P006: Multimorbidity: development of organisation models and integrated health assessment for frail patients at home

2014 ◽  
Vol 5 ◽  
pp. S84-S85
Author(s):  
D. Salerno ◽  
G. Cosenza ◽  
L. Cesari ◽  
A.M. Lussiana ◽  
M.P. Boscolo ◽  
...  
Keyword(s):  
Health Assessment ◽  
Frail Patients ◽  
Integrated Health ◽  
At Home

scholarly journals Feasibility of a Mobile Health Tool for Mothers to Identify Neonatal Illness in Rural Uganda: Acceptability Study

10.2196/16426 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e16426
Author(s):  
Shababa B Matin ◽  
Allison Wallingford ◽  
Shicheng Xu ◽  
Natalie Ng ◽  
Anthony Ho ◽  
...  
Keyword(s):  
Health Workers ◽  
Health Assessment ◽  
Care Seeking ◽  
Wearable Sensor ◽  
Middle Income ◽  
Neonatal Deaths ◽  
Danger Signs ◽  
Study Team ◽  
And Training ◽  
At Home

Background A shortage of community health workers to triage sick neonates and poor recognition of neonatal illness by mothers contribute significantly toward neonatal deaths in low- and middle-income countries. Providing low-resource communities with the tools and knowledge to recognize signs of neonatal distress can lead to early care-seeking behavior. To empower and educate mothers to recognize signs of neonatal illness, we developed a neonatal health assessment device consisting of a smartphone app and a wearable sensor (the NeMo system). Objective The aim of this study was to determine if mothers in rural Uganda were willing and able to use the NeMo system during the first week of their infant’s life. We also assessed mothers’ responses to the device’s recommendation to seek care. Methods A total of 20 mothers were enrolled in the study after giving birth in the Iganga District Hospital. Each mother was trained to use the NeMo system to assess her infant for signs of illness before leaving the hospital and was given the NeMo system to use at home for 1 week. Throughout the week, the smartphone tracked the mothers’ usage of NeMo, and the study team visited twice to observe mothers’ ability to use NeMo. Each mother was interviewed at the end of 1 week to gather qualitative feedback on her experience with the NeMo system. Results In total, 18 mothers completed the study; 2 mothers were withdrawn during the week because of extenuating health circumstances. Moreover, 1 day after enrollment and training, 75% (15/20) of mothers used NeMo properly with no mistakes. 3 days after enrollment and training, only 1 mother placed the wearable sensor improperly on her infant. On the final study day, only 1 mother connected the device improperly. Mothers used NeMo an average of 11.67 (SD 5.70) times on their own at home during the 5 full study days. Although the frequency of use per day decreased from day 1 to day 5 of the study (P=.04), 72% (13/18) of mothers used NeMo at least once per day. In total, 64% (9/14) of mothers who received an alert from the NeMo system to seek care for their infants either called the health care professional working with the study team or reused the system immediately and found no danger signs. All 18 mothers agreed or strongly agreed that the NeMo system was easy to use and helped them know when to seek care for their babies. Conclusions NeMo is a feasible and acceptable tool to aid mothers in rural Uganda to assess their infant’s health.

Health Assessment of the Very Old Person at Home

2007 ◽  
Vol 25 (6) ◽  
pp. 388-398
Author(s):  
Leslie Neal-Boylan
Keyword(s):  
Health Assessment ◽  
Very Old ◽  
At Home

scholarly journals Care in Chronic Diseases and in "Frail" Patients in General Practice

2020 ◽  
Vol 1 (1) ◽  
pp. 28-31
Author(s):  
Lucio Mango
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Health Service ◽  
Health Services ◽  
Chronic Diseases ◽  
Frail Patients ◽  
The World ◽  
Progressive Growth ◽  
At Home

The world of chronicity is an area in progressive growth that involves a considerable commitment of resources, requiring continuity of assistance for long periods of time and a strong integration of health services with social ones and those requiring residential and territorial services often not sufficiently designed and developed. The fundamental aim of the treatment of chronic systems is to keep as much as possible the patient at home and prevent or reduce the risk of institutionalization. GP could put their expertise to good use in the Complex of Primary Care Units and Territorial Functional Aggregations, reducing the costs of the health service.

Capecitabine (Cap) and oxaliplatin (Ox) in elderly and/or frail patients with metastatic colorectal cancer: The FOCUS2 trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9030-9030 ◽  
Author(s):  
M. T. Seymour ◽  
T. S. Maughan ◽  
H. S. Wasan ◽  
A. E. Brewster ◽  
S. F. Shepherd ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Primary Endpoint ◽  
Performance Status ◽  
Health Assessment ◽  
Progression Free Survival ◽  
Full Dose ◽  
Frail Patients ◽  
Comprehensive Health ◽  
Dose Combination

9030 Background: Elderly/frail patients, though commonly treated, are under-represented in clinical trials. Evidence is needed to guide choices of drugs and doses in this population. Methods: FOCUS2 is a multicenter, 2x2 factorial randomized trial for patients with unpretreated metastatic colorectal cancer judged unfit for full-dose combination chemotherapy. After comprehensive health assessment (CHA), randomization was to: (A) simplified LV5FU2 infusional fluorouracil/leucovorin (FU); (B) OxFU; (C) Cap; or (D) OxCap. In each case, starting doses were 80% standard, with an option to escalate to full-dose at 6 weeks (wk). The factorial questions were: (A+B v C+D) - does replacing FU with Cap improve quality of life (QL)? (primary endpoint: improved global QL at 12 wk [QLQ-C30]); and (A+C v B+D) - how much does Ox improve efficacy in this population? (primary endpoint: progression-free survival (PFS). Results: 460 patients were randomized, 22% < 70 yrs; 35% 70–75 yrs; 43% > 75 yrs. 22% were performance status (PS) 0; 49% PS1; 29% PS2. Primary comparisons: (see table ): global QL did not favor Cap over FU. Comparison of PFS favored the addition of oxaliplatin but did not reach significance (HR 0.87, 95% CI 0.71–1.06, p=0.16). Secondary comparisons: Compared with FU, Cap did not affect RR, PFS or 60-day mortality, but it increased the risk of gr =3 toxicity. Oxaliplatin significantly improved RECIST response (RR) by wk 12, did not increase gr =3 toxicity or 60-day mortality, but reduced the chance of improved QL at 12 wk. Conclusion: In this frail elderly population, substituting Cap for FU did not improve overall QL or efficacy, and significantly increased toxicity. Addition of Ox gave significantly higher anticancer activity without increasing toxicity, but at the cost of some reduction in QL at 12 wk. Planned analyses include correlating baseline CHA with treatment outcome. [Table: see text] [Table: see text]

scholarly journals A Sensor-Based mHealth Platform for Remote Monitoring and Intervention of Frailty Patients at Home

2021 ◽  
Vol 18 (21) ◽  
pp. 11730
Author(s):  
Jorge Calvillo-Arbizu ◽  
David Naranjo-Hernández ◽  
Gerardo Barbarov-Rostán ◽  
Alejandro Talaminos-Barroso ◽  
Laura M. Roa-Romero ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Independent Risk Factor ◽  
Clinical Validation ◽  
Frailty Syndrome ◽  
Validation Process ◽  
Frail Patients ◽  
Sensor Devices ◽  
Technical Validation ◽  
The Impact ◽  
At Home

Frailty syndrome is an independent risk factor for serious health episodes, disability, hospitalization, falls, loss of mobility, and cardiovascular disease. Its high reversibility demands personalized interventions among which exercise programs are highly efficient to contribute to its delay. Information technology-based solutions to support frailty have been recently approached, but most of them are focused on assessment and not on intervention. This paper describes a sensor-based mHealth platform integrated in a service-based architecture inside the FRAIL project towards the remote monitoring and intervention of pre-frail and frail patients at home. The aim of this platform is constituting an efficient and scalable system for reducing both the impact of aging and the advance of frailty syndrome. Among the results of this work are: (1) the development of elderly-focused sensors and platform; (2) a technical validation process of the sensor devices and the mHealth platform with young adults; and (3) an assessment of usability and acceptability of the devices with a set of pre-frail and frail patients. After the promising results obtained, future steps of this work involve performing a clinical validation in order to quantify the impact of the platform on health outcomes of frail patients.

Frailty Is Associated With Decreased Time Spent at Home After Critical Illness: A Population-Based Study

2020 ◽  
pp. 088506662093905 ◽  
Author(s):  
Ariel Hendin ◽  
Peter Tanuseputro ◽  
Daniel I. McIsaac ◽  
Amy T. Hsu ◽  
Glenys A. Smith ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Illness ◽  
Long Term Care ◽  
Assessment Instrument ◽  
Index Hospitalization ◽  
Term Care ◽  
Icu Admission ◽  
Frail Patients ◽  
At Home

Background: Frailty is characterized by vulnerability to stressors due to an accumulation of multiple functional deficits. Frailty is increasingly recognized as a risk factor for accelerated functional decline, increasing dependency, and risk of mortality. The objective of this study was to examine the association of frailty, at the time of critical care admission, with days alive at home and health care costs post-discharge. Methods: This retrospective cohort study used linked administrative data (2010-2016) in Ontario, Canada. We identified all patients admitted at the intensive care unit (ICU), aged 19 years and above, assessed using the Resident Assessment Instrument for Home Care (RAI-HC), within 6 months prior to index hospitalization including an ICU stay. Patients were stratified as robust, pre-frail, or frail based on a validated Frailty Index. The primary outcome was days alive at home in the year after admission. Secondary outcomes included mortality, health care–associated costs, ICU interventions, long-term care admissions, and hospital readmissions. Results: Frail patients spent significantly fewer days at home within 1 year of index hospitalization (mean 159 days vs 223 days in robust cohort, P < .001). Mortality was higher among frail patients at 1 year (59.6% in the frail cohort vs 45.9% in robust patients; odds ratio for death 1.59 [1.49-1.69]). Frail patients also had higher rates of long-term care admission within 1 year (30.1% vs 10.6% in robust patients). Total health care–associated costs per person alive were $30 450 higher the year after admission in the frail cohort. Conclusions: Frailty prior to ICU admission among patients who were eligible for RAI-HC assessment was associated with higher mortality and fewer days spent at home following admission. Frail patients had markedly higher rates of long-term care admission and increased costs per life saved following critical illness. These findings add to the discussion of risk–benefit trade-offs for ICU admission.

Sign in / Sign up

Export Citation Format

Share Document