Publications by authors named "M T Mefford"

Background: Prior studies characterizing worsening heart failure events (WHFE) have been limited in using structured healthcare data from hospitalizations, and with little exploration of sociodemographic variation. The current study examined the impact of incorporating unstructured data to identify WHFE, describing age-, sex-, race and ethnicity-, and left ventricular ejection fraction (LVEF)-specific rates.

Methods: Adult members of Kaiser Permanente Southern California (KPSC) with a HF diagnosis between 2014 and 2018 were followed through 2019 to identify hospitalized WHFE.

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Background: Less than 50% of non-Hispanic Asian adults taking antihypertensive medication have controlled blood pressure.

Methods: We compared non-persistence and low adherence to antihypertensive medication between non-Hispanic Asian and other race/ethnicity groups among US adults ≥66 years who initiated antihypertensive medication between 2011 and 2018 using a 5% random sample of Medicare beneficiaries (non-Hispanic Asian, n = 2,260; non-Hispanic White, n = 56,000; non-Hispanic Black, n = 5,792; Hispanic, n = 4,212; and Other, n = 1,423). Non-persistence was defined as not having antihypertensive medication available to take in the last 90 of 365 days following treatment initiation.

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Background: The effectiveness and safety of mineralocorticoid receptor antagonists (MRA) in acute heart failure (HF) is uncertain. We sought to describe the prescription of spironolactone during acute HF and whether early treatment is effective and safe in a real-world setting.

Methods: We performed a retrospective cohort study of adult (≥18 years) nonpregnant patients hospitalized with new-onset HF with reduced ejection fraction (HFrEF, defined by ejection fraction ≤40%) within 15 Kaiser Permanente Southern California medical centers between 2016 and 2021.

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Background: Tenofovir alafenamide fumarate (TAF) was promoted as a safer alternative to tenofovir disoproxil fumarate (TDF) for human immunodeficiency virus oral preexposure prophylaxis (PrEP). It is unknown if switching from TDF to TAF translates to improved renal function. We used electronic health record (EHR) data to assess changes in creatinine-estimated glomerular filtration rate (eGFR) after switching from TDF to TAF.

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Importance: Prior research found increases in diabetes among youth during the COVID-19 pandemic, but few studies examined variation across sociodemographics.

Objective: To examine diabetes incidence rates among a diverse population of youth in the US before and during the COVID-19 pandemic.

Design, Setting, And Participants: This cohort study included data from Kaiser Permanente Southern California (KPSC) between January 1, 2016, and December 31, 2021.

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