Dr. Pickering is an Assistant Professor of Medicine in the Division of General Internal Medicine at the University of Pittsburgh and affiliated faculty at the Center for Pharmaceutical Policy and Prescribing (CP3). She is a board-certified internist, providing clinical care as a primary care physician at UPMC General Internal Medicine, Oakland and as an inpatient teaching attending at UPMC Montefiore. Dr. Pickering’s research focuses on characterizing and reducing low-value care and subsequent care cascades and deprescribing low-value medications in older adults. She is particularly interested in applying implementation science principles to develop strategies to support deprescribing and in the de-implementation of other low-value practices. Dr. Pickering is also involved in medical student and resident education. Along with her clinical care and research, Dr. Pickering enjoys spending time with family and friends, exploring the Pittsburgh food scene, traveling and hiking, and binge-watching reality TV.
Education & Training
- BS (Bioengineering), University of Pittsburgh, 2013
- MD, University of Maryland School of Medicine, 2017
- Internal Medicine Residency, University of Pittsburgh Medical Center, 2020
- General Internal Medicine Clinician-Researcher Fellowship, University of Pittsburgh, 2022
- MS (Clinical Researcher), University of Pittsburgh Institute for Clinical Research Education, 2022
Representative Publications
Pickering AN, Hamm ME, Dawdani A, Hanlon JT, Thorpe CT, Gellad WF, Radomski, TR. Older Patient and Caregiver Perspectives on Medication Value and Deprescribing: A Qualitative Study. Journal of the American Geriatrics Society. 2020.
From qualitative analyses of six focus groups of community-dwelling older adults, or their caregivers, prescribed five or more medications, perceived effectiveness, adverse effects on quality of life, cost and a strong relationship with the prescriber influences patients’ and caregivers’ views on medication value.
Pickering AN, Walter EL, Dawdani A, Decker A, Hamm ME, Gellad WF, Radomski TR. Primary Care Physicians' Approaches to Low-Value Medication Use in Older Adults: A Qualitative Study. BMC Geriatrics, 2022, 22(1): 152.
In this qualitative analysis of primary care physicians’ reactions to two clinical scenarios involving low-value prescribing, we found that PCPs were motivated by their desire to mitigate harm; emphasized good communication with patients; and prioritized patient well-being over satisfying expectations.
Pickering AN, Zhao X, Sileanu FE, Lovelace EZ, Rose L, Schwartz AL, Oakes AH, Hale JA, Schleiden LJ, Gellad WF, Fine MJ, Thorpe CT, Radomski TR. Prevalence and Cost of Care Cascades Following Low-Value Preoperative Electrocardiogram and Chest Radiograph Within the Veterans Health Administration. J Gen Intern Med, 2022.
In this retrospective cohort study of a national cohort of Veterans, we found that low-value care cascades following routine preoperative electrocardiograms and chest radiographs were common, resulting in greater unnecessary care and costs beyond the initial low-value service.
Pickering AN, Zhao X, Sileanu FE, Lovelace EZ, Rose L, Schwartz AL, Oakes AH, Hale JA, Schleiden LJ, Gellad WF, Fine MJ, Thorpe CT, Radomski TR. Assessment of care cascades following low-value prostate specific antigen testing in Veterans dually enrolled in the Veterans Health Administration and Medicare systems. JAMA Network Open, 2022, 5(12):e2247180.
In this retrospective cohort study of Veterans dually enrolled in VHA and Medicare, we found Veterans commonly experienced low-value PSA testing and subsequent care cascades through both systems in FYs 2017 and 2018. Care cascades occurred more frequently through Medicare compared with the VHA.
Click here for a more complete bibliography of Dr. Pickering's work.
Research Interests
- Low-value care cascades
- Medication deprescribing
- Dual-healthcare system use
- De-implementation of low-value care
- Using administrative claims data to measure low-value health service utilization
- Qualitative research