Interprofessional Healthcare Education on Aging Increases Students' Confidence in Medication Management Skills

Abstract Students studying for health care professions have limited opportunities to learn about medication use and aging in an interprofessional experience. Health Care students who interact in a simulation of age-related sensory changes can identify adaptations for safe medication use and counseling necessary to promote healthy aging. This research assessed the impact of a simulated team experience on pharmacy and physician assistant students’ confidence in understanding age related changes and in learning adaptations to promote safe medication use for older adults who may experience those changes. 63 pharmacy and 113 Physician Assistant students participated in 2-hour Interprofessional Education (IPE) sessions. The teams of pharmacy/physician assistant students utilized glasses to simulate changes in vision and gloves to simulate conditions of arthritis and neuropathy which increase in prevalence with age. Teams practiced skills of medication counseling and empathy towards their peers experiencing the simulations and learned medication administration adaptations for aging well. Pre survey results show a deficit of Pharmacist-Physician Assistant IPE with less than 20% of students reporting a strong understanding of the other profession’s role in developing an older adult’s care plan. Post survey results demonstrate an increase in students’ confidence in both understanding how sensory impairments may affect a patient’s ability to properly administer medication and confidence in counseling older adults on safe medication use. Descriptive data on learning in Interprofessional teams, Pre/Post comparison data and application to students studying other majors will be presented.

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THE IMPACT OF AN EDUCATION INTERVENTION: IMPROVING COMMUNICATION BETWEEN OLDER ADULTS AND HEALTH CARE PROVIDERS

Innovation in Aging ◽

10.1093/geroni/igz038.3316 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S909-S909

Author(s):

Janna Heyman ◽

Linda White-Ryan ◽

Peggy Kelly

Keyword(s):

Older Adults ◽

Health Care ◽

Health Care Providers ◽

Educational Intervention ◽

Prescription Drugs ◽

Medication Use ◽

Care Providers ◽

Over The Counter ◽

Medical Needs ◽

The Impact

Abstract As people age, ensuing physical and psychological problems can increase, which makes it paramount to be comfortable discussing medical needs with health care professionals, particularly in light of the danger associated with misunderstanding medication use and combining alcohol with prescriptions and/or over the counter medications (National Institute on Aging, 2018). National studies found that about 40 percent of adults ages 65 and older drink alcohol and often do not understand the dangers of combining alcohol with medications (National Institute for Alcohol and Alcohol Abuse, 2008). An educational intervention was developed with a team of expert physicians, nurses, pharmacists and social workers who work in gerontology to focus on improving communication and addressing alcohol and medication use for older adults. A randomized controlled trial was conducted to assess whether the educational intervention improved older adults’ comfort in communicating with their health care providers, as well as their knowledge of the concomitant use of alcohol and prescription and over-the-counter (OTC) medications. Results of a MANCOVA showed that those in the intervention group showed larger increases in scores on communication with their health providers and knowledge about the implications of combining alcohol with prescription drugs than those in the control group (Wilks’ Lamda=.808, F(3,76)=6.039, p=.001<.05). In addition, linear regression models showed that the intervention was significantly associated with participants’ knowledge of the implications of combining alcohol with prescription drugs. The coefficient across models was approximately 1.00, which represented a substantial increase given the average score of 6.5.

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Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

BMC Public Health ◽

10.1186/s12889-021-11078-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elaine Thumé ◽

Marciane Kessler ◽

Karla P. Machado ◽

Bruno P. Nunes ◽

Pamela M. Volz ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Cohort Study ◽

Primary Health Care ◽

Rio Grande ◽

Cognitive Testing ◽

Rio Grande Do Sul ◽

Primary Health ◽

The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

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Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084370 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4370

Author(s):

A Kim ◽

Hayeon Lee ◽

Eun-Jeong Shin ◽

Eun-Jung Cho ◽

Yoon-Sook Cho ◽

...

Keyword(s):

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Medication Management ◽

Medication Use ◽

Potentially Inappropriate Medications ◽

Management Service ◽

Ckd Stage ◽

The Impact

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

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Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.690 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 214-214

Author(s):

Michael McKee ◽

Yunshu Zhou ◽

Joshua Ehrlich ◽

Elham Mahmoudi ◽

Jennifer Deal ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Self Care ◽

Household Activity ◽

Cross Sectional ◽

Age Related ◽

Increased Risk ◽

Lower Mobility ◽

Independent Effects ◽

The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p <0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p<.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p<.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

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The Impact of Behavioral Intervention on Obesity Mediated Declines in Mobility Function: Implications for Longevity

Journal of Aging Research ◽

10.4061/2011/392510 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Joe Nocera ◽

Thomas W. Buford ◽

Todd M. Manini ◽

Kelly Naugle ◽

Christiaan Leeuwenburgh ◽

...

Keyword(s):

Older Adults ◽

Aging Process ◽

Strong Predictor ◽

Functional Limitations ◽

Mobility Performance ◽

Mobility Function ◽

Age Related ◽

Close Relationship ◽

Primary Focus ◽

The Impact

A primary focus of longevity research is to identify prognostic risk factors that can be mediated by early treatment efforts. To date, much of this work has focused on understanding the biological processes that may contribute to aging process and age-related disease conditions. Although such processes are undoubtedly important, no current biological intervention aimed at increasing health and lifespan exists. Interestingly, a close relationship between mobility performance and the aging process has been documented in older adults. For example, recent studies have identified functional status, as assessed by walking speed, as a strong predictor of major health outcomes, including mortality, in older adults. This paper aims to describe the relationship between the comorbidities related to decreased health and lifespan and mobility function in obese, older adults. Concurrently, lifestyle interventions, including diet and exercise, are described as a means to improve mobility function and thereby limit the functional limitations associated with increased mortality.

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Age-Related Differences in Actual-Ideal Personality Trait Level Discrepancies

10.31234/osf.io/642kf ◽

2020 ◽

Author(s):

Marie Hennecke ◽

Paul Schumann ◽

jule specht

Keyword(s):

Older Adults ◽

Big Five ◽

Personality Trait ◽

Age Effects ◽

Big Five Personality ◽

Age Related ◽

Trait Level ◽

Patterns Of Behavior ◽

Nationally Representative ◽

The Impact

People differ from each other in their typical patterns of behavior, thought, and emotion and these patterns are considered to constitute their personalities (Funder, 2001). For various reasons, for example because certain trait levels may help to attain certain goals or fulfill certain social roles, people may experience that their actual trait levels are different from their ideal trait levels. In this study, we investigated (1) the impact of age on discrepancies between actual and ideal Big Five personality trait levels and (2) the impact of these discrepancies on personality trait changes across a period of two years. We use data of a large, nationally representative, and age-diverse sample (N = 4,057, 17-94 years, M = 53 years). Results largely confirmed previously reported age effects on actual personality trait levels but were sometimes more complex. Ideal trait levels exceeded actual trait levels more strongly for younger compared to older adults. Unexpectedly, neither ideal trait levels nor their interaction with beliefs about the extent to which personality is malleable vs. fixed predicted trait change over two years (controlling for actual trait levels). We conclude that ideal-actual trait level discrepancies may provide an impetus for change but that they appear to neither alone nor in combination with the belief that personality trait change is possible suffice to produce such change. We discuss commitment, self-efficacy, and strategy knowledge as potential additional predictors of trait change.

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Effects of Reallocating Time Spent in Different Physical Activity Intensities on Sarcopenia Risk in Older Adults: An Isotemporal Substitution Analysis

Biology ◽

10.3390/biology11010111 ◽

2022 ◽

Vol 11 (1) ◽

pp. 111

Author(s):

Jort Veen ◽

Diego Montiel-Rojas ◽

Fawzi Kadi ◽

Andreas Nilsson

Keyword(s):

Physical Activity ◽

Older Adults ◽

Protein Intake ◽

Handgrip Strength ◽

Community Dwelling ◽

Self Report ◽

Linear Regression Models ◽

Age Related ◽

Muscle Health ◽

The Impact

The role of daily time spent sedentary and in different intensities of physical activity (PA) for the maintenance of muscle health currently remains unclear. Therefore, we investigated the impact of reallocating time spent in different PA intensities on sarcopenia risk in older adults, while considering PA type (muscle strengthening activities, MSA) and protein intake. In a sample of 235 community-dwelling older adults (65–70 years), a sarcopenia risk score (SRS) was created based on muscle mass assessed by bioimpedance, together with handgrip strength and performance on the five times sit-to-stand (5-STS) test assessed by standardized procedures. Time spent in light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and being sedentary was assessed by accelerometry, and PA type (MSA) by self-report. Linear regression models based on isotemporal substitution were employed. Reallocating sedentary time to at least LPA was significantly (p < 0.05) related to a lower SRS, which remained evident after adjustment by PA type (MSA) and protein intake. Similarly, reallocating time in LPA by MVPA was related to a significantly (p < 0.05) lower SRS. Our results emphasize the importance of displacing sedentary behaviours for more active pursuits, where PA of even light intensities may alleviate age-related deteriorations of muscle health in older adults.

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District nurses’ experiences of using a clinical decision support system and an assessment tool at elderly care units in primary health care: a qualitative study

Primary Health Care Research & Development ◽

10.1017/s1463423621000530 ◽

2021 ◽

Vol 22 ◽

Author(s):

Annica Lagerin ◽

Lena Törnkvist ◽

Johan Fastbom ◽

Lena Lundh

Keyword(s):

Older Adults ◽

Health Care ◽

Primary Health Care ◽

Decision Support ◽

Clinical Decision Support System ◽

Elderly Care ◽

Medication Use ◽

Clinical Decision ◽

Primary Health ◽

District Nurses

Abstract Aim: The present study aimed to describe the experience of district nurses (DNs) in using a clinical decision support system (CDSS) and the safe medication assessment (SMA) tool during patient visits to elderly care units at primary health care centres. Background: In Swedish primary health care, general practitioners (GPs) prescribe and have the responsibility to regularly review older adults’ medications, while DN (nurses specialised in primary health care) play an important role in assessing older adults’ ability to manage their medications, detecting potential drug-related problems and communicating with patients and GPs about such problems. In a previous feasibility study, we found that DNs who use a combination of a CDSS and the SMA tool identified numerous potentially harmful or dangerous factors and took a number of nursing care actions to improve the safety and quality of patients’ medication use. In telephone interviews, patients indicated that they were positive towards the assessment and interventions. Methods: Individual interviews with seven DNs who worked at six different primary health care centres in Region Stockholm were carried out in 2018. In 2019, an additional group interview was conducted with two of the seven DNs so they could discuss and comment on preliminary findings. Qualitative content analysis was used to analyse the interview transcripts. Findings: Using the tools, the DNs could have a natural conversation about medication use with older adults. They could get a clear picture of the older adults’ medication use and thus obtain information that could facilitate collaboration with GPs about this important component of health care for older adults. However, for the tools to be used in clinical practice, some barriers would have to be overcome, such as the time-consuming nature of using the tools and the lack of established routines for interprofessional collaboration regarding medication discussions.

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Can Undergraduate Students Help Change Older Adults’ Confidence for Making Nutrition-Related Decisions in a 45-Minute Nutrition Workshop?

Canadian Journal of Dietetic Practice and Research ◽

10.3148/cjdpr-2021-010 ◽

2021 ◽

pp. 1-4

Author(s):

Rakhshan Kamran ◽

Giulia Coletta ◽

Janet M. Pritchard

Keyword(s):

Older Adults ◽

Undergraduate Students ◽

Social Cognitive ◽

Cognitive Theory ◽

Outcome Expectations ◽

Community Members ◽

Age Related ◽

Dietary Choices ◽

The Social ◽

The Impact

Purpose: The Social Cognitive Theory (SCT) suggests health behaviour can be modified by enhancing knowledge of health benefits and outcome expectations of changing behaviour, improving self-efficacy (confidence), and developing goals to overcome barriers to behaviour change. This study aimed to determine the impact of student-led nutrition workshops on participants’ confidence related to SCT constructs for making dietary choices that align with evidence-based nutrition recommendations. Methods: Level-4 Science students developed and delivered 9 workshops on nutrition recommendations for the prevention and management of age-related diseases. Participants attending the workshops completed pre- and post-surveys to assess SCT constructs. For each SCT construct, participants rated their confidence on a 10-point Likert scale. The number (%) of participants who rated their confidence as ≥8/10 on the pre- and post-surveys were compared using the χ2 test. Results: Sixty-three community members (60% female, mean ± SD age 71 ± 7 years) attended the workshops. The number of participants rating confidence as ≥8/10 for each SCT construct increased after the workshops (P < 0.05). Conclusion: Undergraduate students can positively influence community members’ confidence for making nutrition-related decisions. Involving students in interventions where SCT-structured workshops are used may help conserve health care resources and reach older adults who may not have access to dietitian services.

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