The identification of frail older adults in primary care: comparing the accuracy of five simple instruments
In this study, frail older adults were oversampled. We estimated the accuracy of each instrument by calculating the area under ... (Source: NeLM - Care of Older People)
Source: NeLM - Care of Older People - February 26, 2013 Category: Geriatrics Source Type: news
Utility of an adverse drug event trigger tool in Veterans Affairs nursing facilities
Source: Consultant Pharmacist
Area: Evidence > Medicines Management > References
Objective: To determine the utility (i.e. positive predictive value (PPV) and time requirement) of an adverse drug event (ADE) trigger tool in US Veterans Affairs (VA) nursing facilities and to describe the most common types of potential ADEs detected with the trigger tool.
Design: Retrospective chart review.
Setting/Patients: Veterans residing in three VA nursing facilities between 29 Sep 2010 and 29 Oct 2010.
Measurements: We used the US Institute for Healthcare Improvement-endorsed nursing facility ADE trigger tool,...
Source: NeLM - Care of Older People - February 25, 2013 Category: Geriatrics Source Type: news
Prevalence of concomitant use of alcohol and sedative-hypnotic drugs in middle and older aged persons: a systematic review
Source: Annals of Pharmacotherapy
Area: Evidence > Medicines Management > References
Objective: To systematically review the prevalence of concomitant alcohol and sedative-hypnotic use among middle-aged and older persons.
Data Sources: A bibliographic search of English-language literature was performed using MEDLINE, EMBASE and PsycINFO (Jan 1990-Aug 2012). The reference lists of all included articles were screened for additional relevant articles not identified by any of the bibliographic searches.
Study Selection and Data Extraction: Population-based studies in which the mean age of participants w...
Source: NeLM - Care of Older People - February 19, 2013 Category: Geriatrics Source Type: news
Psychotropic medications and the transition into care: a national data linkage study
Source: Journal of the American Geriatrics Society
Area: Evidence > Medicines Management > References
Objectives: To determine whether excessive and often inappropriate or dangerous psychotropic drug dispensing to older adults is unique to care homes or is a continuation of community treatment.
Design: Population-based data-linkage study using prescription drug information.
Setting: Northern Ireland's national prescribing database and care home information from the national inspectorate.
Participants: 250,617 individuals aged 65 and older.
Measurements: Prescription information was extracted for all p...
Source: NeLM - Care of Older People - February 18, 2013 Category: Geriatrics Source Type: news
Ten-year trajectory of potentially inappropriate medications in very old women: importance of cognitive status
Source: Journal of the American Geriatrics Society
Area: Evidence > Medicines Management > References
Objectives: To determine which older adults tend to receive potentially inappropriate medications (PIMs), how this may differ according to cognitive status, and how the trajectories of PIM use change over time.
Design: 10-year longitudinal cohort study.
Setting: Three clinical sites in the United States.
Participants: 1484 community-dwelling women aged 75 and older.
Measurements: At follow-up, cognitive status was ascertained and classified as normal, mild cognitive impairment (MCI) or dementia. Beer...
Source: NeLM - Care of Older People - February 18, 2013 Category: Geriatrics Source Type: news
CQC review of home care services
Source: Care Quality Commission (CQC)
Area: News
The review by the Care Quality Commission looked at whether people receiving care at home are treated with dignity and respect, have a choice about the care they receive and benefit from effective systems to keep them safe. During the review, it inspected 250 services providing care to 26,419 people, gathered the views of more than 4,600 people and visited 738 people in their own homes. The review found that good care is being delivered, but also noted concerns around the following areas:
. On many occasions, people received no prior notice that they wo...
Source: NeLM - Care of Older People - February 14, 2013 Category: Geriatrics Source Type: news
Medication beliefs and self-reported adherence among community-dwelling older adults
This study examines the barriers associated with nonadherence among community-dwelling older persons participating in Aging Service Network nutrition programmes in the USA.
Objective: The goal of this study was to examine the relation of psychological, illness, and tangible barriers to reported medication adherence among older adults in a community, nonmedical setting.
Methods: Older adults (N = 299) receiving congregate meals participated in a study of factors associated with medication-taking behaviours and adherence. Self-reported medication nonadherence was measured by using the Morisky Medication Adherence S...
Source: NeLM - Care of Older People - February 13, 2013 Category: Geriatrics Source Type: news
Osteoporosis prescribing trends in primary care: a population-based retrospective cohort study
Source: Primary Health Care Research and Development
Area: Evidence > Medicines Management > References
Background: Osteoporosis is a highly prevalent and costly disease associated with aging. Previous studies have indicated low intervention rates in primary care; however, there is little research investigating the prescribing patterns of osteoporosis medications by primary-care physicians.
Methods: We conducted a population-based retrospective cohort study to examine trends in osteoporosis medication utilisation in primary care between 1 Jan 2000 and 31 Dec 2009 in Ontario, Canada. All Ontario resid...
Source: NeLM - Care of Older People - February 11, 2013 Category: Geriatrics Source Type: news
Utility of an adverse drug event trigger tool in Veterans Affairs nursing facilities
Source: Consultant Pharmacist
Area: Evidence > Medicines Management > References
Objective: To determine the utility (i.e. positive predictive value (PPV) and time requirement) of an adverse drug event (ADE) trigger tool in US Veterans Affairs (VA) nursing facilities and to describe the most common types of potential ADEs detected with the trigger tool.
Design: Retrospective chart review.
Setting/Patients: Veterans residing in three VA nursing facilities between 29 Sep 2010 and 29 Oct 2010.
Measurements: We used the Institute for Healthcare Improvement-endorsed nursing facility ADE trigger tool, modified to ...
Source: NeLM - Care of Older People - February 11, 2013 Category: Geriatrics Source Type: news
Study protocol: High risk prescribing in older adults: prevalence, clinical and economic implications and potential for intervention at the population level
Source: BMC Public Health
Area: Evidence > Medicines Management > References
Background: High-risk prescribing can compromise independent well-being and quality of life in older adults. The aims of this project are to determine the prevalence, risk factors, clinical consequences and costs of high risk prescribing, and to assess the impact of interventions on high risk prescribing in older people.
Methods: The proposed project will utilise data from the 45 and Up Study, a large scale cohort of 267,153 men and women aged 45 and over recruited during 2006-09 from the state of New South Wales, Austra...
Source: NeLM - Care of Older People - February 10, 2013 Category: Geriatrics Source Type: news
Inappropriate long-term use of antipsychotic drugs is common among people with dementia living in specialized care units
This study was conducted in 40 specialised care units in northern Sweden, with a total study population of 344 people with dementia. The study population was described in regard to antipsychotic drug use, ADL function, cognitive function and BPSD, using the Multi-Dimensional Dementia Assessment Scale (MDDAS). These data were collected at baseline and six months later. Detailed data about antipsychotic prescribing were collected from prescription records.
Results: This study showed that 132 persons (38%) in the study population used antipsychotic drugs at the start of the study. Of these, 52/1...
Source: NeLM - Care of Older People - February 9, 2013 Category: Geriatrics Source Type: news
Antipsychotic use among nursing home residents
Source: Journal of the American Medical Association
Area: Evidence > Medicines Management > References
Research letter reporting an analysis of recent and detailed prescription data from a long-term care pharmacy (Omnicare, Inc.) covering about half the nursing homes in the USA to address: (1) What is the current level of antipsychotic use? (2) Does antipsychotic use in nursing homes display geographical variation? and (3) Which antipsychotics are most commonly prescribed? (Source: NeLM - Care of Older People)
Source: NeLM - Care of Older People - February 6, 2013 Category: Geriatrics Source Type: news
Physician patient communication failure facilitates medication errors in older polymedicated patients with multiple comorbidities
Source: Family Practice
Area: Evidence > Medicines Management > References
Objective: To analyse the frequency of mistakes in communication between the physician and the patient and their incidence in errors in self-administered drugs.
Methods: We undertook a descriptive, cross-sectional study in Spain based on interviews with a random sample of patients older than 65 years who were polymedicated (5 or more drugs) and had multiple comorbidities. Data were analysed about the patients' reports of what the physician said, medication mistakes by the patients and their consequences.
Results: Responses we...
Source: NeLM - Care of Older People - January 31, 2013 Category: Geriatrics Source Type: news
Patient education in geriatrics: which specific points?
Source: Presse Medicale
Area: Evidence > Medicines Management > References
The prevalence of chronic diseases strongly increases with age, and the treatment of these diseases is complex in very old persons due to multiple comorbidities, loss of independence and/or frailty. In addition, cognitive disorders, dementia and sensory disturbances are common.
Patient education is becoming an important component of chronic disease management.
Patient education programmes aim to provide patients with information and skills to help them live with their chronic condition.
The authors describe several spe...
Source: NeLM - Care of Older People - January 30, 2013 Category: Geriatrics Source Type: news
A physician-focused intervention to reduce potentially inappropriate medication prescribing in older people
The objective of this study was to assess the effect of a physician-focused, multi-factorial, quality-improvement intervention on PIM prescribing in older patients in primary care.
Methods: This 3-year, multi-phase, prospective, proof-of-concept project introduced in 2007 was aimed at engaging all 303 general practitioners (GPs) in the Local Health Authority (LHA) of Parma, Italy, to positively influence the quality of prescribing to the entire older outpatient population (those aged at least 65 years) served by these physicians. The intervention focused on increasing GPs' awareness of prescribing for older people ...
Source: NeLM - Care of Older People - January 29, 2013 Category: Geriatrics Source Type: news
