Medication Adherence in New Zealand Older Adults: Effects of an External Cognitive Support

2005 ◽  
Vol 11 (2) ◽  
pp. 69-83
Author(s):  
June Greyvenstein ◽  
Nikolaos Kazantzis ◽  
Nancy A. Pachana
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Medication Adherence ◽  
Older Adult ◽  
Controlled Trial ◽  
Adult Population ◽  
Community Dwelling ◽  
Cognitive Support ◽  
Present Sample ◽  
Randomised Controlled

Pharmacotherapy is the most frequently used treatment modality among the older adult population. Consequently, medication adherence represents an important treatment consideration. The present study was conducted to assess the extent of medication adherence in the New Zealand sample, and evaluate the effectiveness of an external cognitive support in a sample of 50 community-dwelling older adults (M = 70.70, Mdn = 72.00, SD = 8.12). A randomised controlled trial to compare the usual medication practice with a medication calendar was conducted. The present sample had high levels of medication adherence, with high adherence measured on an adherence ratio 97% (range 82% to 109%), and low rate of medication errors (19 errors). There were no significant differences in medication adherence between intervention and control groups (ps > .05). However, consistent with prior research, there was some evidence to suggest that female participants were less compliant and made more errors than male participants. Further research on larger more representative older adult samples is warranted.

scholarly journals Better Outcomes for Older people with Spinal Trouble (BOOST) Trial: a randomised controlled trial of a combined physical and psychological intervention for older adults with neurogenic claudication, a protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022205 ◽  
Author(s):  
Esther Williamson ◽  
Lesley Ward ◽  
Karan Vadher ◽  
Susan J Dutton ◽  
Ben Parker ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomised Controlled Trial ◽  
Older People ◽  
Best Practice ◽  
Psychological Intervention ◽  
Controlled Trial ◽  
Health Economic Evaluation ◽  
Community Dwelling ◽  
Neurogenic Claudication ◽  
Randomised Controlled

IntroductionNeurogenic claudication due to spinal stenosis is common in older adults. The effectiveness of conservative interventions is not known. The aim of the study is to estimate the clinical and cost-effectiveness of a physiotherapist-delivered, combined physical and psychological intervention.Methods and analysisThis is a pragmatic, multicentred, randomised controlled trial. Participants are randomised to a combined physical and psychological intervention (Better Outcomes for Older people with Spinal Trouble (BOOST) programme) or best practice advice (control). Community-dwelling adults, 65 years and over, with neurogenic claudication are identified from community and secondary care services. Recruitment is supplemented using a primary care-based cohort. Participants are registered prospectively and randomised in a 2:1 ratio (intervention:control) using a web-based service to ensure allocation concealment. The target sample size is a minimum of 402. The BOOST programme consists of an individual assessment and twelve 90 min classes, including education and discussion underpinned by cognitive behavioural techniques, exercises and walking circuit. During and after the classes, participants undertake home exercises and there are two support telephone calls to promote adherence with the exercises. Best practice advice is delivered in one to three individual sessions with a physiotherapist. The primary outcome is the Oswestry Disability Index at 12 months. Secondary outcomes include the 6 Minute Walk Test, Short Physical Performance Battery, Fear Avoidance Beliefs Questionnaire and Gait Self-Efficacy Scale. Outcomes are measured at 6 and 12 months by researchers who are masked to treatment allocation. The primary statistical analysis will be by ‘intention to treat’. There is a parallel health economic evaluation and qualitative study.Ethics and disseminationEthical approval was given on 3 March 2016 (National Research Ethics Committee number: 16/LO/0349). This protocol adheres to the Standard Protocol Items: Recommendations for Interventional Trials checklist. The results will be reported at conferences and in peer-reviewed publications using the Consolidated Standards of Reporting Trials guidelines. A plain English summary will be published on the BOOST website.Trial registration numberISRCTN12698674; Pre-results.

Effects of golf training on cognition in older adults: a randomised controlled trial

2018 ◽  
Vol 72 (10) ◽  
pp. 944-950 ◽  
Author(s):  
Hiroyuki Shimada ◽  
Sangyoon Lee ◽  
Masahiro Akishita ◽  
Koichi Kozaki ◽  
Katsuya Iijima ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomised Controlled Trial ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Training Group ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Control Group ◽  
Logical Memory ◽  
Randomised Controlled

BackgroundAlthough research indicates that a physically active lifestyle has the potential to prevent cognitive decline and dementia, the optimal type of physical activity/exercise remains unclear. The present study aimed to determine the cognitive benefits of a golf-training programme in community-dwelling older adults.MethodsWe conducted a randomised controlled trial between August 2016 and June 2017 at a general golf course. Participants included 106 Japanese adults aged 65 and older. Participants were randomly assigned to either a 24-week (90–120 min sessions/week) golf-training group or a health education control group. Postintervention changes in Mini-mental State Examination (MMSE) and National Centre for Geriatrics and Gerontology-Functional Assessment Tool scores were regarded as primary outcome measures. Secondary outcome measures included changes in physical performance and Geriatric Depression Scale (GDS) scores.ResultsA total of 100 participants (golf training, n=53; control, n=47) completed the assessments after the 24-week intervention period. The adherence to the golf programme was 96.2% (51/53 participants). Analysis using linear mixed models revealed that the golf training group exhibited significantly greater improvements in immediate logical memory (p=0.033), delayed logical memory (p=0.009) and composite logical memory (p=0.013) scores than the control group. However, no significant changes in MMSE, word memory, Trail Making Test or Symbol Digital Substitution Test scores were observed. In addition, no significant changes in grip strength, walking speed or GDS were observed.ConclusionsGolf-based exercise interventions may improve logical memory in older adults, but no significant changes in other cognitive tests. Further follow-up investigations are required to determine whether the observed effects are associated with delayed onset of mild cognitive impairment or Alzheimer’s disease in older adults.Trial registration numberUMIN-CTR UMIN000024797; Pre-results.

scholarly journals Recipient and instructor perspectives of an adapted exercise-based fall prevention programme for adults aged 50+ years with vision impairment: a qualitative study nested within a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038386
Author(s):  
Lisa Dillon ◽  
Lindy Clemson ◽  
Helen Nguyen ◽  
Kirsten Bonrud Jakobsen ◽  
Jodi Martin ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomised Controlled Trial ◽  
Qualitative Study ◽  
Fall Prevention ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Vision Impairment ◽  
Prevention Programme ◽  
Randomised Controlled ◽  
Fall Prevention Programme

ObjectiveOlder adults with vision impairment currently have no access to tailored fall prevention programmes. Therefore, the purpose of this study, nested within an ongoing randomised controlled trial (RCT), is to document the adaptation of an existing fall prevention programme and investigate the perspectives of instructors involved in delivery and the older adults with vision impairment receiving the programme (recipients).DesignWe documented programme adaptations and training requirements, and conducted semistructured, individual interviews with both the instructors and the recipients of the programme from 2017 to 2019. The content of each interview was analysed using behaviour change theory through deductive qualitative analysis.SettingNew South Wales and Australian Capital Territory, Australia.ParticipantsThe 11 trained instructors interviewed were employees of a vision rehabilitation organisation and had delivered at least one programme session as part of the RCT. The 154 recipients interviewed were community-dwelling adults aged ≥50 years with vision impairment and no diagnosis of dementia, and had completed their participation in the programme as part of the intervention group of the RCT.ResultsSix key themes were identified relating to recipient (delivery aptitude, social norms, habit formation) and instructor (individualised adaptation, complimentary to scope of practice, challenges to delivery) perspectives. With initial training, instructors required minimal ongoing support to deliver the programme and made dynamic adaptations to suit the individual circumstances of each recipient, but cited challenges delivering the number of programme activities required. Recipient perspectives varied; however, most appreciated the delivery of the programme by instructors who understood the impact of vision impairment.Conclusions and implicationsThis novel qualitative study demonstrates that the adapted programme, delivered by instructors, who already have expertise delivering individualised programmes to older people with vision impairment, may fill the gap for a fall prevention programme in this population.Trial registration numberACTRN12616001186448.

scholarly journals 86 Developing the Adapted Lifestyle - Integrated Functional Exercise Programme in Thai Context (TLIFE) to Prevent Falls among Older Adults in Thailand: A Mixed Methods Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Sasiporn Ounjaichon ◽  
Chris Todd ◽  
Emma Stanmore ◽  
Elisabeth Boulton
Keyword(s):  
Older Adults ◽  
Randomised Controlled Trial ◽  
Retention Rate ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Programme ◽  
Community Dwelling ◽  
Control Group ◽  
Functional Exercise ◽  
Randomised Controlled

Abstract Introduction Falls are the leading cause of injuries in older Thai adults. There is a need to develop a fall prevention exercise programme to encourage participation and adherence. The adapted Lifestyle-integrated Functional Exercise (aLiFE) programme may be suitable by integrating exercise into daily routines as opposed to attending an exercise class. This study aimed to explore the acceptability and feasibility of the aLiFE programme in Thai context (TLiFE) among older Thai adults. Methods Based on the findings of a prior qualitative study, a feasibility randomised controlled trial (RCT) of TLiFE was conducted among community-dwelling older adults, comparing the TLiFE intervention group with a usual care control group. Outcome measures were analysed at baseline, 3 months, and after 6 months of the intervention. Results We recruited a total of 72 older adults into the RCT, randomised to TLiFE (n=36) and control (n=36). The retention rate at 6 months was 91.7%. Attendance in the intervention group (3 home visits and 4 follow-up calls) was 82.9%. There were no differences in fall incidence between the groups. The acceptability survey reveals TLiFE is easy to perform in daily life, safe, and useful. No adverse events were reported. Conclusion The TLiFE programme appears to be acceptable and feasible to deliver to community-dwelling older Thai adults. This feasibility study was not powered to detect a difference between groups. A further fully powered definitive randomised controlled trial of TLiFE is needed to evaluate long-term outcomes and cost-effectiveness before it is integrated within the healthcare system in Thailand.

scholarly journals Relationship Between Dietary Lutein and Cognition in an Older Adult Population (P14-030-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Krystle Zuniga ◽  
Alexandria Turner ◽  
Nicholas Bishop
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Older Adult ◽  
Verbal Memory ◽  
Adult Population ◽  
Panel Study ◽  
Community Dwelling ◽  
Leafy Vegetables ◽  
Cognitive Domain ◽  
Word Recall

Abstract Objectives The dietary carotenoid lutein accumulates in the brain, and lutein supplementation has been demonstrated to improve cognitive function in older adults. The purpose of the study was to examine the association between dietary lutein intake and cognitive function in a recent and representative sample of the older adult U.S. population. Additionally, we aimed to identify the major contributors to dietary lutein intake in older adults. Methods Observations were drawn from the 2012 Health and Retirement Study (HRS), a nationally-representative panel study of older U.S. adults, and the 2013 Health Care and Nutrition Study (HCNS), which assessed dietary intake via food frequency questionnaire in a subsample of HRS respondents. The analytic sample included 7045 respondents age 50 and older. Cognitive function was evaluated on the cognitive domain of episodic verbal memory, assessed using immediate word recall (IWR) and delayed word recall (DWR). Quartiles of lutein intake were calculated then used to compare IWR and DWR scores in 2012. Descriptive statistics and bivariate comparisons were adjusted for the complex survey design of the HRS and HCNS with results representative of community-dwelling older Americans in 2013. Results The average age of the sample was 65.6 ± 10.3 years old. Leafy vegetables, cruciferous vegetables, dark yellow vegetables, eggs, fruit and other vegetables were significant predictors of dietary lutein intake. Lutein intake was significantly different between quartiles (P < 0.001) with lutein intakes of 720 ± 231 ug/day (Q1), 1468 ± 229 ug/day (Q2), 2394 ± 324 ug/day (Q3), and 5632 ± 3029 ug/day (Q4). Quartiles 3 and 4 had significantly higher IWR and DWR scores than quartiles 1 and 2 (P < 0.001). Conclusions Older adults may benefit from higher lutein intake through consumption of various vegetables, fruits, and eggs, as lutein may specifically protect episodic memory. Further research is needed to identify the mechanism of lutein's cognitive benefits. Funding Sources American Egg Board/Egg Nutrition Center.

scholarly journals Demonstrating a Technology-Mediated Intervention to Support Medication Adherence in Community-Dwelling Older Adults in Primary Care: A Feasibility Study

2019 ◽  
Vol 5 ◽  
pp. 233372141984517
Author(s):  
Henry Yu-Hin Siu ◽  
Bethany Delleman ◽  
Jessica Langevin ◽  
Dee Mangin ◽  
Michelle Howard ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Medication Adherence ◽  
Older Adult ◽  
Feasibility Study ◽  
Clinical Work ◽  
Medication Administration ◽  
Recruitment Rate ◽  
Community Dwelling ◽  
Adherence Rate

Background: Medication non-adherence can lead to significant morbidity and mortality. This 4-week feasibility study aims to demonstrate that the eDosette intervention can be implemented with older adults in primary care. Method: Fifty-six older adults from four primary care sites in Southwestern Ontario, Canada participated. The intervention involved generating, for pharmacist review, weekly medication administration records based on transmitted data captured by the eDosette. The primary outcome is implementation feasibility defined by recruitment, adherence rates, frequency of captured missed and late doses, descriptions of clinical work resulting from the intervention, and participant feedback. Results: The recruitment rate was 24% (57/240); one withdrew due to personal reasons. The mean observed adherence rate was 82% (range 49%-100%). Overall, participants missed 505 and took 2,105 doses late; 118 clinical decisions occurred with 72 unique medication changes in 31 participants. Participants found the eDosette easy to use and did not feel that they were viewed negatively because of their potential non-adherence. Conclusion: The eDosette intervention could be feasibly implemented in primary care with older adults. Providing information about when an older adult takes their medications could play a role in medication adherence by prompting more informed discussions between the older adult and primary care clinicians.

Association between Skin Conditions and Depressive Disorders in Community-Dwelling Older Adults

2014 ◽  
Vol 18 (4) ◽  
pp. 256-264 ◽  
Author(s):  
Samantha Gontijo Guerra ◽  
Michel Préville ◽  
Helen-Maria Vasiliadis ◽  
Djamal Berbiche
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Depressive Disorders ◽  
Adult Population ◽  
Community Sample ◽  
The Elderly ◽  
Population Based ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Skin Conditions

Background: Depression is frequently observed in dermatologic patients. However, the association between depressive disorders and skin conditions has rarely been explored through population-based studies, especially within older-adult populations. Objective: To test this association in a representative sample of an older-adult population. Methods: Data came from the Survey on the Health of the Elderly (Enquête sur la Santé des Aînés [ESA]), a longitudinal survey conducted in Quebec among 2,811 older adults. Cross-lagged panel models were used to simultaneously examine cross-sectional and longitudinal relationships between the presence of skin conditions and depressive disorders. Results: The prevalence of skin conditions was 13%, and the prevalence of depressive disorders among participants presenting with skin conditions was 11%. Our results indicated significant cross-sectional correlation ( ζ = 0.20) between skin conditions and depressive disorders, but no longitudinal association was observed. Conclusion: Our results reinforce the hypothesis that skin conditions and depressive disorders are concurrently associated in older adults. However, no evidence of the predictive effect of skin problems on depression (and vice versa) was found in our community sample. Despite the deleterious effect of the coexistence of these problems in older adults, studies are lacking. This article highlights the importance of this issue and emphasizes the need for further research on this topic.

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