The Potential of Optometrists’ Referrals of Older Patients to Community-Based Exercise Programs: Findings From a Mixed-Methods Study

2020 ◽  
Vol 28 (2) ◽  
pp. 194-207
Author(s):  
Christina E. Miyawaki ◽  
Rebecca L. Mauldin ◽  
Carolyn R. Carman
Keyword(s):  
Older Adults ◽  
Mixed Method ◽  
Older Patients ◽  
Exercise Program ◽  
Mixed Methods Study ◽  
Routine Practice ◽  
Exercise Programs ◽  
Community Based ◽  
Cross Sectional ◽  
Cross Sectional Design

Exercise is important for older adults in order to prevent falls and live safer, healthier lives. Visual impairment is a risk factor for falling. Older adults tend to visit optometrists frequently; however, assessing patients’ physical exercise levels is not a routine practice for optometrists. The purpose of this study was to examine the potential for optometrists’ referrals to exercise programs. This study used a mixed-method, cross-sectional design. In focus groups, optometry patients (N = 42) discussed the acceptability of an optometrist’s prescription for exercise programs. The vast majority of optometry patients (90%) indicated that they would follow such a prescription for exercise from their optometrists. Texas optometrists (N = 268) were surveyed about the potential for exercise program prescriptions, and 97% indicated a willingness to prescribe exercise programs to their patients. The results suggest that there is an opportunity for community–clinical partnerships to prevent falls and to improve the health of older patients.

“Are Your Clients Having Fun?” The Implications of Respondents’ Preferences for the Delivery of Group Exercise Programs for Falls Prevention

2016 ◽  
Vol 24 (1) ◽  
pp. 129-138 ◽  
Author(s):  
Lucy McPhate ◽  
Emily M. Simek ◽  
Terry P. Haines ◽  
Keith D. Hill ◽  
Caroline F. Finch ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Exercise Program ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Group Exercise ◽  
Exercise Programs ◽  
Cross Sectional ◽  
Advantages And Disadvantages ◽  
Framework Approach

Background:Group exercise has been shown to be effective in preventing falls; however, adherence to these interventions is often poor. Older adults’ preferences for how these programs can be delivered are unknown.Objective:To identify older people’s preferences for how group exercise programs for falls prevention can be delivered.Design:A two-wave, cross-sectional, state-wide telephone survey was undertaken. Respondents were community-dwelling men and women aged 70+ in Victoria, Australia.Methods:Open-ended questions were asked to elicit information regarding respondent preferences of the program, which were analyzed using a framework approach.Results:Ninetyseven respondents completed the follow-up survey. The results indicate that older adults most frequently report the short-term advantages and disadvantages when describing their preferences for group exercise, such as enjoyment, social interaction, and leader qualities. Longer-term advantages such as falls prevention were described less frequently.Conclusions:This study indicates the importance of interpersonal skills, and that the opportunity for social interaction should not be overlooked as a positive feature of a group exercise program.

scholarly journals Sonoelastography to Assess Muscular Stiffness Among Older Adults and its Use for the Diagnosis of Sarcopenia: A Systematic Review

2020 ◽  
Author(s):  
Ewa Magdalena Janczyk ◽  
Noémie Champigny ◽  
Emeline Michel ◽  
Charles Raffaelli ◽  
Cédric Annweiler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Older Patients ◽  
Shear Wave Elastography ◽  
Rectus Femoris ◽  
Muscle Stiffness ◽  
Cross Sectional ◽  
Significant Difference ◽  
Independent Review ◽  
Cross Sectional Design

AbstractChanges in muscle stiffness have been reported with sarcopenia. Sonoelastography is an accessible and non-radiating imaging technique allowing quantification of elastic properties of tissue. We performed a systematic review of the literature to investigate whether sonoelastography can be a reliable method to assess sarcopenia in older patients. We searched Medline, Google Scholar, Scopus, SpringerLink and Science direct from January 1, 1990 to April 1, 2020. Three independent review authors assessed trial eligibility, extracted the data, and assessed risk of bias. We intended to learn which types of elastography have been tested, if such measures are repeatable, and if they have been compared to the currently accepted diagnostic method. Ten studies met the inclusion criteria. Most followed a cross-sectional design with young and older adult subgroups. The gastrocnemius, rectus femoris, and vastus intermedius appeared most frequently. Nine of the included studies used shear wave elastography and one-strain elastography. The passive elastic constant was significantly greater in sarcopenic versus healthy subjects after passive stretching (124.98 ± 60.82 vs. 46.35 ± 15.85, P = 0.004). However, even in non-sarcopenic patients, the age of the patient was responsible for about 45.5 % of the variance in SWV. Among ten included articles, four reported higher stiffness in the muscles of older adults, two reported lower stiffness, and four found no significant difference. Due to the substantial heterogenicity of actual data, we could not make any conclusions about the potential usefulness of elastography to assess sarcopenia. Further studies are needed, including a larger sample of older patients and using a standardized and reproducible protocol.

scholarly journals Comparison of adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing potentially inappropriate medication use in Hong Kong older patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huanyu ZHANG ◽  
Eliza L. Y. WONG ◽  
Samuel Y. S. WONG ◽  
Patsy Y. K. CHAU ◽  
Benjamin H. K. YIP ◽  
...  
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Female Gender ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Beers Criteria ◽  
Medical Conditions ◽  
Cross Sectional

Abstract Background The Hong Kong-specific criteria have been established in 2019 to assess potentially inappropriate medication (PIM) use in older adults and improve the local prescribing quality. The aim of this study was to compare the adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing the prevalence and correlates of PIM use in Hong Kong older patients. Methods A cross-sectional study was performed from January 1, 2014 to December 31, 2014 using the Hospital Authority (HA) database. A total of 489,301 older patients aged 65 years and older visiting general outpatient clinics (GOPCs) during the study period were included in the study. Two categories of PIM use included in the Hong Kong-specific criteria and 2015 Beers criteria, i.e. PIMs independent of diagnoses and PIMs considering specific medical conditions, were adapted to assess the prevalence of PIM use among the study sample. Characteristics of PIM users and the most frequently prescribed PIMs were investigated for each set of the criteria. Factors associated with PIM use were identified using the stepwise multivariable logistic regression analysis. Results The adaptive Hong Kong-specific criteria could detect a higher prevalence of patients exposed to at least one PIM than that assessed by the adaptive Beers criteria (49.5% vs 47.5%). Meanwhile, the adaptive Hong Kong-specific criteria could identify a higher rate of patients exposed to PIMs independent of diagnoses (48.1% vs 46.8%) and PIMs considering specific medical conditions (7.3% vs 4.9%) compared with that of the adaptive Beers criteria. The most frequently prescribed PIMs detected by the adaptive Beers criteria were all included in the adaptive Hong Kong-specific criteria. The strongest factor associated with PIM use was number of different medications prescribed. Patients with female gender, aged 65 ~ 74 years, a larger number of GOPC visits, and more than six diagnoses were associated with greater risk of PIM use, whereas advancing age was associated with lower risk of PIM use. Conclusions The adaptive Hong Kong-specific criteria could detect a higher prevalence of PIM use than the adaptive Beers criteria in older adults visiting GOPCs in Hong Kong. It is necessary to update the prevalence and correlates of PIM use regularly in older adults to monitor the burden of PIM use and identify vulnerable patients who need further interventions.

scholarly journals Prevalence and determinants of potentially inappropriate medication use in Hong Kong older patients: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051527
Author(s):  
Huanyu Zhang ◽  
Eliza LY Wong ◽  
Samuel YS Wong ◽  
Patsy YK Chau ◽  
Benjamin HK Yip ◽  
...  
Keyword(s):  
Older Adults ◽  
Regression Analysis ◽  
Hong Kong ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesTo assess the prevalence of potentially inappropriate medication (PIM) use in Hong Kong older patients visiting general outpatient clinics (GOPCs) between 2006 and 2014 and to identify factors associated with PIM use among older adults visiting GOPCs in 2014.DesignCross-sectional study.SettingGOPC.ParticipantsTwo study samples were constructed including a total of 844 910 patients aged 65 and above from 2006 to 2014 and a cohort of 489 301 older patients in 2014.MeasurementsTwo subsets of the 2015 American Geriatrics Society Beers criteria—PIMs independent of diagnosis and PIMs due to drug–disease interactions—were used to estimate the prevalence of PIM use over 12 months. PIMs that were not included in the Hospital Authority drug formulary or with any specific restriction or exception in terms of indication, dose or therapy duration were excluded. Characteristics of PIM users and non-PIM users visiting GOPCs in 2014 were compared. Independent associations between patient variables and PIM use were assessed by stepwise multivariable logistic regression analysis.ResultsThe 12-month period prevalence of PIM use decreased from 55.56% (95% CI 55.39% to 55.72%) in 2006 to 47.51% (95% CI 47.37% to 47.65%) in 2014. In the multivariable regression analysis, the strongest factor associated with PIM use was the number of different drugs prescribed (adjusted OR, AOR 23.01, 95% CI 22.36 to 23.67). Being female (AOR 0.89, 95% CI 0.85 to 0.87 for males vs females) and having a greater number of GOPC visits (AOR 1.83, 95% CI 1.78 to 1.88) as well as more than six diagnoses (AOR 1.43, 95% CI 1.36 to 1.52) were associated with PIM use.ConclusionsThe overall prevalence of PIM use in older adults visiting GOPCs decreased from 2006 to 2014 in Hong Kong although the prevalence of PIM use was still high in 2014. Patients with female gender, a larger number of medications prescribed, more frequent visits to GOPCs, and more than six diagnoses were at higher risk for PIM use.

scholarly journals The effectiveness of nutrition education for care takers at Al-Sabah children hospital in patient therapeutic feeding center, Juba South Sudan.

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
John Bosco Alumai
Keyword(s):  
Nutrition Education ◽  
Mixed Method ◽  
Qualitative Data ◽  
Group Discussion ◽  
South Sudan ◽  
Transfer Of Knowledge ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Feeding Center ◽  
Successful Transfer

 AbstractBackgroundA key part of treating and preventing malnutrition is the provision of effective nutrition education to the clients and caretakers so that they can self-manage their nutrition needs even after discharge from the hospital. For effective nutrition education, three factors are paramount; The successful transfer of knowledge and skills, client motivation to act on the acquired skills and knowledge and ensuring that the patient is able to understand and put to practice the educational messages given.MethodsThe study used cross sectional design with mixed method of data collection that involved 83 caretakers of admitted SAM children at Al-Sabah children hospital ITC, Sample size was determined using Cochran 1975, interviewer administered questionnaires and focus group discussion guide were the tools used in collecting data.Data set was generated using EPI info and analyzed using SPSS version 21, the analyzed descriptive data was triangulated with the qualitative data collected using FGD.Results The majority of the caretakers were female 78 (94%) of which 68 (81.9%) were mothers to the children that were admitted. Only 8 (9.6%) of the respondents were found to have attained effective nutrition education and majority of the respondents were found not to be recalling the information they were given during the education session.ConclusionAs per the guidelines adapted by the ministry of health republic of South Sudan, the nutrition education sessions conducted was found not be effective as most of the clients could not even recall the information given. 

scholarly journals Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

2021 ◽  
Vol 14 (9) ◽  
pp. 844
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Mohammed Assen Seid ◽  
Aynishet Adane ◽  
Eyob Alemayehu Gebreyohannes ◽  
Jovana Brkic ◽  
...  
Keyword(s):  
Older Adults ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Routine Practice ◽  
Cross Sectional ◽  
Inappropriate Medication Use ◽  
High Prevalence ◽  
Sliding Scale

Few studies have been conducted on multimorbidity (two or more chronic diseases) and rational geriatric prescribing in Africa. This study examined the prevalence and determinants of multimorbidity, polypharmacy (five or more long-term medications), and potentially inappropriate medication (PIM) use according to the 2019 Beers criteria among the older adults attending chronic care clinics from a single institution in Ethiopia. A hospital-based cross-sectional study was conducted among 320 randomly selected older adults from 12 March 2020 to 30 August 2020. A multivariable logistic regression analysis was performed to identify the predictor variables. The prevalence of multimorbidity, polypharmacy, and PIM exposure was 59.1%, 24.1%, and 47.2%, respectively. Diuretics (10%), insulin sliding scale (8.8%), amitriptyline (7.8%), and aspirin (6.9%) were among the most frequently prescribed PIMs. Older patients experiencing pain flare-ups were more likely to have multimorbidity (adjusted odds ratio (AOR): 1.64, 95% confidence intervals: 1.13–2.39). Persistent anger (AOR: 3.33; 1.71–6.47) and use of mobility aids (AOR: 2.41, 1.35–4.28) were associated with polypharmacy. Moreover, cognitive impairment (AOR: 1.65, 1.15–2.34) and health deterioration (AOR: 1.61, 1.11–2.32) increased the likelihood of PIM exposure. High prevalence of multimorbidity and PIM use was observed in Ethiopia. Several important determinants that can be modified by applying PIM criteria in routine practice were also identified.

scholarly journals Anxiety and depression symptoms in older adults during coronavirus disease 2019 pandemic: A community-based cross-sectional study

2021 ◽  
Vol 9 ◽  
pp. 205031212110400
Author(s):  
Kemal Jemal ◽  
Tinsae Abeya Geleta ◽  
Berhanu Senbeta Deriba ◽  
Mukemil Awol
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
High Morbidity ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Symptoms Of Depression

Objectives: The coronavirus disease 2019 pandemic has caused high morbidity and mortality in older adults over the world. Because the coronavirus disease 2019 pandemic greatly affects older adults who have a preexisting health condition, they are generally susceptible to a high incidence of severe symptoms of anxiety and depression. Therefore, we aimed to assess the prevalence of anxiety and depression symptoms in older adults during the coronavirus disease 2019 pandemic. Methods: Community-based cross-sectional study was completed in August 2020. Standardized and pretested General Anxiety Disorder–7 and Geriatric Depression Scale were used to screen the symptoms of anxiety and depression, respectively. Data were entered into EpiData (version 4.3.2) and transferred to SPSS (version 24) for further analysis. Bivariate and multivariate logistic regression analyses were carried out to determine the significantly associated variables with a 95% confidence interval at p < 0.05. Results: Of the total older adults interviewed, 68.7% had developed symptoms of anxiety and 59.9% had symptoms of depression during the coronavirus disease 2019 pandemic. Female participants, having a chronic disease and poor knowledge of the coronavirus disease 2019 pandemic, were significantly associated with anxiety symptoms. Age category of 81 to 90 and above 90, lack of social support, and having a chronic disease were significantly associated with symptoms of depression. Conclusion: The symptoms of anxiety and depression among older adults in the North Shoa Zone during coronavirus disease 2019 were higher than before the coronavirus disease 2019 happened. The results were evidence points for developing a psychological intervention to tackle the older adults’ mental health needs in the community during and after the coronavirus disease 2019 pandemic.

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