In-Home Drug Storage by Older Adults

Globally, in-home drug-storage compliance is often unsatisfactory, especially among older adults, and can lead to negative health outcomes. This study used a cross-sectional and descriptive design to examine in-home drug-storage compliance among older adults. Convenience sampling was used to recruit 117 older adults in Hong Kong. An in-home drug-storage checklist was used to assess the in-home drug-storage environments (light, temperature, and humidity) and drug-storage methods (drug safety, packaging, information, and expiration) of each older adult. The findings showed that Hong Kong older adults’ overall compliance rate in drug storage was 87.25%, and their compliance rate for drug-storage methods (84.59%) was lower than that for drug-storage environments (97.02%). Older adults who were of advanced age, who were less educated or who lived alone demonstrated lower in-home drug-storage compliance. This indicates the need to revise existing health-education strategies to encourage in-home drug-storage compliance. Healthcare professionals should assess older adults’ drug-storage compliance to identify less compliant subgroups and deliver specific drug-storage support as required. Family members should also be involved in this process.

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Usability of a tablet computer designed for older adults: a qualitative approach based on an intra-hospital living-lab for healthcare (Preprint)

10.2196/preprints.25186 ◽

2020 ◽

Author(s):

Guillaume Sacco ◽

Pauline Carliez ◽

Frédéric Noublanche ◽

Romain Simon ◽

Anne Renaudin ◽

...

Keyword(s):

Older Adults ◽

Geriatric Patients ◽

Healthcare Professionals ◽

Cross Sectional Study ◽

Satisfaction Score ◽

Tablet Computer ◽

Sectional Study ◽

Cross Sectional ◽

System Usability Scale ◽

Perceived Usability

BACKGROUND Usability is the keystone in the evolution of tablet technology in healthcare. The Ardoiz® tablet has been designed with a simplified interface for older adults. OBJECTIVE To assess the perceived usability and satisfaction of the Ardoiz® tablet. METHODS We conducted a mixed methods with cross-sectional study using System Usability Scale (SUS), satisfaction score and workshops, including geriatric patients, healthcare professional and caregivers. RESULTS Between September 25, 2019 and March 11, 2020, 58 participants were included in a cross-sectional study (including 38 patients, mean ±SD 85±6 years, 66% women), 26 in workshops (including 5 patients, mean ±SD 86.4±2.9, 40% women). The SUS was 74±12/100, the satisfaction score was 2.8±0.9/4, with 59% of satisfied participants with the use of Ardoiz® pads. The intent to acquire remained low with 18% (n=6) of participants who would be interested in acquiring the tablet. This tablet computer seemed to be difficult to use by geriatric patients and healthcare professionals, mainly because of its complex homepage. Nevertheless, former caregivers and healthcare professionals thought that the tablet could be of great interest to hospitals for leisure and medical use. The main feedback in order to improve the tablet is to simplify the home page with fewer and more static icons (without switching). CONCLUSIONS Notwithstanding the usability of the tablet, the intent to acquire of Ardoiz® tablet remained low. The interface should be simplified for older adults in order to improve usability and adherence. CLINICALTRIAL NCT04091152

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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

BMC Geriatrics ◽

10.1186/s12877-021-02324-5 ◽

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.

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

BMJ Open ◽

10.1136/bmjopen-2021-051527 ◽

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.

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Open space and sense of community of older adults: a study in a residential area in Hong Kong

International Journal of Architectural Research Archnet-IJAR ◽

10.1108/arch-11-2020-0260 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Andrew Yu

Keyword(s):

Older Adults ◽

Hong Kong ◽

Sense Of Community ◽

Open Space ◽

Residential Areas ◽

Open Spaces ◽

Cross Sectional ◽

Content Type ◽

Chinese Older Adults ◽

The Relationship

PurposeThis study examines the relationship between quality and quantity of open space in residential areas and the sense of community of Chinese older adults in Hong Kong.Design/methodology/approachA survey was conducted with 257 adults aged 55 and over in Kwun Tong, Hong Kong. The quality of open space was assessed from four dimensions: social and recreational facilities, entrance, location and environment. Geographic information system (GIS) was used to evaluate the quantity of open space in terms of size and amount.FindingsThe result shows that the environment has a strong influence on the sense of community, while the quantity of open space does not. The results provide urban planners with evidence for open space planning in the future. Urban planners should consider building more people-oriented environment; such as green areas instead of merely increasing the size, amount and facilities of open space. The Hong Kong Government also needs to review the current standardised planning guideline in order to maximise the social connection of older adults.Originality/valueThis cross-sectional study tried to understand the relationship between the quality and quantity of open spaces and sense of community in Chinese older adults in Hong Kong. It is one of the few studies to simultaneously examine both the quality and quantity of open spaces when studying its relationship with sense of community.

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Hot Weather and Suicide Deaths among Older Adults in Hong Kong, 1976–2014: A Retrospective Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103449 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3449

Author(s):

Pui Hing Chau ◽

Paul Siu Fai Yip ◽

Eric Ho Yin Lau ◽

Yee Ting Ip ◽

Frances Yik Wa Law ◽

...

Keyword(s):

Older Adults ◽

Time Series ◽

Hong Kong ◽

Retrospective Study ◽

Ambient Temperature ◽

Older Adult ◽

Meteorological Data ◽

Daily Maximum ◽

Time Series Approach ◽

Hot Weather

Findings of the association between hot weather and suicide in a subtropical city such as Hong Kong are inconsistent. This study aimed to revisit the association by identifying meteorological risk factors for older-adult suicides in Hong Kong using a time-series approach. A retrospective study was conducted on older-adult (aged ≥65) suicide deaths in Hong Kong from 1976 to 2014. Suicides were classified into those involving violent methods and those involving nonviolent methods. Meteorological data, including ambient temperature, were retrieved. Transfer function time-series models were fitted. In total, 7314 older-adult suicide deaths involving violent methods and 630 involving nonviolent methods were recorded. For violent-method suicides, a monthly average daily minimum ambient temperature was determined to best predict the monthly rate, and a daily maximum ambient temperature of 30.3 °C was considered the threshold. For suicide deaths involving nonviolent methods, the number of days in a month for which the daily maximum ambient temperature exceeded 32.7 °C could best predict the monthly rate. Higher ambient temperature was associated with more older-adult suicide deaths, both from violent and nonviolent methods. Weather-focused preventive measures for older-adult suicides are necessary, such as the provision of more public air-conditioned areas where older adults can shelter from extreme hot weather.

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Objectively-Measured Neighbourhood Attributes as Correlates and Moderators of Quality of Life in Older Adults with Different Living Arrangements: The ALECS Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16050876 ◽

2019 ◽

Vol 16 (5) ◽

pp. 876 ◽

Cited By ~ 4

Author(s):

Casper Zhang ◽

Anthony Barnett ◽

Janice Johnston ◽

Poh-chin Lai ◽

Ruby Lee ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Hong Kong ◽

Living Arrangements ◽

Local Environment ◽

Living Alone ◽

World Population ◽

Cross Sectional ◽

Objectively Measured

With an ageing world population, preservation of older adults’ health and quality of life (QoL) is paramount. Due to lower levels of physical functionality, older adults are particularly susceptible to local environment influences, especially those living alone and lacking family support. Using generalised additive mixed models, we examined associations and confounder-adjusted associations between objectively-measured neighbourhood attributes and QoL domains in 909 Hong Kong Chinese elderly community dwellers. Most examined neighbourhood attributes were not associated with QoL in the whole sample. Neighbourhood residential and entertainment density was curvilinearly and/or linearly related to specific QoL domains. Number of parks was negatively associated with social QoL and having well-treed parks with higher levels of social QoL. Older adults living alone in neighbourhoods with poor access to destinations and few activities in parks showed lower environmental and/or social QoL than their counterparts. Neighbourhood built environment characteristics do not seem to impact Hong Kong older adults’ physical and psychological QoL. Medium-to-high density, well-ordered neighbourhoods with optimal mixes of well-treed public open spaces and services meeting their daily needs may significantly contribute to social and environmental QoL in this population and appear particularly important to those living alone.

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Pre-frailty, frailty and associated factors in older caregivers of older adults

Revista de Saúde Pública ◽

10.11606/s1518-8787.2020054001655 ◽

2020 ◽

Vol 54 ◽

pp. 17

Author(s):

Roberta De Oliveira Máximo ◽

Ingrid Cristina Lopes ◽

Allan Gustavo Brigola ◽

Bruna Moretti Luchesi ◽

Aline Cristina Martins Gratão ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Low Income ◽

Associated Factors ◽

Multinomial Logistic Regression ◽

Community Dwelling ◽

Clinical Aspects ◽

Frailty Phenotype ◽

Cross Sectional ◽

Older Caregivers

INTRODUCTION: Providing care to an older adult is an activity that requires considerable physical effort and can cause stress and psychological strain, which accentuate factors that trigger the cycle of frailty, especially when the caregiver is also an older adult. However, few studies have analyzed the frailty process in older caregivers. OBJECTIVES: To investigate the prevalence of pre-frailty, frailty and associated factors in older caregivers of older adults. METHODS: A cross-sectional study was conducted including 328 community-dwelling older caregivers. Frailty was identified using frailty phenotype. Socio-demographic, behavioral and clinical aspects, characteristics related to care and functioning were covariables in the multinomial logistic regression. RESULTS: The prevalence of pre-frailty and frailty were 58.8% and 21.1%, respectively. An increased age, female sex, not having a conjugal life, depressive symptoms and pain were commonly associated with pre-frailty and frailty. Sedentary lifestyle was exclusively associated with pre-frailty, whereas living in an urban area, low income and the cognitive decline were associated with frailty. A better performance on instrumental activities of daily living reduced the chance of frailty. CONCLUSION: Many factors associated with the frailty syndrome may be related to the act of providing care, which emphasizes the importance of the development of coping strategies for this population.

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Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong

BMC Geriatrics ◽

10.1186/s12877-020-01851-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Johnny T. K. Cheung ◽

Samuel Y.S. Wong ◽

Dicken C. C. Chan ◽

Dexing Zhang ◽

Lawrence H. F. Luk ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Hong Kong ◽

Chronic Disease ◽

Disease Management ◽

Continuity Of Care ◽

Chronic Disease Management ◽

Outpatient Clinics ◽

Cross Sectional ◽

The Public

Abstract Background The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care. Methods This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective. Results A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73). Conclusions While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.

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Dynapaenic obesity and its association with health outcomes in older adult populations: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2018-027728 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027728 ◽

Cited By ~ 2

Author(s):

Siobhan Leahy ◽

Marica Cassarino ◽

Matthew DL O' Connell ◽

Liam Glynn ◽

Rose Galvin

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Older Adult ◽

Observational Studies ◽

Functional Disability ◽

Age Groups ◽

Ageing Population ◽

Cross Sectional ◽

Age Related

IntroductionTwo major global health challenges are the rapidly ageing population and the high prevalence of obesity in all age groups. Older adults are also susceptible to age-related loss of muscle strength, termed dynapaenia. The co-occurrence of both obesity and dynapaenia, termed dynapaenic obesity (DO), has been associated with poorer health outcomes and increased healthcare usage compared with either state alone. The purpose of this systematic review is to quantify the prevalence and incidence of DO in older adult populations, and to explore the association between DO and health outcomes, specifically chronic disease and multimorbidity, functional disability and healthcare usage.Methods and analysisUsing the Meta-analyses Of Observational Studies in Epidemiology guidelines, we will conduct a systematic review of cross-sectional and longitudinal observational studies of older adults, which include measures of DO and specified outcomes. Detailed literature searches of will be conducted using six electronic databases: Excerpta Medica dataBASE (EMBASE), PubMed, MEDLINE, SCOPUS, ScienceDirect and Cumulative Index of Nursing and Allied Health Complete (CINAHL), including articles published from database inception until Febuary 2019. The reference lists of included articles will also be searched. Two independent reviewers will undertake a three-step screening and review process using the Population, Risk Factor, Outcome framework to define eligibility. The Newcastle Ottawa Scale for non-randomised studies will be used to assess risk of bias and to rate study quality. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval is not required for this systematic review. Findings from this research will be submitted for peer-reviewed publication in academic journals, and presented at relevant academic conferences.PROSPERO registration numberCRD42018112471.

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50 Sociodemographic, Physical Performance and Fear of Falls Profile of Older Adult Fallers and Non Fallers: A Preliminary Study

Age and Ageing ◽

10.1093/ageing/afz164.50 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv13-iv17

Author(s):

Azianah Ibrahim ◽

Nur Aimuni Abu Hassan ◽

Halizahanim Hassan

Keyword(s):

Older Adults ◽

Older Adult ◽

Physical Performance ◽

Cross Sectional Study ◽

Falls Prevention ◽

Timed Up And Go ◽

Cross Sectional ◽

Sit To Stand ◽

Management Plans ◽

Fear Of Falls

Abstract Introduction It is important to identify older adult fallers in order to implement early prevention management also prevent recurrent falls. This study aimed to explore the profiles of older adult fallers and non-fallers in regards to socio-demographic, physical performance, fear of falls that includes the activities that were feared in regard to falls. Analysis Descriptive and mean comparison test. Methodology Participants for this study were recruited among individuals aged 60 years and above, able to walk 3m, able to stand independently for longer than 1min and able to comprehend and follow instructions. Exclusion criteria include recent vertebral or lower limb fracture (less than 6months), unstable angina, unable to follow command and severe hearing and vision impairment. Design: Cross-sectional study. Results A number of 27 older adults were screened for falls. Based on Timed Up and Go test (cut off 11.18s), 8 (29.6%) of them were identified as fallers. Fallers were majority females (10, 37%), had visual impairment (4,14.8%), older (77.4±2.9years versus 68.4±5.7years) and had slightly higher in fear of falls score (13.2±5.5 versus 12.0±7.0). In view of physical performance, fallers were slower in Timed Up and Go test (13.6±2.4 versus 9.1±1.4), weaker in hand grip strength (14.3±2.5kg versus 21.5±19.3kg) and weaker in sit-to-stand performance (13.3±2.7s versus 10.7±2.7s). Age (p<0.05) and sit-to-stand performance (p<0.05) significantly differed between fallers and non-fallers. Among seven activities assessed using short Falls Efficacy Scale-International, non-fallers were found to have more fear during various activities compared to fallers. Implication Exploration of falls risk profiles in older adults will hopefully allow better understanding and further improvement in developing falls prevention management plans.

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