristics and Utilization Patterns of Short-Acting Recombinant Granulocyte Colony-Stimulating Factor (G-CSF) Biosimilars Compared to Their Reference Product.

Journal Article Drugs Real World Outcomes · June 2021 BACKGROUND: Data on short-acting recombinant granulocyte colony-stimulating factor (G-CSF) biosimilar utilization from claims data in the USA are limited. OBJECTIVE: To evaluate patient baseline characteristics and utilization patterns for short-acting G-C ... Full text Link to item Cite

Utilization patterns and characteristics of users of biologic anti-inflammatory agents in a large, US commercially insured population.

Journal Article Pharmacol Res Perspect · February 2021 We report utilization patterns and characteristics of patients treated with biologic anti-inflammatory agents in a large commercially insured patient population in the United States. We identified adult (age ≥18 years) patients receiving biologic anti-infl ... Full text Link to item Cite

Polypharmacy and medication costs at end of life among commercially insured adults age 65 and older with cancer.

Conference Journal of Clinical Oncology · December 1, 2018 65 Background: Polypharmacy, or the concurrent use of multiple medications, may expose patients to drug-drug interactions and excessive costs. There are limited data on polypharmacy for commercially insured older adults, primaril ... Full text Cite

Depression and Health Care Utilization at End of Life Among Older Adults With Advanced Non-Small-Cell Lung Cancer.

Journal Article J Pain Symptom Manage · November 2018 CONTEXT: Limited data exist regarding how depression diagnosed at different times relative to a cancer diagnosis may affect healthcare utilization at end of life (EOL). OBJECTIVES: To assess the relationship between depression and health care utilization a ... Full text Link to item Cite

How do clinics perform across multiple end of life metrics?

Conference Journal of Clinical Oncology · November 1, 2017 86 Background: National bodies have proposed a number of metrics to measure quality of care at the end of life (EOL). MACRA legislation allows clinics to select the metrics they report to CMS. The self-selection of reported metri ... Full text Cite

Polypharmacy and out-of-pocket medication costs in the last month of life among commercially insured patients with advanced cancer: Insights from linking a regional cancer registry and insurance claims.

Conference Journal of Clinical Oncology · November 1, 2017 79 Background: Polypharmacy, defined as the concurrent use of multiple medications, may expose patients to drug-drug interactions and excessive medication costs. Patients with advanced cancer may benefit from medication discontin ... Full text Cite

Development of cancer care episodes to measure costs for breast, colorectal, and non-small cell lung cancer.

Conference Journal of Clinical Oncology · March 10, 2017 29 Background: Cancer care costs are rising, creating concerns about affordability. As a result, delivery systems are creating alternative payment structures to lower costs while maintaining or improving quality. As cancer care d ... Full text Cite

Health care utilization and costs at end of life among patients with leukemia or lymphoma in a regional cancer registry-insurance claims linked database.

Conference Journal of Clinical Oncology · October 9, 2016 184 Background: End-of-life (EOL) care for persons with hematologic malignancies is variable and often involves high-intensity services at death approaches, which may not reflect patient or family preferences. We characterized he ... Full text Cite