scholarly journals Exploratory Validation Study of the Individual AUDIT-C Items among Older People

2020 ◽  
Author(s):  
Duncan Stewart ◽  
Catherine Hewitt ◽  
Jim McCambridge
Keyword(s):  
Older People ◽  
Validation Study ◽  
High Sensitivity ◽  
Alcohol Screening ◽  
Clinical Settings ◽  
Long Term Conditions ◽  
Single Item ◽  
Men And Women ◽  
The Uk

Abstract Aims The AUDIT-C is a brief and commonly used alcohol screening tool, with few data available on the relative validity of the three individual items in older adult populations. The aim of this study was to explore the validity of the AUDIT-C items in identifying unhealthy drinking among older people, with a view to developing a single-item screener. Methods A sample of 143 older adults (mean age = 71) were recruited from non-clinical settings in the UK. AUDIT-C scores were compared to an unhealthy drinking reference category of consuming more than the UK recommended weekly units of alcohol. Standard analyses were conducted for men and women, and for those prescribed medications for long term conditions. Results The AUDIT-C items performed well in identifying unhealthy drinking in this sample of older people, with generally high sensitivity, specificity and area under the ROC curve. No significant differences were found in the validity of the three items, though the combined sensitivity and specificity scores and ROC values for item 3 were consistently slightly lower than for items 1 and 2. The findings were similar for men and women, and for participants prescribed medications for long-term conditions. Conclusions AUDIT-C items 1 and 2 performed as well as item 3 in identifying unhealthy drinking among older people in this study. Both are reasonable single-item screener candidates, especially given relative ease of administration, with further validation study needed to examine psychometrics and how alcohol screening for older people can best be implemented in clinical settings.

Preventing falls and falls-injuries in hospitals and long-term care facilities

2007 ◽  
Vol 17 (2) ◽  
pp. 75-91 ◽  
Author(s):  
David Oliver
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Falls Prevention ◽  
Care Homes ◽  
Term Care ◽  
Long Term Conditions ◽  
Global Challenge ◽  
The Uk ◽  
Developed Nations

Falls are predominantly a problem of older people. In the UK, people over 65 currently account for around 60% of admissions and 70% of bed days in hospitals. There are approximately half a million older people in long-term care settings – many with frailty and multiple long-term conditions. The proportion of the population over 65 years is predicted to rise 25% by 2025, and that over 80 by 50%, with a similar increase in those with dependence for two or more activities of daily living. Despite policies to drive care to the community, it is likely that the proportion of older people in hospitals and care homes will therefore increase. Accidental falls are the commonest reported patient/resident safety incidents. Similar demographic trends can be seen in all developed nations, so that the growing problem of fall prevention in institutions is a global challenge. There has been far more focus in falls-prevention research on older people in ‘community’ settings, but falls are a pressing issue for hospitals and care homes, and a threat to the safety of patients and residents, even if a relatively small percentage of the population is in those settings at any one time.

scholarly journals ABCD position statement on risk stratification of adult patients with diabetes during COVID-19 pandemic

2021 ◽  
Author(s):  
Dinesh Nagi ◽  
Emma Wilmot ◽  
Karissa Owen ◽  
Dipesh Patel ◽  
Lesley Mills ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Clinical Care ◽  
Position Statement ◽  
Specialist Care ◽  
Long Term Conditions ◽  
Use Of Technology ◽  
Patients With Diabetes ◽  
Long Term Impact ◽  
The Uk

At the time of submission of this manuscript, the COVID-19 pandemic had cost nearly 60,000 lives in the UK. This number currently stands at over 120,000 deaths. A high proportion (one third) of these lived with diabetes. The huge acute and emergency medicine effort to support people with COVID-19 has had a major knock-on impact on the delivery of routine clinical care, especially for long-term conditions like diabetes.Challenges to the delivery of diabetes services during this period include a reduction in medical and nursing staff, limitations placed by social distancing on physical clinical space, and balancing virtual vs face-to-face care. There is a need to re-group and re-organise how we deliver routine out-patient adult diabetes services during the ongoing COVID-19 pandemic. We offer some suggestions for how patients can be stratified into red (urgent), amber (priority) and green (routine) follow up with suggestions of how often people should be seen. We also offer recommendation on how we can identify those at highest risk and try and minimise the long- term impact of COVID on diabetes careDuring the COVID pandemic we have seen things happen in days that previously took years. The restart of diabetes services has triggered a more widespread use of virtual consultations and data management systems, but also offers an opportunity for more joined-up and cohesive working between primary and specialist care. While we do our best to keep our patients and colleagues safe, this pandemic is already proving to be a catalyst for change, accelerating the appropriate use of technology in diabetes care and implementing innovative solutions. To achieve this aspiration, further work – currently led by the Association of British Clinical Diabetologists in collaboration with Diabetes UK and the Primary Care Diabetes Society – to make recommendations on future proofing diabetes care in UK is in progress.

scholarly journals Can social media reduce discrimination and ignorance towards patients with long term conditions? A chronic kidney disease example in the UK and more widely

2016 ◽  
Vol 3 (1) ◽  
pp. 35-41
Author(s):  
Shahid N Muhammad ◽  
Amy J Zahra ◽  
Howard J Leicester ◽  
Heather Davis ◽  
Stephen Davis
Keyword(s):  
Chronic Kidney Disease ◽  
Social Media ◽  
Kidney Disease ◽  
Long Term Conditions ◽  
The Uk

Comparative Study of Outcomes for Older People with Long Term Conditions Attending Day Care Services Delivered by Paid Staff or by Volunteers

2020 ◽  
Author(s):  
Catherine Lunt ◽  
Chris Shiels ◽  
Christopher Dowrick ◽  
Mari Lloyd-Williams
Keyword(s):  
Older People ◽  
Comparative Study ◽  
Day Care ◽  
Symptom Burden ◽  
Well Being ◽  
Long Term Conditions ◽  
North West ◽  
Age In Place ◽  
Care Services

Abstract Background Day care services can support older people living with multiple long term conditions (LTCs), to age in place, but little research on outcomes of Day Care attendance. Aims The aims of this comparative study were to determine outcomes for older people with LTCs attending day care services run entirely by paid staff or predominantly volunteers Methods Newly referred older people with LTCs to nine day care services in North West of England and North Wales were invited to participate in this longitudinal study with data being collected at baseline attendance and at 6 and 12 weeks. Demographic information was collected and the EQ-5D-3L and De Jong Loneliness 6 item questionnaire were completed at each time point.RESULTS 94 older people (64% female),age range 65 - 99 years (mean 82 years) were recruited. The mean number of LTCs was 4.3 (range 2-9) and 52% people lived alone. More than a third (36%) lived in one of the 20% most deprived local authorities in England and Wales. The outcomes in this exploratory study over 12 weeks appeared to be similar for paid, blended (paid staff and volunteers) and for volunteer led service, with those attending volunteer led services were significantly more likely to report fewer health problems in follow-up (OR=3.45, 95% CI 1.01-12.8, P=0.04). CONCLUSIONS This study suggests that Day Care Services for older people with long term conditions provide benefits in terms of self-rated physical and emotional well-being. Older people attending paid staff services were more likely to have greater number of LTCs associated with a higher symptom burden. However, at baseline there was no difference in self-reported health by service type. This study suggests that Day Care Services provided by volunteers can provide comparable outcomes. Following the Covid-19 pandemic, it is increasingly urgent to support older people with long term conditions who have lost physical and cognitive function during lockdown and to maintain and improve their function. Our study suggests that volunteers may be able to complement the care provided by paid staff freeing up resources and enabling increasing numbers of people to be supported.

The context of healthcare

2020 ◽  
pp. 1-34
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Northern Ireland ◽  
Healthcare Services ◽  
Health Profile ◽  
Long Term Conditions ◽  
Key Concepts ◽  
The Uk

This chapter begins by covering the UK health profile, then defines the key concepts in primary care and public health, and outlines the generic long-term conditions model. It provides a brief overview of the National Health Service, including differences in England, Northern Ireland, Scotland, and Wales. It covers current NHS entitlements for people from overseas, commissioning of services, and public health in a broader context. It also describes health needs assessment, and provides an overview of the services in primary care, the role of general practice, and other primary healthcare services. Further services, including those to prevent unplanned hospital admission, aid hospital discharge, those that support children and families, housing, social support, and care homes are all covered.

Extending the Comfort Zone: Building Resilience in Older People With Long-Term Conditions

2017 ◽  
Vol 38 (6) ◽  
pp. 825-848 ◽  
Author(s):  
Mark Robinson ◽  
Esmée Hanna ◽  
Gary Raine ◽  
Steve Robertson
Keyword(s):  
Older People ◽  
Peer Support ◽  
Social Engagement ◽  
Well Being ◽  
Significant Drop ◽  
Long Term Conditions ◽  
Before And After ◽  
And Gender ◽  
Ongoing Support

This article examines how a 6-week mental health resilience course for people with long-term conditions (LTCs; diabetes, heart disease, and arthritis) increased perceived resilience of older participants. This article examines how peer support assisted participants to develop resilience, considers gender issues, examines the importance of course activities, and explores how resilience enhances quality of life. A mixed methods approach was used. A before-and-after questionnaire was administered 3 times, including 3-month follow-up. Interviews were held with 24 program participants, aged 45 to 80 years. Diaries were kept by participants over 3 months. Survey findings showed significant gains in perceived resilience, at the end of the course, with no significant drop-off after 3 months. Interview and diary narratives highlighted positive experiences around well-being, condition management, and social engagement. Peer support was key to effective processes. Challenges concern ongoing support in communities, and considering age and gender variables when researching what improved resilience means to older people with LTCs.

scholarly journals Domestic Homicide of Older People (2010–15): A Comparative Analysis of Intimate-Partner Homicide and Parricide Cases in the UK

2018 ◽  
Vol 49 (5) ◽  
pp. 1234-1253 ◽  
Author(s):  
Hannah Bows
Keyword(s):  
Older People ◽  
Elder Abuse ◽  
Older Men ◽  
Intimate Partner ◽  
Theory And Practice ◽  
Intimate Partner Homicide ◽  
Domestic Homicide ◽  
Men And Women ◽  
The Uk ◽  
Older Men And Women

AbstractDespite half a century of research on both domestic violence and elder abuse, homicide of older people by a partner or family member (domestic homicide (DH)) remains largely unexplored. This article presents data drawn from a larger parent study examining homicide of older people (aged sixty and over) in the UK. This analysis is based on a subset of cases that would fall within current definitions of DH (n = 221). Analysis reveals differences in DH of older men and women in relation to the perpetrator gender and relationship and differences between intimate-partner homicides and those perpetrated by other family members. Implications for research, theory and practice are discussed.

scholarly journals Effects of participating in community assets on quality of life and costs of care: longitudinal cohort study of older people in England

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e033186 ◽  
Author(s):  
Luke Aaron Munford ◽  
Anna Wilding ◽  
Peter Bower ◽  
Matt Sutton
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Secondary Outcome ◽  
Long Term Conditions ◽  
Community Assets ◽  
Costs Of Care ◽  
Life Years ◽  
Double Robust

ObjectivesImproving outcomes for older people with long-term conditions and multimorbidity is a priority. Current policy commits to substantial expansion of social prescribing to community assets, such as charity, voluntary or community groups. We use longitudinal data to add to the limited evidence on whether this is associated with better quality of life or lower costs of care.DesignProspective 18-month cohort survey of self-reported participation in community assets and quality of life linked to administrative care records. Effects of starting and stopping participation estimated using double-robust estimation.SettingParticipation in community asset facilities. Costs of primary and secondary care.Participants4377 older people with long-term conditions.InterventionParticipation in community assets.Primary and secondary outcome measuresQuality-adjusted life years (QALYs), healthcare costs and social value estimated using net benefits.ResultsStarting to participate in community assets was associated with a 0.017 (95% CI 0.002 to 0.032) gain in QALYs after 6 months, 0.030 (95% CI 0.005 to 0.054) after 12 months and 0.056 (95% CI 0.017 to 0.094) after 18 months. Cumulative effects on care costs were negative in each time period: £−96 (95% CI £−512 to £321) at 6 months; £−283 (95% CI £−926 to £359) at 12 months; and £−453 (95% CI £−1366 to £461) at 18 months. The net benefit of starting to participate was £1956 (95% CI £209 to £3703) per participant at 18 months. Stopping participation was associated with larger negative impacts of −0.102 (95% CI −0.173 to −0.031) QALYs and £1335.33 (95% CI £112.85 to £2557.81) higher costs after 18 months.ConclusionsParticipation in community assets by older people with long-term conditions is associated with improved quality of life and reduced costs of care. Sustaining that participation is important because there are considerable health changes associated with stopping. The results support the inclusion of community assets as part of an integrated care model for older patients.

Working with older people with multiple long-term conditions: a qualitative exploration of nurses' experiences

2014 ◽  
Vol 71 (1) ◽  
pp. 90-99 ◽  
Author(s):  
Susan Waterworth ◽  
Merryn Gott ◽  
Deborah Raphael ◽  
John Parsons ◽  
Bruce Arroll
Keyword(s):  
Older People ◽  
Long Term Conditions ◽  
Qualitative Exploration

Patient satisfaction with a nurse-led, telephone-based disease management service in Birmingham

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 3-4 ◽  
Author(s):  
Pejman Azarmina ◽  
Jill Lewis
Keyword(s):  
Disease Management ◽  
Response Rate ◽  
Management Service ◽  
Educational Materials ◽  
Long Term Conditions ◽  
Qualitative Feedback ◽  
Telephone Calls ◽  
The Uk

In April 2006, a nurse-led telephone-based service was launched in Birmingham to improve the health outcomes of up to 2000 patients with high-risk, long-term conditions. Patients received regular telephone calls and educational materials selected according to their conditions. In August 2006, 506 questionnaires with 30 five-point Likert-type questions were sent to patients and 128 were returned within four weeks (25% response rate). The results showed that 96% of the respondents strongly agreed or agreed that they were satisfied with the quality of service being provided by the care managers. The educational material (care books) was found to be informative, easy to read and easy to understand. The qualitative feedback indicated that patients perceived the service to be useful, accessible and helped them to be more efficient in taking care of themselves. More than 40% of the patients agreed that the service reduced their need to go to hospital. Using a telephone-based disease management service seems to be an acceptable option for patients with long-term conditions in the UK.

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