Kimberly Johnson

Positions:

Associate Professor of Medicine

Medicine, Geriatrics
School of Medicine

Senior Fellow in the Center for the Study of Aging and Human Development

Center for the Study of Aging and Human Development
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1997

Johns Hopkins University

Medical Resident, Me Dicine

Duke University

Chief Medical Resident-Ambulatory Services, Medicine

Duke University

Fellow in Geriatrics, Medicine

Duke University

Grants:

PCplanner: operationalizing needs-focused palliative care for older adults in intensive

Administered By
Medicine, Pulmonary, Allergy, and Critical Care Medicine
Awarded By
National Institutes of Health
Role
Investigator
Start Date
End Date

Duke Center for REsearch to AdvanCe Healthcare Equity (REACH EQUITY)

Administered By
Medicine, Geriatrics
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

IPA-Kimberly Johnson

Administered By
Medicine, Geriatrics
Role
Physician
Start Date
End Date

Implementing Best Practice in Palliative Care

Administered By
Center for the Study of Aging and Human Development
Awarded By
Agency for Healthcare Research and Quality
Role
Principal Investigator
Start Date
End Date

IPA - Kimberly Johnson

Administered By
Medicine, Geriatrics
Role
Investigator
Start Date
End Date

Publications:

Reducing Disparities in the Quality of Palliative Care for Older African Americans through Improved Advance Care Planning: Study Design and Protocol.

Advance care planning (ACP) improves end-of-life care for patients and their caregivers. However, only one-third of adults have participated in ACP and rates are substantially lower among African Americans than among whites. Importantly, ACP improves many domains of care where there are racial disparities in outcomes, including receipt of goal-concordant care, hospice use, and provider communication. Yet, few studies have examined the effectiveness of ACP interventions among African Americans. The objectives of reducing disparities in the quality of palliative care for older African Americans through improved advance care planning (EQUAL ACP) are as follows: to compare the effectiveness of two interventions in (1) increasing ACP among African Americans and whites and (2) reducing racial disparities in both ACP and end-of-life care; and to examine whether racial concordance of the interventionist and patient is associated with ACP. EQUAL ACP is a longitudinal, multisite, cluster randomized trial and a qualitative study describing the ACP experience of participants. The study will include 800 adults ≥65 years of age (half African American and half white) from 10 primary care clinics in the South. Eligible patients have a serious illness (advanced cancer, heart failure, lung disease, etc.), disability in activities of daily living, or recent hospitalization. Patients are followed for one year and participate in either a patient-guided, self-management ACP approach, including a Five Wishes form or structured ACP with Respecting Choices First Steps. The primary outcome is formal or informal ACP-completion of advance directives, documented discussions with clinicians, and other written or verbal communication with surrogate decision makers about care preferences. Secondary outcomes assessed through after-death interviews with surrogates of patients who die during the study include receipt of goal-concordant care, health services use in the last year of life, and satisfaction with care. EQUAL ACP is the first large study to assess which strategies are most effective at both increasing rates of ACP and promoting equitable palliative care outcomes for seriously ill African Americans.
Authors
Ejem, DB; Barrett, N; Rhodes, RL; Olsen, M; Bakitas, M; Durant, R; Elk, R; Steinhauser, K; Quest, T; Dolor, RJ; Johnson, K
MLA Citation
Ejem, Deborah B., et al. “Reducing Disparities in the Quality of Palliative Care for Older African Americans through Improved Advance Care Planning: Study Design and Protocol..” J Palliat Med, vol. 22, no. S1, Sept. 2019, pp. 90–100. Pubmed, doi:10.1089/jpm.2019.0146.
URI
https://scholars.duke.edu/individual/pub1409801
PMID
31486728
Source
pubmed
Published In
Journal of Palliative Medicine
Volume
22
Published Date
Start Page
90
End Page
100
DOI
10.1089/jpm.2019.0146

Factors That Impact Family Perception of Goal-Concordant Care at the End of Life.

Background: Goal-concordant care (GCC)-care aligned with a patient's known goals and values-is a measure of the quality of end-of-life (EOL) care that can be assessed by surveying family members after a patient's death. It is unknown whether patient characteristics affect this measure. Objective: The objective of the article was to examine family report of GCC and its associations with patient characteristics. Methods: Using the Health and Retirement Study, which is a nationally representative, longitudinal cohort of adults over age 50, we sampled decedents whose family completed the 2014 postdeath interview. Families reported frequency of GCC at the EOL. A multivariable regression model assessed the associations between family report of GCC and decedent characteristics. Results: Of 1175 respondents, 76% reported that the decedent "usually" or "always" received GCC. Proxy report of GCC was independently associated with age (adjusted odds ratio [AOR] 1.02, 95% confidence interval [CI] 1.01-1.03), having three or more chronic medical conditions (AOR 1.34, CI 1.02-1.77), the presence of written or verbal advance care planning (ACP) (AOR 1.38, CI 1.02-1.88), and an interaction term of race and ability to participate in EOL decision making (AOR 3.83, CI 1.02-14.40). African American race was not independently associated with GCC (AOR 0.73, CI 0.5-1.06). Conclusion: Family's report of GCC is associated with ACP, age, and multimorbidity. Being African American and perceived as able to participate in EOL decision making was significantly associated with report of GCC. Bringing the patient's voice into EOL care discussions through upstream ACP with likely surrogates may be particularly important to improving GCC for African Americans.
Authors
Haines, L; Rahman, O-K; Sanders, JJ; Johnson, K; Kelley, A
MLA Citation
Haines, Lindsay, et al. “Factors That Impact Family Perception of Goal-Concordant Care at the End of Life..” J Palliat Med, vol. 22, no. 8, Aug. 2019, pp. 927–32. Pubmed, doi:10.1089/jpm.2018.0508.
URI
https://scholars.duke.edu/individual/pub1368925
PMID
30758243
Source
pubmed
Published In
Journal of Palliative Medicine
Volume
22
Published Date
Start Page
927
End Page
932
DOI
10.1089/jpm.2018.0508

African Americans With Advanced Heart Failure Are More Likely to Die in a Health Care Facility Than at Home or in Hospice: An Analysis From the PAL-HF Trial.

Authors
Warraich, HJ; O'Connor, CM; Yang, H; Granger, BB; Johnson, KS; Mark, DB; Anstrom, KJ; Patel, CB; Steinhauser, KE; Tulsky, JA; Taylor, DH; Rogers, JG; Mentz, RJ
MLA Citation
Warraich, Haider J., et al. “African Americans With Advanced Heart Failure Are More Likely to Die in a Health Care Facility Than at Home or in Hospice: An Analysis From the PAL-HF Trial..” J Card Fail, vol. 25, no. 8, Aug. 2019, pp. 693–94. Pubmed, doi:10.1016/j.cardfail.2019.05.013.
URI
https://scholars.duke.edu/individual/pub1387991
PMID
31158470
Source
pubmed
Published In
Journal of Cardiac Failure
Volume
25
Published Date
Start Page
693
End Page
694
DOI
10.1016/j.cardfail.2019.05.013

Gender Equity and Career Advancement: Implications for Hospice and Palliative Medicine (TH352)

Authors
Johnson, KS; O’Mahony, S; Chen, H; Hingle, S; Moyer, D
MLA Citation
Johnson, Kimberly S., et al. “Gender Equity and Career Advancement: Implications for Hospice and Palliative Medicine (TH352).” Journal of Pain and Symptom Management, vol. 57, no. 2, Elsevier BV, 2019, pp. 388–388. Crossref, doi:10.1016/j.jpainsymman.2018.12.079.
URI
https://scholars.duke.edu/individual/pub1368663
Source
crossref
Published In
Journal of Pain and Symptom Management
Volume
57
Published Date
Start Page
388
End Page
388
DOI
10.1016/j.jpainsymman.2018.12.079

State of the Science of Spirituality and Palliative Care Research Part I: Definitions, Measurement, and Outcomes.

The State of the Science in Spirituality and Palliative Care was convened to address the current landscape of research at the intersection of spirituality and palliative care and to identify critical next steps to advance this field of inquiry. Part I of the SOS-SPC two-part series focuses on questions of 1) What is spirituality? 2) What methodological and measurement issues are most salient for research in palliative care? And 3) What is the evidence relating spirituality and health outcomes? After describing current evidence we make recommendations for future research in each of the three areas of focus. Results show wide variance in the ways spirituality is operationalized and the need for definition and conceptual clarity in research in spirituality. Furthermore, the field would benefit from hypothesis-driven outcomes research based on a priori specification of the spiritual dimensions under investigation and their longitudinal relationship with key palliative outcomes, the use of validated measures of predictors and outcomes, and rigorous assessment of potential confounding variables. Finally, results highlight the need for research in more diverse populations.
Authors
Steinhauser, KE; Fitchett, G; Handzo, GF; Johnson, KS; Koenig, HG; Pargament, KI; Puchalski, CM; Sinclair, S; Taylor, EJ; Balboni, TA
MLA Citation
Steinhauser, Karen E., et al. “State of the Science of Spirituality and Palliative Care Research Part I: Definitions, Measurement, and Outcomes..” J Pain Symptom Manage, vol. 54, no. 3, Sept. 2017, pp. 428–40. Pubmed, doi:10.1016/j.jpainsymman.2017.07.028.
URI
https://scholars.duke.edu/individual/pub1266788
PMID
28733252
Source
pubmed
Published In
J Pain Symptom Manage
Volume
54
Published Date
Start Page
428
End Page
440
DOI
10.1016/j.jpainsymman.2017.07.028