Measures of polypharmacy and chemotherapy toxicity in older adults with cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9545-9545 ◽  
Author(s):  
Ronald John Maggiore ◽  
Tao Feng ◽  
William Dale ◽  
Cary Philip Gross ◽  
William P. Tew ◽  
...  

9545 Background: Polypharmacy is common and associated with adverse clinical outcomes in older adults. Potentially inappropriate medication (PIM) use serves as an adjunctive assessment of polypharmacy. The goals of this study in an outpatient population of older adults with cancer (CA) were: 1) to estimate the prevalence of polypharmacy using multiple measures; and 2) to determine the relationship between polypharmacy and chemotherapy (chemo) toxicity. Methods: Medication use was evaluated in 500 patients (pts) age ≥65 years with invasive CA who were starting a new chemo regimen. Polypharmacy was defined by number of daily medications (meds), including non-prescription meds. PIM use was defined by 4 indices: Beers (2003 and 2012 update), Zhan, and HEDIS Drugs to Avoid in the Elderly (DAE) criteria. Prevalence of polypharmacy, PIM, and their association with grade 3-5 chemo toxicity [NCI Common Toxicity Criteria (v. 3.0)] were analyzed using chi square test and unconditional logistic regression. Results: All 500 pts were evaluable [mean age, 73 years (range 65-91); 56% female; 61% stage IV]. The mean number of daily meds was 5 (range 0-23); 38% used ≤3 daily meds, 51% used 4-9 meds, and 11% using ≥10 meds. Using 0-3 daily meds as the referent group, no association was found between daily meds and chemo tox: 4-9 meds, OR 1.34 (95% CI: 0.92-1.97); ≥10, OR 0.82 (95% CI: 0.45-1.49). PIM use was identified in 87 (17%), 147 (29%), 54 (11%), and 69 (13%) patients utilizing the 2003 Beers, 2012 Beers, Zhan, and HEDIS DAE criteria, respectively. There was no association between each PIM use index and chemo toxicity (p>0.10 for all). Conclusions: Polypharmacy and PIM use were common in the geriatric oncology population. Although polypharmacy did not increase the risk of chemotherapy toxicity in this sample, further studies of polypharmacy’s impact on additional outcomes, including non-chemotherapy adverse drug events, in older persons with cancer are warranted.

2021 ◽  
pp. 105477382098668
Author(s):  
Kathleen Schell ◽  
Denise Lyons ◽  
Barry Bodt

The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings ( n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance ( p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.


2020 ◽  
Vol 2 (2) ◽  
pp. 128-134
Author(s):  
Pramila Bhandari ◽  
Mira Baral

Background: Abuse of the elderly is a hidden problem in Nepalese community. Pokhara city is highly affected by urbanization, modernization and migration that predispose older adults to social isolation and financial difficulties increasing their risk to abuse. This study aims to fill the gap in the knowledge in the area of abuse of elderly in Pokhara city.Objectives: The major objective of this study was to determine the prevalence of caregiver abuse experienced by the older adults and find out the factors associated with the abuse. Method: A cross sectional study was used for the study. Convenience sampling technique was used and data was collected from 192 elderly above the age of 60 years residing a community of Pokhara-28, Kaski at their households using a structured interview schedule. Data was collected in June 2018, for a period of one month. Before data collection, informed written consent was taken from participants. The data was analyzed by using SPSS-16 and chi-square test was used as inferential statistics to determine the association between the elder abuse and selected variables.Result: We found out that 65.6% of the elderly experienced at least one abuse in the last 6 months. The most common forms of abuse were caregiver neglect (55.2%) and psychological abuse (38.5%). The elderly abuse was statistically significant with female sex (p=0.001), unmarried/widow/widower/separated/divorced (p=.021), illiterate (p=0.002), and among those having chronic illness (p=0.003). Conclusion: Almost 7 out of 10 elderly experienced abuse in the past 6 months. The most common form of abuse was caregiver neglect followed by psychological and financial abuse. Older adults who were females, unmarried/widowed/separated/divorced, illiterate and those having chronic disease were at higher risk for abuse.


Author(s):  
Kyuwon Lee ◽  
Areum Han ◽  
Tae Hui Kim

The aim of this study was to examine whether a Simulation-based Empathy Enhancement program for Caregivers of the Elderly (SEE-C) was effective in increasing program satisfaction and positive emotional changes of older adults. A total of 100 older adults living alone were randomly assigned to experimental and control groups. The experimental group was interviewed by caregivers who experienced SEE-C while the control group was interviewed by caregivers who did not experience SEE-C. In both elderly groups, post session satisfaction and affective state were assessed using a Session Evaluation Questionnaire (SEQ). Chi-square test and Mann-Whitney U test were conducted. The experimental group (n = 49) reported significantly higher scores than the control group (n = 51) for all three categories of SEQ: session-depth (Mann-Whitney U = 1651.5, p = 0.005), session-smoothness (Mann-Whitney U = 1803.0, p = 0.000), and emotion-positivity (Mann-Whitney U = 1783.0, p = 0.000). However, the experimental group had significantly lower scores for the arousal category of SEQ (Mann-Whitney U = 873.5, p = 0.009). SEE-C could have a positive impact on interviews for elderly care in terms of raising the satisfaction of the interviewee.


2020 ◽  
Vol 10 (3) ◽  
pp. 85-91
Author(s):  
Daniel Vicentini de Oliveira ◽  
Sônia Maria Marques Gomes Bertolini ◽  
Ellis Gilson Chatalov ◽  
Maura Fernandes Franco ◽  
Maria do Carmo Correia de Lima ◽  
...  

Aims: To evaluate factors associated with the practice of transcendental meditation (TM) in the elderly. Methods: Cross-sectional study, with the inclusion of 113 older adults and women, 60 of them practitioners and 53 non-MT practitioners. A semi-structured questionnaire was used as an instrument, composed of sociodemographic, health and TM practice data. Data analysis was performed using the chi-square test and binary logistic regression. Results: The average age of practitioners was lower than that of non-practitioners (63.7 ± 4.0 vs. 69.1 ± 6.6 years). Most of the sample had completed higher education (f = 45; 75%; p = 0.001) and received more than three minimum wages (f = 40; 67.8%; p = 0.001). In the group of TM practitioners there was a greater proportion of individuals with excellent / good self-perceived health (91.7% vs 77.4%; p = 0.034), and less hospitalization in the last semester (5% vs 24.5 %; p = 0.003). Older adults who denied hospitalization or the presence of diabetes mellitus (DM) presented, respectively, 5.7 (95% CI OR 1.1 - 28.9) and 4.9 (95% CI OR 1.3 - 19.2) times chance to practice MT. The practice of TM is 80% more likely to be practiced by older adults with better self-perceived health (OR 0.17; 95% CI 0.03 - 0.96). Conclusion: The practice of a holistic activity such as TM is associated with better self-perceived health than older adults of the same age, and less chance of hospitalization in the last semester and the presence of DM.


1970 ◽  
Vol 4 ◽  
pp. 129-142 ◽  
Author(s):  
Raj Kumar Subedi

Insomnia is one of the major and unsolved problems in older people. Most of the sleep studies report that the different forms of insomnia like Difficulty Initiating Sleep (DIS), Difficulty Maintaining Sleep (DMS) and Non-Restorative Sleep (NRS) are common among the elderly that are associated to many factors. The objective of the study was to measure the prevalence of insomnia and the factors associated to it among the elderly people. A cross-sectional study was conducted among 142 elderly people of and above 60 years of age in Sarangdanda VDC of Panchthar District of Eastern Nepal. The presence or absence of insomnia and the associated factors were assessed on them by the help of interview schedule. The results were analyzed using chi-square test in SPSS (version 11.5). DMS was the most common reported form of insomnia among the elderly followed by DIS and NRS. Association between insomnia and each of factors like use of tobacco before sleeping hours, eating too close to bedtime, use of tea/coffee before sleeping hours and use of alcohol before sleeping hours were statistically significant at 95% level of confidence. Insomnia affects a large proportion of elderly and is triggered by many factors like use of tobacco before sleeping hours, use of tea/coffee before sleeping hours, eating too close to bedtime and use of alcohol before sleeping hours. Keywords: Alcohol; tea/coffee; difficulty initiating sleep (DIS); difficulty maintaining sleep (DMS); non-restorative sleep (NRS); tobacco DOI: 10.3126/dsaj.v4i0.4517 Dhaulagiri Journal of Sociology and Anthropology Vol.4 2010 pp.129-142


2021 ◽  
Vol 13 (5) ◽  
pp. 2563
Author(s):  
Małgorzata Ćwiek ◽  
Katarzyna Maj-Waśniowska ◽  
Katarzyna Stabryła-Chudzio

This article undertakes the research problem of the assessment of the significance of poverty as a social challenge for local self-government units, and the differences in the assessment of the incidence of this phenomenon depending on the type of municipality. The authors also analyse the relationships between the ageing of the population and the assessment of the extent of poverty by municipalities. It must be pointed out that the undertaken problem has not been a subject of in-depth analysis thus far. Hence, this article fills the identified research gap in this field. The empirical part is based on the results of our own research, conducted using the Computer-Assisted Web Interview (CAWI) method on a sample of 144 municipalities of the Małopolskie Voivodship (Poland). In order to verify whether there is a relationship between the researched qualitative variables, the chi-square test of independence was used. In order to determine the relationships occurring between the categories of variables characterising the scale of the incidence of poverty and the remaining variables, a correspondence analysis was conducted. The research enabled us to find the issue of poverty to be one of the most important social problems from the point of view of municipalities. It is also worth noting that the degree of ageing in the population has an impact on the assessment of poverty among the elderly.


Author(s):  
Brain Guntoro ◽  
Kasih Purwati

Hypertension is one of the number one causes of death and disability in the world. Hypertension contributes nearly 9.4 million deaths from cardiovascular disease each year. Hypertension can cause undesirable effects, it needs good handling, one of them is by doing a hypertension diet. To carry out a hypertension diet requires knowledge, lack of knowledge can increase risk factors for hypertension. This study aims to determine the relationship of the level of knowledge about hypertension diet to the incidence of hypertension in the elderly at the Baloi Permai Public Health Center Batam City. This research method is an analytic observational with a cross-sectional approach conducted at the Baloi Permai Public Health Center Batam City 2018. Sampling technique is a total sampling with a sample of 64 people in 2018 determined by inclusion and exclusion criteria. The results of the study were analyzed with frequency distribution and then tested with the Chi-square test. Based on the results of this study indicate that of the 64 respondents found elderly who have a good level of knowledge are 41 people (64.1%), 48 people (75.0%) have an age range between 60-70 years. 27 people (42.2%) elderly have the last high school education and 40 people (62.5%) have jobs as entrepreneurs. Elderly people who have normal blood pressure are 40 people (62.5%), and those affected by hypertension are 24 people (37.5%). The elderly who have a family history of hypertension is 21 people (32.8%) and those who do not have a history of hypertension are 43 people (67.2%). Chi-Square Test analysis results show the significance value p = 0.009. This number is significant because the p-value is smaller than the significance level (α) ≤ 5% (0.05), so H0 is rejected and Ha is accepted. Therefore it can be concluded that there is a significant relationship about the level of knowledge about the hypertension diet to the incidence of hypertension in the elderly. From the results of this study it was concluded that there was a relationship between the level of knowledge about the hypertension diet and the incidence of hypertension in the elderly at the Baloi Permai Public Health Center Batam City in 2016.


2013 ◽  
Vol 16 (4) ◽  
pp. 872-879 ◽  
Author(s):  
Johnnatas Mikael Lopes ◽  
Fábio Galvão Dantas ◽  
Jovany Luis Alves de Medeiros

OBJECTIVE: To observe the relationship between Excessive Daytime Sleepiness (EDS) and the presence of risk factors for cardiovascular dysfunction, depression and obesity in the elderly. METHODS: We interviewed 168 elderly from the community of Campina Grande, Paraíba. They were selected according to health districts in the period of 2010. We used the Epworth Sleepiness Scale to diagnose excessive daytime sleepiness (> 10 points); waist circumference for the risk of cardiovascular dysfunction (> 94 or > 80 cm); Geriatric Depression Scale for depression (>10 points) and body mass index for obesity (> 25 kg/m2). Association analysis was performed by the Chi-square test adjusted for sex and age group, adopting α < 0.05. RESULTS: One hundred and sixty eight elderly individuals with mean age of 72.34 ± 7.8 years old participated in this study, being 122 (72.6%) women. EDS was identified in 53 (31.5%) of them; depression, in 72 (42.9%); overweight/obesity, in 95 (64.46%); and risk of cardiovascular dysfunction, in 129 (79.6%). Depressed men (78.6%, p = 0.0005) and risk of cardiovascular dysfunction (57.1%, p = 0.02) were more prone to EDS. In women, only obesity was related to sleepiness (42.1%, p = 0.01). Only those aged between 70 - 79 years old showed association between sleepiness and obesity. CONCLUSION: It was found that obesity for women, and depression and cardiovascular dysfunction risking for men were associated with EDS in the elderly. The variable sex is a confusion condition for the association with sleepiness.


2018 ◽  
Vol 12 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Rafael Thomazi ◽  
Liciana Vaz de Arruda Silveira ◽  
Paulo José Fortes Villas Boas ◽  
Alessandro Ferrari Jacinto

ABSTRACT Patients with dementia are commonly admitted to inpatient sectors. The aim of this study was to describe the frequency of dementia among elderly inpatients admitted to the Geriatrics Sector of a Brazilian Tertiary University Hospital, and to identify associations between dementia and clinical and sociodemographic factors. Methods: All patients admitted to the Geriatrics Sector of a public Brazilian university-hospital from March 1st 2014 to January 31st 2015 were assessed by geriatricians. The patients were divided into groups "with or without diagnosis of dementia". Univariate analysis was performed between these two groups using the Chi-Square Test, Student's t-test or the Mann-Whitney Test. Results: One hundred and three elderly inpatients, with a mean age of 82 (±7.9) years, were assessed. Overall, 74.7% had low educational level (<4 years), 66% used polypharmacy, 57.2% developed delirium during hospitalization and 59% were totally dependent for basic activities of daily living. The diagnosis of dementia was observed in 59 (57%) subjects. Conclusion: The frequency of dementia was high among the elderly inpatients evaluated. The association between dementia and certain clinical conditions, such as incontinence, delirium and use of psychoactive drugs, was in line with the medical literature.


2021 ◽  
pp. 01-06
Author(s):  
Unnati Saxena ◽  
Debdipta Bose ◽  
Shruti Saha ◽  
Nithya J Gogtay ◽  
Urmila M Thatte

The present audit was carried out with the objective of evaluating warning letters (WLs) issued to trial sponsors, clinical investigators and institutional review boards (IRBs) by the United States Food and Drug Administration during a six-year period and compare it with two similar earlier audits. WLs were reviewed and classified as per stakeholders and further categorised as per predefined violation themes. The chi-square test was performed for trend analysis of WLs. A total of 62 WLs were issued to the three stakeholders. The maximum number of WLs were issued to the clinical investigators (36/62, 58.06%), followed by sponsors (19/62, 30.64%), and least to the IRBs (7/62, 11.29%). Among sponsors, lack of standard operating procedures for the monitoring, receipt, evaluation and reporting of post-marketing adverse drug events was the most common violation theme (8/19, 42.1%). Among clinical investigators, deviation from investigational plan was the most common violation theme (31/36, 86.11%.). For IRBs, inadequate documentation was the most common violation theme (6/7, 85.71%). We saw an overall reduction in the number of WLs issued to the stakeholders. Thus, we identified multiple areas on which each stakeholder should work for improvement.


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