scholarly journals Potentially inappropriate medication among people with dementia in eight European countries

2017 ◽  
Vol 47 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Anna Renom-Guiteras ◽  
Petra A Thürmann ◽  
Ramón Miralles ◽  
Renate Klaaßen-Mielke ◽  
Ulrich Thiem ◽  
...  
Keyword(s):  
Long Term Care ◽  
Inappropriate Medication ◽  
Cognitive Status ◽  
Adverse Outcomes ◽  
Potentially Inappropriate Medication ◽  
The European Union ◽  
Term Care ◽  
People With Dementia

Abstract Objectives to evaluate the frequency of potentially inappropriate medication (PIM) prescription among older people with dementia (PwD) from eight countries participating in the European study ‘RightTimePlaceCare’, and to evaluate factors and adverse outcomes associated with PIM prescription. Methods survey of 2,004 PwD including a baseline assessment and follow-up after 3 months. Interviewers gathered data on age, sex, prescription of medication, cognitive status, functional status, comorbidity, setting and admission to hospital, fall-related injuries and mortality in the time between baseline and follow-up. The European Union(7)-PIM list was used to evaluate PIM prescription. Multivariate regression analysis was used to investigate factors and adverse outcomes associated with PIM prescription. Results overall, 60% of the participants had at least one PIM prescription and 26.4% at least two. The PIM therapeutic subgroups most frequently prescribed were psycholeptics (26% of all PIM prescriptions) and ‘drugs for acid-related disorders’ (21%). PwD who were 80 years and older, lived in institutional long-term care settings, had higher comorbidity and were more functionally impaired were at higher risk of being prescribed two PIM or more. The prescription of two or more PIM was associated with higher chance of suffering from at least one fall-related injury and at least one episode of hospitalisation in the time between baseline and follow-up. Conclusions PIM use among PwD is frequent and is associated with institutional long-term care, age, advanced morbidity and functional impairment. It also appears to be associated with adverse outcomes. Special attention should be paid to psycholeptics and drugs for acid-related disorders.

Polypharmacy and Potentially Inappropriate Medication Use Among Long Term Care Residents on Hospice Care

2011 ◽  
Vol 12 (3) ◽  
pp. B20
Author(s):  
Gina Gerardine S. Fernandez ◽  
Gina Gerardine S. Fernandez ◽  
Amy Ehrlich ◽  
Claudene George ◽  
Rubina Malik ◽  
...  
Keyword(s):  
Long Term Care ◽  
Hospice Care ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Potentially Inappropriate Medication ◽  
Term Care ◽  
Inappropriate Medication Use

scholarly journals CNAs’ Ratings of Nursing Home Residents’ Pain: The Role of CNA and Resident Traits

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 381-381
Author(s):  
Emily Behrens ◽  
Hyunjin Noh ◽  
A Lynn Snow ◽  
Patricia Parmelee
Keyword(s):  
Long Term Care ◽  
Pain Catastrophizing ◽  
Nursing Home Residents ◽  
Cognitive Status ◽  
Pain Rating ◽  
Sources Of Information ◽  
Term Care ◽  
Rating Accuracy ◽  
Lower Accuracy

Abstract Long-term care residents with and without cognitive impairment may experience undertreatment of persistent pain (Fain et. al, 2017). Certified nursing assistants (CNAs) are important sources of information about resident pain as they provide the majority of residents’ hands-on care. Therefore, assessing the accuracy of CNAs’ pain assessments and potential influencing factors may provide insight regarding the undertreatment of pain. Informed by prior research, this study examined resident pain catastrophizing and cognitive status as predictors of CNAs’ pain assessment accuracy. CNA empathy was examined as a moderating variable. Analyses confirmed a relationship between pain catastrophizing and CNA pain rating accuracy (R^2 = .205, p < .01), reflecting lower accuracy of ratings for residents higher in catastrophizing. Hypotheses predicting a relationship between resident cognitive status and CNA pain rating accuracy and moderating effects of empathy were disconfirmed. Challenges of conducting research in long-term care are discussed.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

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