The impact of decreasing potentially inappropriate medications on activities of daily living in a convalescent rehabilitation setting

2020 ◽  
Author(s):  
Eiji Kose ◽  
Toshiyuki Hirai ◽  
Toshiichi Seki ◽  
Nobuhiro Yasuno
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Potentially Inappropriate Medications ◽  
The Impact ◽  
Inappropriate Medications

scholarly journals Association of Polypharmacy and Potentially Inappropriate Medications With Physical Functional Impairments in Older Adults With Cancer

2021 ◽  
Vol 19 (3) ◽  
pp. 267-274
Author(s):  
Mostafa R. Mohamed ◽  
Erika Ramsdale ◽  
Kah Poh Loh ◽  
Huiwen Xu ◽  
Amita Patil ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Physical Function ◽  
Daily Living ◽  
Youden Index ◽  
Potentially Inappropriate Medications ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Patient Reported ◽  
Inappropriate Medications

Background: Polypharmacy and potentially inappropriate medications (PIMs) are prevalent in older adults with cancer, but their associations with physical function are not often studied. This study examined the associations of polypharmacy and PIMs with physical function in older adults with cancer, and determined the optimal cutoff value for the number of medications most strongly associated with physical functional impairment. Methods: This cross-sectional analysis used baseline data from a randomized study enrolling patients aged ≥70 years with advanced cancer starting a new systemic cancer treatment. We categorized PIM using 2015 American Geriatrics Society Beers Criteria. Three validated physical function measures were used to assess patient-reported impairments: activities of daily living (ADL) scale, instrumental activities of daily living (IADL) scale, and the Older Americans Resources and Services Physical Health (OARS PH) survey. Optimal cutoff value for number of medications was determined by the Youden index. Separate multivariate logistic regressions were then performed to examine associations of polypharmacy and PIMs with physical function measures. Results: Among 439 patients (mean age, 76.9 years), the Youden index identified ≥8 medications as the optimal cutoff value for polypharmacy; 43% were taking ≥8 medications and 62% were taking ≥1 PIMs. On multivariate analysis, taking ≥8 medications was associated with impairment in ADL (adjusted odds ratio [aOR], 1.64; 95% CI, 1.01–2.58) and OARS PH (aOR, 1.73; 95% CI, 1.01–2.98). PIMs were associated with impairments in IADL (aOR, 1.72; 95% CI, 1.09–2.73) and OARS PH (aOR, 1.97; 95% CI, 1.15–3.37). A cutoff of 5 medications was not associated with any of the physical function measures. Conclusions: Physical function, an important component of outcomes for older adults with cancer, is cross-sectionally associated with polypharmacy (defined as ≥8 medications) and with PIMs. Future studies should evaluate the association of polypharmacy with functional outcomes in this population in a longitudinal fashion.

scholarly journals Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044416
Author(s):  
Tan Van Nguyen ◽  
Huyen Thanh Dang ◽  
Mason Jenner Burns ◽  
Hiep HH Dao ◽  
Tu Ngoc Nguyen
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Tertiary Hospital ◽  
Logistic Regression Models ◽  
Hospitalised Patients ◽  
Patients With Heart Failure ◽  
The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

scholarly journals Anemia and functional capacity in elderly Brazilian hospitalized patients

2013 ◽  
Vol 29 (7) ◽  
pp. 1322-1332 ◽  
Author(s):  
Raquel de Macedo Bosco ◽  
Elisa Priscila Souza Assis ◽  
Renata Rosseti Pinheiro ◽  
Luiza Cristina Viana de Queiroz ◽  
Leani S. M. Pereira ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Functional Capacity ◽  
Daily Living ◽  
Strong Association ◽  
Population Based ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Cross Sectional ◽  
Belo Horizonte ◽  
The Impact

This study evaluated the association between anemia and physical functional capacity in a cross-sectional population-based sample of 709 hospitalized elderly patients aged 60 years and over admitted to the Madre Teresa Hospital, Belo Horizonte, State of Minas Gerais, Brazil. The Mann-Whitney or "t" test, and chi-square or Fisher exact test were used for quantitative and categorical variables, respectively, and hierarchical binary logistic regression was used to identify significant predictors. The presence of anemia was found in 30% of participants and was significantly associated with decreased functionality according to the two measures which were used - ADL (activities of daily living) and IADL (instrumental activities of daily living). Anemia was also independently associated with older age. The results of this study demonstrate a strong association between the presence of anemia and lower levels of functional capacity. Further investigations are needed to assess the impact of anemia treatment on the functionality and independence of older people.

scholarly journals OVERVIEW: THE VA GERIATRIC SCHOLARS PROGRAM FOR PRIMARY CARE WORKFORCE DEVELOPMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S765-S766
Author(s):  
Josea Kramer ◽  
Joe Douglas ◽  
Shawn Clarke ◽  
Luis Melendez
Keyword(s):  
Primary Care ◽  
Workforce Development ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Potentially Inappropriate Medications ◽  
Primary Care Workforce ◽  
Core Components ◽  
Intensive Course ◽  
The Impact ◽  
Inappropriate Medications

Abstract The VA has invested in developing the skills of its primary care workforce through the longitudinal Geriatric Scholars Program. The program consists of core components --- intensive course in geriatrics, intensive workshop in quality improvement (QI) and initiation of a micro QI projects in the Scholar’s clinic; electives allow learners to tailor the program to self-identified gaps in knowledge, skills and competencies. The program has demonstrated direct impacts of continuing education through a workforce development process that enhances skills and competencies at a pace and selection that meets clinicians’ self-identified gaps in training. Now in its 11th year, the program has been shown to increase career satisfaction and job retention, standardize provider behaviors, improve clinical decision-making and reduce dispensing of potentially inappropriate medications. This symposium further explores the impact of the program on individual clinicians and on clinical teams.

scholarly journals Level of asthma control and its impact on activities of daily living in asthma patients in Brazil

2013 ◽  
Vol 39 (5) ◽  
pp. 532-538 ◽  
Author(s):  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Federico Montealegre ◽  
James Fish ◽  
Jose Roberto Jardim
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Emergency Room ◽  
Asthma Control ◽  
Daily Living ◽  
Negative Impact ◽  
Uncontrolled Asthma ◽  
School Work ◽  
The Impact

OBJECTIVE: To evaluate the impact of asthma on activities of daily living and on health status in patients with controlled, partially controlled, or uncontrolled asthma in Brazil. METHODS: We used data related to 400 patients in four Brazilian cities (São Paulo, Rio de Janeiro, Salvador, and Curitiba), obtained in a survey conducted throughout Latin America in 2011. All study subjects were > 12 years of age and completed a standardized questionnaire in face-to-face interviews. The questions addressed asthma control, hospitalizations, emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. The level of asthma control was determined in accordance with the Global Initiative for Asthma criteria. RESULTS: Among the 400 respondents, asthma was controlled in 37 (9.3%), partially controlled in 226 (56.5%), and uncontrolled in 137 (34.2%). The numbers of patients with uncontrolled or partially controlled asthma who visited the emergency room, who were hospitalized, and who missed school/work were higher than were those of patients with controlled asthma (p = 0.001, p = 0.05, and p = 0.01, respectively). Among those with uncontrolled asthma, the impact of the disease on activities of daily living, sleep, social activities, and normal physical exertion was greater than it was among those with controlled or partially controlled asthma (p < 0.001). CONCLUSIONS: In Brazil, asthma treatment should be monitored more closely in order to increase treatment adherence and, consequently, the level of asthma control, which can improve patient quality of life and minimize the negative impact of the disease.

Sign in / Sign up

Export Citation Format

Share Document