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:

Behavioral and Physiology in Aging

Administered By
Center for the Study of Aging and Human Development
Awarded By
National Institutes of Health
Role
Mentor
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:

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

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

Adherence to Measuring What Matters Items When Caring for Patients With Hematologic Malignancies Versus Solid Tumors.

CONTEXT: Measuring What Matters (MWM) prioritizes quality measures in palliative care practice. Hematologic malignancy patients are less likely to access palliative care, yet little is known about their unique needs. Differences in MWM adherence may highlight opportunities to improve palliative care in hematology. OBJECTIVES: To assess adherence to MWM measures by palliative care clinicians caring for patients with hematologic malignancies, compared to those with solid tumors. METHODS: We used the Quality Data Collection Tool to assess completion of MWM measures across nine sites. RESULTS: We included data from 678 patients' first visits and various care settings; 64 (9.4%) had a hematologic malignancy, whereas 614 (90.6%) had a solid tumor. Hematology patients were more likely to be seen in a hospital (52 or 81.3% vs. 420 or 68%), whereas solid tumor patients were more frequently seen at home or in clinics (160 or 26% vs. 7 or 10.9%). Of the nine MWM measures we assessed, high adherence (>90%) was seen regardless of tumor type in measures #3 (Pain Treatment), #7 (Spiritual Concerns), #8 (Treatment Preferences), and #9 (Care Consistent With Preferences). Clinicians seeing hematology patients were significantly less likely to meet measures #2 (Screening for Physical Symptoms; 57.8% vs. 84.2%, P < 0.001), and #5 (Discussion of Emotional Needs; 56.3% vs. 70.0%, P = 0.03). CONCLUSION: MWM adherence regarding symptom assessment and meeting emotional needs was lower for patients with hematologic malignancies compared to those with solid tumors. This finding suggests two key areas for quality improvement initiatives in palliative care for patients with hematologic malignancies.
Authors
LeBlanc, TW; Ritchie, CS; Friedman, F; Bull, J; Kutner, JS; Johnson, KS; Kamal, AH; AAHPM Research Committee Writing Group,
MLA Citation
LeBlanc, Thomas W., et al. “Adherence to Measuring What Matters Items When Caring for Patients With Hematologic Malignancies Versus Solid Tumors..” J Pain Symptom Manage, vol. 52, no. 6, Dec. 2016, pp. 775–82. Pubmed, doi:10.1016/j.jpainsymman.2016.09.004.
URI
https://scholars.duke.edu/individual/pub1152455
PMID
27810570
Source
pubmed
Published In
J Pain Symptom Manage
Volume
52
Published Date
Start Page
775
End Page
782
DOI
10.1016/j.jpainsymman.2016.09.004