scholarly journals Using Smartphone Applications to Manage Chronic Conditions in Older Adults – A Review on Level of Evidence

2021 ◽  
Vol 5 (4) ◽  
pp. 381
Author(s):  
Shaorin Tanira
Keyword(s):  
Older Adults ◽  
Mobile Phone ◽  
Behaviour Change ◽  
Health Monitoring ◽  
Chronic Conditions ◽  
Mobile Technologies ◽  
Current Evidence ◽  
Smartphone Apps ◽  
Smartphone Applications ◽  
Level Of Evidence

Background: From health monitoring to health education and from behaviour change to falls sensing and health alerts to the simple pleasure of communication and connectedness, the mobile technologies (smartphone applications) are changing the lives of older adults.Objective: To examine current evidence of use of smartphones by older adults for health purposes (including communication, education, and health monitoring), and understand gaps and challenges in order to inform the design of future systems given the ubiquity of mobile phone technology.Methods: MEDLINE, CINAHL and Google scholar databases were searched from October 2016 to January 2017. Keywords used include ‘smartphone apps’, ‘mobile phone’, ‘chronic disease’, ‘chronic condition’, ‘older adults’ and ‘elderly’. A total of 12 articles were selected for quality assessment and grading of evidence.Results: Twelve different articles were found and categorized into nine different clinical domains with specific health related interventions. Articles were focused on diabetes care (2 articles), followed by COPD (2 articles), heart disease (1 article), Alzheimer’s/dementia Care (2 articles), osteoarthritis and pain management (1 article), fall prevention (1 article), colon cancer (1 article), palliative care (1 article), chronic kidney disease (1 article). Areas of interest studied included feasibility, acceptability, functionality and thereby determining their effectiveness. There were many different clinical domains; however, most of the studies were pilot studies. Current work in using mobile phones for older adult use are spread across a variety of clinical domains. Findings from different studies indicate that the use of mobile phone interventions has the potential to support successful management of chronic conditions and health behaviour change in older adults.Conclusion: Perceived benefits and willingness to use the smartphone apps are high; however, technical training and cost are main concerns. A common problem with elderly users was their reluctance to press buttons due to the fear of breaking something which has been resolved by touch screen technology of the smartphones. However, the advanced user clicked around the screen until he found what he was looking for, while the others spent a lot of time observing the screen and trying to determine the correct step. Promotion of user-friendly apps are expected especially for older adults having a diminished physical and cognitive abilities.International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page: 381-387

scholarly journals Focus and features of prescribing indications spanning multiple chronic conditions in older adults: A narrative review

2021 ◽  
Vol 11 ◽  
pp. 263355652110128
Author(s):  
Carole E Aubert ◽  
Eve A Kerr ◽  
Mandi L Klamerus ◽  
Timothy P Hofer ◽  
Melissa Y Wei
Keyword(s):  
Older Adults ◽  
Adverse Drug Event ◽  
Chronic Conditions ◽  
Patient Perspective ◽  
Inappropriate Prescribing ◽  
Adverse Outcomes ◽  
Drug Event ◽  
Multiple Chronic Conditions ◽  
Level Of Evidence ◽  
Prescribing Quality

Background: Inappropriate prescribing is frequent in older adults and associated with adverse outcomes. Prescribing indications aim to optimize prescribing, but little is known about the focus and features of prescribing indications for the most common chronic conditions in older adults. Understanding the conditions, medications, and issues addressed (e.g., patient perspective, drug-disease interaction, adverse drug event) in current prescribing indications may help to identify missing indications and develop standardized measures to improve prescribing quality. Methods: We searched Ovid/MEDLINE and EMBASE for articles published between 2015 and 2020 reporting prescribing indications for older adults. Prescribing indication included 1) prescribing “criteria,” or statements that guide prescribing action, and 2) prescribing “measures,” or prescribing actions observed in a population. We categorized their focus by conditions, medications and issues addressed, as well as level of evidence provided. Results: Among 16 sets of prescribing indications, we identified 748 criteria and 47 measures. The most common addressed medications were antihypertensives, analgesics/antirheumatics, and antiplatelets/anticoagulants. The most frequently addressed issues were drug-disease interaction, adverse drug event, administration, better therapeutic alternative, and (co-)prescription omission (20.8–36.1%). Age/functioning, drug-drug interaction, monitoring, and efficacy/safety ratio were found in only 9.9–16.5% of indications. Indications rarely focused on the patient perspective or issues with multiple providers. Conclusion: Most prescribing indications for chronic conditions in older patients are criteria rather than measures. Indications accounting for patient perspective and multiple providers are limited. The gaps identified in this review may help improve the development of prescribing measures for older adults and ultimately improve quality of care.

scholarly journals COVID-19 in Adults and Children, Symptoms and Treatment

2021 ◽  
Vol 12 (2) ◽  
pp. 1735-1748
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Chronic Conditions ◽  
Pediatric Patients ◽  
Age Groups ◽  
The United States ◽  
Scientific Data ◽  
Level Of Evidence ◽  
Risk Of Death ◽  
Adults And Children

The COVID-19 is quickly spreading globally, and the number of cases in Europe and the United States is highly increasing. Compared to diseases caused by earlier identified human CoVs, COVID-19 displays higher transmission competence with minimal severe pathogenesis, as is obvious from the unceasingly increasing numeral of confirmed cases. Older adults with diabetes, respiratory disease, cardiovascular disease, etc., are more likely to be infected with COVID-19, and COVID-19 disease affects older adults with underlying chronic conditions more than other age groups. Comorbidities are known to aggravate the course of COVID-19 and increase the risk of death associated with COVID-19. However, one factor that makes it difficult for older adults to fight infection is that they have a weaker immune system than other individuals. Another group that the new coronavirus, SARS-CoV-2, could infect is children. However, they seem to be lesser sensitive to infections than adults, and COVID-19 symptoms are usually milder. There are currently no scientific data with a sufficient level of evidence regarding the treatments for COVID-19 infection in children. Therefore, COVID-19 for children's treatment recommendations should be evaluated according to adult studies and pediatric patients. We highlight the diagnostic, clinical, epidemiological, radiological characteristics laboratory and treatment in adults and children in the present study.

Utilization of Smartphone Apps for improving physical function capacity in Cardiac Patient Rehabilitation: A Systematic Review. (Preprint)

2020 ◽  
Author(s):  
Yulan Liang ◽  
Arpad Kelemen ◽  
Arpad Kelemen
Keyword(s):  
Systematic Review ◽  
Cardiac Rehabilitation ◽  
Real Time ◽  
Clinical Outcomes ◽  
Cardiac Patients ◽  
Current Evidence ◽  
Smartphone Apps ◽  
Smartphone Applications ◽  
Published Evidence ◽  
Depth Analysis

UNSTRUCTURED Cardiac rehabilitation (CR) is an evidence-based approach for preventing secondary cardiac events. Smartphone applications are starting to be used in cardiac rehabilitation to give patients real time feedback on their health, connect them remotely with their medical team, reduce the cost of cardiac rehabilitation, and allow them to perform their rehabilitation at home. The usage of smartphone apps is becoming ubiquitous and has real potential in impacting patients in need of CR. Currently, the published evidence is not strong enough to confirm that the usage of smartphone apps with CR can substantially improve clinical outcomes for cardiac patients. This paper provides critical summaries of existing research studies with an in-depth analysis of not only individual studies, but also the larger patterns that have emerged with smartphone application usage in CR as well as their significance for practice change. Results from this systematic review reveal that smartphone apps being used in cardiac rehabilitation have better clinical outcomes related to exercise capacity if the app auto-records information or provides real-time feedback for the participant to see their progress, compared to apps that only educate and encourage usage while making the participant manually log CR activities. Current evidence in the literature suggests nonhomogeneous results for successful usage of smartphone applications in CR. More clinical trials are needed that implement smartphone apps with bio- sensing capabilities, which can automatically log results and send results out to providers on a real-time dashboard. Future smartphone app research can focus on incorporating the observed successful components related to CR in order to best support cardiac patients for better patient outcomes, quality improvement, and increased patient safety.

Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Yvette M. McCoy
Keyword(s):  
Older Adults ◽  
Medical Model ◽  
Recovery Process ◽  
Swallowing Disorders ◽  
Current Evidence ◽  
Care Needs ◽  
Skilled Nursing ◽  
Person Centered Care ◽  
Centered Care ◽  
Traditional Medical Model

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.

Activity Engagement in Cognitive Aging: A Review of the Evidence

2013 ◽  
Vol 23 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Yvonne Rogalski ◽  
Muriel Quintana
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cognitive Aging ◽  
Social Activity ◽  
Current Evidence ◽  
Omega 3 ◽  
Neuroprotective Effects ◽  
Activity Engagement ◽  
Age Related ◽  
Age Related Cognitive Decline

The population of older adults is rapidly increasing, as is the number and type of products and interventions proposed to prevent or reduce the risk of age-related cognitive decline. Advocacy and prevention are part of the American Speech-Language-Hearing Association’s (ASHA’s) scope of practice documents, and speech-language pathologists must have basic awareness of the evidence contributing to healthy cognitive aging. In this article, we provide a brief overview outlining the evidence on activity engagement and its effects on cognition in older adults. We explore the current evidence around the activities of eating and drinking with a discussion on the potential benefits of omega-3 fatty acids, polyphenols, alcohol, and coffee. We investigate the evidence on the hypothesized neuroprotective effects of social activity, the evidence on computerized cognitive training, and the emerging behavioral and neuroimaging evidence on physical activity. We conclude that actively aging using a combination of several strategies may be our best line of defense against cognitive decline.

scholarly journals Environmental Influences of Extreme Heat on the Health of Older Adults: A Retrospective Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 280-280
Author(s):  
Mei Liu ◽  
Carol Buller ◽  
Barbara Polivka ◽  
Terri Woodburn ◽  
Mark Jakubauskas ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Environmental Influence ◽  
Emergency Department Visits ◽  
Extreme Heat ◽  
Extreme Weather Events ◽  
Study Cohort ◽  
Outpatient Visits ◽  
Extreme Heat Event ◽  
Heat Event

Abstract Studies have suggested that extreme weather events have differential effects by age. By leveraging electronic medical records, we aim to analyze the environmental influence of extreme heat on the health of older adults. From our healthcare system’s de-identified data warehouse, we extracted a retrospective cohort of 108,192 patients who were ≥65 years of age as of 1/1/2018 with pre-existing chronic conditions including diabetes, COPD, cardiovascular disease, or kidney disease. Extreme heat event period was defined as 5/1/2018 to 9/1/2018 (79 days with temperature ≥90o; 15 days of moderately poor/poor air quality index (AQI) [≥75] values) and the comparison period was defined as 5/1/2019 to 9/1/2019 (51 days with temperature ≥90o; 0 days with moderately poor/poor AQI values) in the Kansas City area. We randomly partitioned the study cohort into two sets and demonstrated the two patient sets were statistically similar (p>0.05) with respect to their demographic and underlying health conditions. Finally, we compared the respiratory, cardiovascular, and renal health outcomes between the 2018 and the 2019 cohorts. Most patients were Caucasians, female and had comorbid conditions. Results showed significantly higher number of all-cause emergency department visits (p=0.04) and outpatient visits (p=<.001) during the extreme heat event period in 2018. Analyses also showed significantly higher number of outpatient visits due to upper respiratory diseases (p=0.008) and acute renal failure (p=0.01) in 2018. In conclusion, extreme heat increased use of healthcare services in older adults with chronic conditions.

scholarly journals Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e048350
Author(s):  
Monika Kastner ◽  
Julie Makarski ◽  
Leigh Hayden ◽  
Jemila S Hamid ◽  
Jayna Holroyd-Leduc ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Randomised Controlled Trial ◽  
Disease Management ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Management Tool ◽  
Self Management ◽  
Plain Language ◽  
Randomised Controlled

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

scholarly journals Disease-related disability burden: a comparison of seven chronic conditions in middle-aged and older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chieh-Ying Chou ◽  
Ching-Ju Chiu ◽  
Chia-Ming Chang ◽  
Chih-Hsing Wu ◽  
Feng-Hwa Lu ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Disability ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Disease Diagnosis ◽  
Rate Of Change ◽  
Middle Aged ◽  
Rates Of Change ◽  
Depression Status ◽  
Stage Disease

Abstract Background Although previous studies have explored the effect of chronic conditions on physical disability, little is known about the levels and rates of change in physical disability after a chronic condition diagnosis in middle-aged and older adults in the Asian population. The aim of this study is to ascertain the average levels and rates of change in the development of disability after disease diagnosis, as well as to determine the influences of sociodemographic and health-related correlates in the development of disability. Methods This is a retrospective cohort study analyzing data of nationally representative participants aged 50 and over with a chronic condition or having developed one during follow-ups based on data from the 1996–2011 Taiwan Longitudinal Study on Aging (TLSA) (n = 5131). Seven chronic conditions were examined. Covariates included age at initial diagnosis, gender, education level, number of comorbidities, and depression status. Physical disability was measured by combining self-reported ADL, IADL, and strength and mobility activities with 17 total possible points, further analyzed with multilevel modeling. Results The results showed that (1) physical disability was highest for stroke, followed by cancer and diabetes at the time of the initial disease diagnosis. (2) The linear rate of change was highest for stroke, followed by lung disease and heart disease, indicating that these diseases led to higher steady increases in physical disability after the disease diagnosis. (3) The quadratic rate of change was highest in diabetes, followed by cancer and hypertension, indicating that these diseases had led to higher increments of physical disability in later stage disease. After controlling for sociodemographic and comorbidity, depression status accounted for 39.9–73.6% and 37.9–100% of the variances in the physical disability intercept and change over time, respectively. Conclusions Despite the fact that a comparison across conditions was not statistically tested, an accelerated increase in physical disabilities was found as chronic conditions progressed. While stroke and cancer lead to disability immediately, conditions such as diabetes, cancer, and hypertension give rise to higher increments of physical disability in later stage disease. Mitigating depressive symptoms may be beneficial in terms of preventing disability development in this population.

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