Ophthalmic drugs as part of polypharmacy in nursing home residents with glaucoma
Source: Drugs and Aging
Area: Evidence > Medicines Management > References
Background: Glaucoma comprises age-related neurodegenerative diseases of retinal ganglion cells, the worldwide prevalence of which is increasing. Local pharmacotherapy is the primary treatment option, especially in the elderly. But this therapeutic approach may include risks for adverse drug effects and drug-drug interactions, of particular importance in frail nursing home resident populations.
Objective: The aim of the present study was to investigate anti-glaucoma pharmacotherapy in nursing home residents in the context of m...
Source: NeLM - Care of Older People - January 23, 2013 Category: Geriatrics Source Type: news
Safety of a tetanus-diphtheria-acellular pertussis vaccine when used off-label in an elderly population
This study aims to examine a large cohort of Tdap users 65 years or older for evidence of increased risk of adverse events following vaccination.
Methods: A matched cohort study design and a self-controlled case series (SCCS) design were used. The study population was adults aged 65 years or older who received the Tdap or tetanus and diphtheria (Td) vaccine during 1 Jan 2006 to 31 Dec 2010 at 7 health maintenance organisations in the United States. Seven major groups of prespecified events were identified electronically by diagnostic codes.
Results: The study included 119,573 Tdap vaccinees and th...
Source: NeLM - Care of Older People - January 21, 2013 Category: Geriatrics Source Type: news
Antipsychotic use in nursing home residents admitted with hip fracture
Source: Journal of the American Geriatrics Society
Area: Evidence > Medicines Management > References
Objectives: To evaluate the association between receiving antipsychotics and the outcomes of a cohort of nursing home (NH) residents with and without presumed delirium after hip fracture.
Design: Population-based cohort study.
Setting: 11,119 nursing homes throughoit the USA from 1 Jan 2000 to 31 Dec 2007.
Participants: First-time NH admissions with hip fracture (n = 77,759).
Measurements: The Nursing Home Confusion Assessment Method was used to identify residents with no delirium, subsyndromal d...
Source: NeLM - Care of Older People - January 15, 2013 Category: Geriatrics Source Type: news
Drug-related readmissions to medical units of older adults discharged from acute geriatric units: results of the Optimization of Medication in AGEd multicenter randomized controlled trial
Source: Journal of the American Geriatrics Society
Area: Evidence > Medicines Management > References
Objectives: To assess the effect of an intervention on drug-related problem (DRP; adverse drug reactions, adherence problems, underuse)-related readmission rates in older adults.
Design: Ancillary study from a 6-month, prospective, randomised, parallel-group, open-label trial.
Setting: Six acute geriatric units in Paris, france, and suburbs.
Participants: 665 consecutively admitted individuals were included: 317 in the intervention group (IG) and 348 in the control group (CG) (mean age 86.1 +/- 6.2 year...
Source: NeLM - Care of Older People - January 15, 2013 Category: Geriatrics Source Type: news
Influence of a transitional care clinic on subsequent 30-day hospitalizations and emergency department visits in individuals discharged from a skilled nursing facility
This study is a natural experiment using a pre-post design. The intervention was a one-time visit to a PDC before SNF discharge, where an advanced nurse practitioner conducted medication reconciliation, ordered medical supplies and equipment and home health services if needed, provided individual and caregiver education, and communicated the information to the individual's primary outpatient care provider ... (Source: NeLM - Care of Older People)
Source: NeLM - Care of Older People - January 15, 2013 Category: Geriatrics Source Type: news
Prescribing benzodiazepines in residential aged-care facilities
Source: Journal of Pharmacy Practice and Research
Area: Evidence > Medicines Management > References
Background: Benzodiazepines (BZDs) are used to treat sleep disturbances and behavioural and psychological symptoms of dementia in residents of aged-care facilities. Older people are vulnerable to the adverse effects of BZDs. In Australia, guidelines exist for prescribing BZDs, however there are a lack of data comparing prescribing patterns with guidelines.
Aim: To review BZD prescribing patterns in residential aged-care facilities and to compare these with best-practice guidelines.
Method: A cross-s...
Source: NeLM - Care of Older People - January 15, 2013 Category: Geriatrics Source Type: news
Prevalence of anticholinergic use among older home health patients
Source: Journal of Clinical Nursing
Area: Evidence > Medicines Management > References
Anticholinergic usage patterns for patients in the USA aged 65 years and older who received home health (HH) services were examined using the 2007 National Home and Hospice Care Survey (NHHCS) data.
Slightly over 80% (80.30; 95% CI, 77.5 to 83.25) of older HH patients received at least one anticholinergic drug. High prevalence of the use of higher level anticholinergics was found. Almost 30% (29.62; 95% CI, 26.90 to 32.33) took either a level 2 (5.42%; 95% CI, 4.00 to 6.85) or level 3 (25.99%; 95% CI, 23.54 to 28.44...
Source: NeLM - Care of Older People - January 9, 2013 Category: Geriatrics Source Type: news
Recognition of adverse drug events in older hospitalized medical patients
Source: European Journal of Clinical Pharmacology
Area: Evidence > Medicines Management > References
Objective: To assess medical teams' ability to recognize adverse drug events (ADEs) in older inpatients.
Methods: The study cohort comprised 250 patients aged 65 years or older consecutively admitted to internal medicine wards of three hospitals in the Netherlands between Apr and Nov 2007. An independent expert team identified ADEs present upon admission or occurring during hospitalisation by a structured retrospective patient chart review. For all ADEs identified, the expert team assessed causality, ...
Source: NeLM - Care of Older People - January 8, 2013 Category: Geriatrics Source Type: news
Impact of the demand for 'proxy assent' on recruitment to a randomised controlled trial of vaccination testing in care homes
Source: Journal of Medical Ethics
Area: Evidence > Medicines Management > References
Legal frameworks are in place to protect those who lack the capacity to consent to research, such as the Mental Capacity Act in the UK. Assent is sought instead from a proxy, usually a relative. However, the same legislation may, perversely, affect the welfare of those who lack capacity and of others by hindering the process of recruitment into otherwise potentially beneficial research. In addition, the onus of responsibility is moved from those who know most about the study (i.e. the scientific community) to tho...
Source: NeLM - Care of Older People - January 4, 2013 Category: Geriatrics Source Type: news
An observational study of psychotropic drug use and initiation in older patients resident in their own home or in care
Source: Age and Ageing
Area: Evidence > Medicines Management > References
Objective: To compare the prescription of psychotropic medications for patients living in care homes with that for patients living at home.
Design and Setting: Retrospective population database study in the Tayside region of Scotland.
Subjects: 70,297 patients aged 65 or older and followed until death or the end of the study.
Methods: Examining registered addresses for all people aged 65-99 identified those in care. Prescriptions for a 12-week period were examined and psychotropic drug use compared by their place of residenc...
Source: NeLM - Care of Older People - January 3, 2013 Category: Geriatrics Source Type: news
The impact of patient knowledge of patient-centered medication label content on quality of life among older adults
Source: Research in Social and Administrative Pharmacy
Area: Evidence > Medicines Management > References
Background: Prescription drugs have made great contributions to health and quality of life (QOL). However, inappropriate use of drugs may result in just the opposite effect. Older adults often take multiple medications simultaneously and thus are more vulnerable to inappropriate drug use. Knowledge of important aspects of medication use might reduce the risk of inappropriate utilisation and improve QOL.
Objective: To determine the extent of patient knowledge concerning patient-centred conte...
Source: NeLM - Care of Older People - January 2, 2013 Category: Geriatrics Source Type: news
