scholarly journals National trends in extremity fracture hospitalizations among older adults between 2003 and 2017

Author(s):  
Lisa Reider ◽  
Andrew Pollak ◽  
Jennifer L. Wolff ◽  
Jay Magaziner ◽  
Joseph F. Levy
2018 ◽  
Vol 74 (12) ◽  
pp. 1910-1915 ◽  
Author(s):  
Taeho Greg Rhee

Abstract Background To estimate prescribing trends of and correlates independently associated with coprescribing of benzodiazepines and opioids among adults aged 65 years or older in office-based outpatient visits. Methods I examined a nationally representative sample of office-based physician visits by older adults between 2006 and 2015 (n = 109,149 unweighted) using data from the National Ambulatory Medical Care Surveys (NAMCS). National rates and prescribing trends were estimated. Then, I used multivariable logistic regression analyses to identify demographic and clinical factors associated with coprescriptions of benzodiazepines and opioids. Results From 2006 to 2015, 15,954 (14.6%) out of 109,149 visits, representative of 39.3 million visits nationally, listed benzodiazepine, opioid, or both medications prescribed. The rate of prescription benzodiazepines only increased monotonically from 4.8% in 2006–2007 to 6.2% in 2014–2015 (p < .001), and the rate of prescription opioids only increased monotonically from 5.9% in 2006–2007 to 10.0% in 2014–2015 (p < .001). The coprescribing rate of benzodiazepines and opioids increased over time from 1.1% in 2006–2007 to 2.7% in 2014–2015 (p < .001). Correlates independently associated with a higher likelihood of both benzodiazepine and opioid prescriptions included: female sex, a visit for chronic care, receipt of six or more concomitantly prescribed medications, and clinical diagnoses of anxiety and pain (p < .01 for all). Conclusion The coprescribing rate of benzodiazepines and opioids increased monotonically over time in outpatient care settings. Because couse of benzodiazepines and opioids is associated with medication burdens and potential harms, future research is needed to address medication safety in these vulnerable populations.


Heart & Lung ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 370-376 ◽  
Author(s):  
Shelli L. Feder ◽  
Raymond A. Jean ◽  
Lori Bastian ◽  
Kathleen M. Akgün

2000 ◽  
Vol 40 (1) ◽  
pp. 165-208 ◽  
Author(s):  
Silvia Sara Canetto ◽  
Janet D. Hollenshead

This study examines the seventy-five suicide cases Dr. Jack Kevorkian acknowledged assisting during the period between 1990 and 1997. Although these cases represent a range of regional and occupational backgrounds, a significant majority are women. Most of these individuals had a disabling, chronic, nonterminal-stage illness. In five female cases, the medical examiner found no evidence of disease whatsoever. About half of the women were between the ages of forty-one and sixty, and another third were older adults. In contrast, men were almost as likely to be middle-aged as to be older adults. Men's conditions were somewhat less likely than women's to be chronic and nonterminal-stage. The main reasons for the hastened death mentioned by both the person and their significant others were having disabilities, being in pain, and fear of being a burden. The predominance of women among Kevorkian's assisted suicides contrasts with national trends in suicide mortality, where men are a clear majority. It is possible that individuals whose death was hastened by Kevorkian are not representative of physician-assisted suicide cases around the country, because of Kevorkian's unique approach. Alternatively, the preponderance of women among Kevorkian's assisted suicides may represent a real phenomenon. One possibility is that, in the United States, assisted suicide is particularly acceptable for women. Individual, interpersonal, social, economic, and cultural factors encouraging assisted suicide in women are examined.


2019 ◽  
Author(s):  
Lynette Hammond Gerido ◽  
Xiang Tang ◽  
Brittany Ernst ◽  
Aisha Langford ◽  
Zhe He

BACKGROUND By 2035, it is expected that older adults (aged 65 years and older) will outnumber children and will represent 78 million people in the US population. As the aging population continues to grow, it is critical to reduce disparities in their representation in medical research. OBJECTIVE This study aimed to describe sociodemographic characteristics and health and information behaviors as factors that influence US adults’ interest in engaging in medical research, beyond participation as study subjects. METHODS Nationally representative cross-sectional data from the 2014 Health Information National Trends Survey (N=3677) were analyzed. Descriptive statistics and weighted multivariable logistic regression analyses were performed to assess predictors of one’s interest in patient engagement in medical research. The independent variables included age, general health, income, race and ethnicity, education level, insurance status, marital status, and health information behaviors. RESULTS We examined the association between the independent variables and patient interest in engaging in medical research (PTEngage_Interested). Patient interest in engaging in medical research has a statistically significant association with age (adjusted <italic>P</italic>&lt;.01). Younger adults (aged 18-34 years), lower middle-aged adults (aged 35-49 years), and higher middle-aged adults (aged 50-64 years) indicated interest at relatively the same frequency (29.08%, 29.56%, and 25.12%, respectively), but older adults (aged ≥65 years) expressed less interest (17.10%) than the other age groups. After the multivariate model was run, older adults (odds ratio 0.738, 95% CI 0.500-1.088) were found to be significantly less likely to be interested in engaging in medical research than adults aged 50 to 64 years. Regardless of age, the strongest correlation was found between interest in engaging in medical research and actively looking for health information (<italic>P</italic>&lt;.001). Respondents who did not seek health information were significantly less likely than those who did seek health information to be interested in engaging in medical research. CONCLUSIONS Patients’ interest in engaging in medical research vary by age and information-seeking behaviors. As the aging population continues to grow, it is critical to reduce disparities in their representation in medical research. Interest in participatory research methods may reflect an opportunity for consumer health informatics technologies to improve the representation of older adults in future medical research.


2020 ◽  
pp. 089826432096626
Author(s):  
Henry K. Onyeaka ◽  
Perla Romero ◽  
Brian C. Healy ◽  
Christopher M. Celano

Background: Despite significant advancements in the use of health information technologies (HITs) in health care, older adults’ adoption of new technologies has consistently lagged behind that of younger adults. Objective: To compare ownership rates and preferences for utilizing technology for health information exchange among older and younger adults. Methods: Utilizing data from the 2017 and 2018 iterations of the Health Information National Trends Survey ( n = 6789), we performed multivariable logistic regression while controlling for sociodemographic characteristics. Results: Older adults were less likely than younger adults to own technological devices such as smartphones, less likely to report finding these tools beneficial in monitoring their health, and less likely to use these tools in communicating with their health providers. However, these differences were substantially attenuated after adjustment for technology ownership. Discussion: Future research should aim to identify factors associated with access, usability, and adoption of HIT for managing care among older adults.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1038-1039
Author(s):  
Christopher Kaufmann ◽  
Adam Spira ◽  
Emerson Wickwire ◽  
Ramin Mojtabai ◽  
Sonia Ancoli-Israel ◽  
...  

Abstract Recent initiatives to discourage over-prescription of sleep medications have increased awareness of their potential adverse effects in older adults; however, it is unknown whether these efforts translated into a decline in use of these medications in the United States. We assessed recent national trends in the use of medications for sleep disorders. Data came from the 2013-2018 National Health and Nutrition Examination Survey. At each of three waves of in-person assessments, participants presented prescription bottles for all medications used in the prior month. Interviewers recorded each medication and participants self-reported duration and indications for use. We identified all medications used for a sleep disorder and categorized medications into two groups: FDA-approved sleep medications, and medications used off-label (i.e., any other medication reported to be used for sleep disorders). We examined changes in the prevalence in use of these medications across the study period. The odds of using medications for sleep disorders decreased 31% between 2013 and 2018 (odds ratio [OR]=0.69, 95% confidence interval [CI]=0.51-0.92). This trend was driven by declines in use of FDA-approved sleep medications (OR=0.45, 95% CI=0.34, 0.59). Of note, among those age 80+ years, we observed an 86% decline (OR=0.14, 95% CI=0.05-0.36) in the odds of using FDA-approved sleep medications over the study period. Results suggest a possible effect of efforts to curb over-prescription and encourage judicious use of these agents. Future research needs to examine whether these changes have coincided with improved sleep health in the growing population of older adults.


2020 ◽  
Vol 68 (10) ◽  
pp. 2240-2248
Author(s):  
Timothy S. Anderson ◽  
Edward R. Marcantonio ◽  
Ellen P. McCarthy ◽  
Shoshana J. Herzig

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