Factors Correlated with Smoking Cessation Success in Older Adults: A Retrospective Cohort Study in Taiwan

Smoking cessation in the elderly is very important. This study aims to explore the success rate of smoking cessation in the elderly and the factors that predict the success of smoking cessation. We collected data from smokers ≥60 years who visited a medical center in Taiwan during 2017. All patients were prescribed either varenicline or nicotine replacement therapy (NRT) for smoking cessation. The participants were asked about their smoking status after treatment. In total, 129 participants were enrolled. The three- or six-month point abstinence rate was 48.1%. No significant difference was found among baseline characteristics (including age, gender, underlying diseases, smoking duration, daily consumption amount of cigarette, carbon monoxide concentration, Fagerström test for nicotine dependence scores, and treatment method) between quitters and non-quitters, except for the type of medication used. The proportion of quitters using varenicline was significantly higher than that of non-quitters. Multivariate regression analyses showed that the patients who received varenicline were 3.22 times more likely to quit smoking than those who received NRT. Therefore, we suggest that varenicline use may help in smoking cessation in older adults, compared to NRT. Other baseline characteristics may not affect the success rate of smoking cessation in this population.

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Development of Machine Learning Models for Prediction of Smoking Cessation Outcome

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052584 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2584

Author(s):

Cheng-Chien Lai ◽

Wei-Hsin Huang ◽

Betty Chia-Chen Chang ◽

Lee-Ching Hwang

Keyword(s):

Machine Learning ◽

Smoking Cessation ◽

Success Rate ◽

Prediction Models ◽

Smoking Status ◽

Medical Center ◽

Machine Learning Algorithms ◽

Classification And Regression Tree ◽

Support Vector ◽

Smoking Cessation Outcome

Predictors for success in smoking cessation have been studied, but a prediction model capable of providing a success rate for each patient attempting to quit smoking is still lacking. The aim of this study is to develop prediction models using machine learning algorithms to predict the outcome of smoking cessation. Data was acquired from patients underwent smoking cessation program at one medical center in Northern Taiwan. A total of 4875 enrollments fulfilled our inclusion criteria. Models with artificial neural network (ANN), support vector machine (SVM), random forest (RF), logistic regression (LoR), k-nearest neighbor (KNN), classification and regression tree (CART), and naïve Bayes (NB) were trained to predict the final smoking status of the patients in a six-month period. Sensitivity, specificity, accuracy, and area under receiver operating characteristic (ROC) curve (AUC or ROC value) were used to determine the performance of the models. We adopted the ANN model which reached a slightly better performance, with a sensitivity of 0.704, a specificity of 0.567, an accuracy of 0.640, and an ROC value of 0.660 (95% confidence interval (CI): 0.617–0.702) for prediction in smoking cessation outcome. A predictive model for smoking cessation was constructed. The model could aid in providing the predicted success rate for all smokers. It also had the potential to achieve personalized and precision medicine for treatment of smoking cessation.

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“Stop smoking!”: Do we say it enough?

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e17500 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e17500-e17500

Author(s):

Jessica Ann Reifer Hildebrand ◽

Sangeeta Sastry ◽

Ashley Adams

Keyword(s):

Smoking Cessation ◽

Smoking Status ◽

Medical Center ◽

Performance Status ◽

Tobacco Dependence ◽

Poor Performance Status ◽

Second Primary ◽

Smoking Cessation Counseling ◽

Significant Difference ◽

Improvement Programs

e17500 Background: There are clear benefits of smoking cessation after the diagnosis of Bronchogenic Carcinoma (BC). Patients who quit smoking after the diagnosis of BC report lower levels of pain and are less likely to develop a second primary tumor when compared to patients who continue to smoke after they are diagnosed. Persistent smoking is also associated with poor performance status and survival outcomes. Evidence suggests that smokers are more likely to quit if they are counseled by their physicians. Yet, there may be a prevailing belief among physicians that treating tobacco dependence is futile in this population. The purpose of this study was to investigate whether physicians addressed smoking cessation with patients who were diagnosed with BC. Methods: A retrospective chart review of patients who were diagnosed with BC was conducted at a community medical center between 2008 and 2010, using the hospital’s cancer registry. Demographic information including age, race, sex, AJCC stage, and smoking status at the time of diagnosis was collected. Evidence of tobacco cessation counseling was sought through billing codes, physician notes, and orders surrounding the time of diagnosis. Results: A total of 948 patients were diagnosed with lung cancer between 2008 and 2010. 438 were current smokers at diagnosis, 422 were former smokers, and 88 had never smoked. Of the 438 smokers, only 36% were counseled on smoking cessation. On average, each patient encountered 3 different physicians in both the inpatient and outpatient settings. Of note, Stage I patients were 1.7 times more likely to be counseled than those with Stage IV disease (p=0.017). There was no significant difference between the counseled group and the non counseled group in regards to age, race, or sex. Conclusions: In spite of evidence that smoking cessation is beneficial even after the diagnosis of BC, physicians are not counseling their patients sufficiently. Reasons physicians may fail to counsel include: an inability to effectively assess tobacco dependence, competing concerns during patient encounters, and reduced awareness of current quality measures. With the implementation of quality improvement programs, we suspect that smoking cessation counseling for patients with BC will improve in the community setting.

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“Stop smoking!” Do we say it enough?

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.34_suppl.268 ◽

2012 ◽

Vol 30 (34_suppl) ◽

pp. 268-268

Author(s):

Jessica Ann Reifer Hildebrand ◽

Sangeeta Sastry ◽

Ashley Adams

Keyword(s):

Smoking Cessation ◽

Smoking Status ◽

Medical Center ◽

Performance Status ◽

Tobacco Dependence ◽

Poor Performance Status ◽

Second Primary ◽

Smoking Cessation Counseling ◽

Significant Difference ◽

Improvement Programs

268 Background: There are clear benefits of smoking cessation after the diagnosis of Bronchogenic Carcinoma (BC). Patients who quit smoking report lower levels of pain and are less likely to develop a second primary tumor when compared to patients who continue to smoke after they are diagnosed with BC. Persistent smoking is also associated with poor performance status and survival outcomes. Evidence suggests that smokers are more likely to quit if they are counseled by their physicians yet, there may be a prevailing belief among physicians that treating tobacco dependence is futile in this population. The purpose of this study was to investigate whether physicians addressed smoking cessation with patients who were diagnosed with BC. Methods: A retrospective chart review of patients who were diagnosed with BC was conducted at a community medical center between 2008 and 2010, using the hospital’s cancer registry. Demographic information including age, race, sex, AJCC stage, and smoking status at the time of diagnosis was collected. Evidence of tobacco cessation counseling was sought through billing codes, physician notes, and orders surrounding the time of diagnosis. Results: A total of 948 patients were diagnosed with lung cancer between 2008 and 2010. 438 were current smokers at diagnosis, 422 were former smokers, and 88 had never smoked. Of the 438 smokers, only 36% were counseled on smoking cessation. On average, each patient encountered 3 different physicians in both the inpatient and outpatient settings. Of note, stage I patients were 1.7 times more likely to be counseled than those with stage IV disease (p=0.017). There was no significant difference between the counseled group and the non-counseled group in regards to age, race, or sex. Conclusions: In spite of evidence that smoking cessation is beneficial even after the diagnosis of BC, physicians are not counseling their patients sufficiently. Reasons physicians may fail to counsel include an inability to effectively assess tobacco dependence, competing concerns during patient encounters, and reduced awareness of current quality measures. With the implementation of quality improvement programs, it will be interesting to see if smoking cessation counseling for patients with BC improves in the community setting.

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Physical Activity Level and Motor Aptitude: Motor Domains and Identification Capacity of Brazilian Insufficiently Active Older Adults

Current Aging Science ◽

10.2174/1874609813666200928141220 ◽

2020 ◽

Vol 13 ◽

Author(s):

Lucia Maria Andreis ◽

Fernando de Aguiar Lemos ◽

Lorenna Walesca de Lima Silva ◽

Cassiana Luiza Pistorello Garcia ◽

Gabrielli Veras ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Activity Level ◽

Area Under The Curve ◽

The Elderly ◽

Activity Level ◽

General Motor ◽

Body Scheme ◽

Significant Difference ◽

Global Coordination

Background: A decrease in the physical activity level in old age is common, which results in an increase in the number of falls and chronic conditions. Associated with that occurs the decline in motor skills as a result of the deficit in the interaction of cognitive and motor processes. Physical activity level can be associated differently with each motor domains. Objective: We analyzed the relationship between physical activity level and motor aptitude, and to identify which motor domains were most sensitive to detect insufficiently active level in older adults. Methods: Participated in the study 385 elderly people of both sexes. For the evaluation of the subjects were adopted the International Questionnaire on Physical Activity and the Motor Scale for Older Adults. Results: The majority of the elderly were active. In the comparison of motor aptitude between active and insufficiently active (IAC) elders a significant difference was found in the Global Coordination, Balance, Body Scheme and General Motor Aptitude. From the analysis of the area under the curve (AUC), we verified that these domains also were the ones that presented adequate diagnostic accuracy to identify IAC elderly. Besides that active elderly have presented the General Motor Aptitude classified within normality while the IAC below the normal. Conclusion: Our data suggest that IAC older adults present lower motor aptitude than the active elderly, especially in the domains of Global Coordination, Balance, Body Scheme and General Motor Aptitude, and that these domains were sensitive to indicate IAC older adults.

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Epidural analgesia is associated with earlier gastrointestinal transit after radical cystectomy but does not reduce the incidence of postoperative ileus: A retrospective cohort study

Journal of Clinical Urology ◽

10.1177/20514158211051587 ◽

2021 ◽

pp. 205141582110515

Author(s):

Julian Knoerlein ◽

Sebastian Heinrich ◽

Kai Kaufmann ◽

Wolfgang Schultze-Seemann ◽

Wolfgang Baar ◽

...

Keyword(s):

General Anaesthesia ◽

Radical Cystectomy ◽

Postoperative Ileus ◽

Medical Center ◽

Gastrointestinal Transit ◽

Level Of Evidence ◽

Significant Difference ◽

Baseline Characteristics ◽

Time Required ◽

First 90 Days

Objective: To compare the effect of combined epidural thoracic analgesia and general anaesthesia (CEGA) in radical cystectomy (RC) with respect to the return of gastrointestinal passage, the incidence of paralytic postoperative ileus (POI) compared to general anaesthesia (GA) only. Patients and methods: We conducted a retrospective review using the electronic medical records of 236 patients who underwent RCs between July 2011 and September 2018 at the Medical Center – University of Freiburg. Results: A CEGA was administered to 202 patients, while 34 patients received only GA. The baseline characteristics of patients with and without CEGA showed no significant differences. CEGA will decrease the time required for return of gastrointestinal transit as measured by time to first defecation by about 13 hours. In the first 90 days after surgery, 82 (34.7%) patients had a POI. There was no significant difference between complications in the CEGA and GA groups. Conclusion: A CEGA accelerates the return of the gastrointestinal transit but does not reduce the incidence of postoperative ileus. Level of evidence: 2b

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Shed-MEDS: pilot of a patient-centered deprescribing framework reduces medications in hospitalized older adults being transferred to inpatient postacute care

Therapeutic Advances in Drug Safety ◽

10.1177/2042098618781524 ◽

2018 ◽

Vol 9 (9) ◽

pp. 523-533 ◽

Cited By ~ 9

Author(s):

Alec W. Petersen ◽

Avantika S. Shah ◽

Sandra F. Simmons ◽

Matthew S. Shotwell ◽

J. Mary Lou Jacobsen ◽

...

Keyword(s):

Older Adults ◽

Usual Care ◽

Medical Center ◽

Academic Medical Center ◽

The United States ◽

Patient Centered ◽

Convenience Sample ◽

Point Reduction ◽

Significant Difference ◽

Hospitalized Older Adults

Background: Polypharmacy is common in hospitalized older adults. Deprescribing interventions are not well described in the acute-care setting. The objective of this study was to describe a hospital-based, patient-centered deprescribing protocol (Shed-MEDS) and report pilot results. Methods: This was a pilot study set in one academic medical center in the United States. Participants consisted of a convenience sample of 40 Medicare-eligible, hospitalized patients with at least five prescribed medications. A deprescribing protocol (Shed-MEDS) was implemented among 20 intervention and 20 usual care control patients during their hospital stay. The primary outcome was the total number of medications deprescribed from hospital enrollment. Deprescribed was defined as medication termination or dose reduction. Enrollment medications reflected all prehospital medications and active in-hospital medications. Baseline characteristics and outcomes were compared between the intervention and usual care groups using simple logistic or linear regression for categorical and continuous measures, respectively. Results: There was no significant difference between groups in mean age, sex or Charlson comorbidity index. The intervention and control groups had a comparable number of medications at enrollment, 25.2 (±6.3) and 23.4 (±3.8), respectively. The number of prehospital medications in each group was 13.3 (±4.6) and 15.3 (±4.6), respectively. The Shed-MEDS protocol compared with usual care significantly increased the mean number of deprescribed medications at hospital discharge and reduced the total medication burden by 11.6 versus 9.1 ( p = 0.032) medications. The deprescribing intervention was associated with a difference of 4.6 [95% confidence interval (CI) 2.5–6.7, p < 0.001] in deprescribed medications and a 0.5 point reduction (95% CI −0.01 to 1.1) in the drug burden index. Conclusions: A hospital-based, patient-centered deprescribing intervention is feasible and may reduce the medication burden in older adults.

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Role of silicone stenting in endoscopic dacryocystorhinostomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200136 ◽

2020 ◽

Vol 6 (2) ◽

pp. 248

Author(s):

Abdussalam M. Jahan ◽

Yousef M. Eldanfur ◽

Abdulhakim B. Ghuzi

Keyword(s):

Success Rate ◽

Medical Center ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

P Value ◽

Success Rates ◽

Duct Obstruction ◽

Significant Difference ◽

Silicone Stent ◽

Endoscopic Dcr

Background: Dacryocystorhinostomy (DCR) is a surgical procedure performed to relief nasolacrimal duct obstruction, which involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. Closure of the rhinostomy opening was considered a major factor for surgical failure. Use of silicone stent in endoscopic DCR to improve the success rate of the operation have been tried by many surgeons. In this study we assess the success rates of endoscopic DCR with and without silicone stents.Methods: Prospective study includes 30 patients were operated in the Department of ENT, Misrata Medical Center, from April 2017 to March 2018. They underwent endonasal endoscopic DCR for primary acquired nasolacrimal duct obstruction. These patients were randomly divided in two groups: A and B with 15 patients in each group. The group A patients underwent endoscopic DCR with silicone stent and group B patients underwent endoscopic DCR without stent. The results were statistically analyzed by chi-square test. Results: 30 patients were included in this study, their age ranged from 17 to 60 years, complaining of epiphora, 24 (80%) were females and 6 (20%) were males. The success rate was higher in patients with silicone stent (93.33%) as compared to patients without silicone stent (86.67%) but this difference in the results is not statistically significant (As p value is 0.542 which is >0.05).Conclusions: Endoscopic DCR is safe, successful procedure for treatment of nasolacrimal duct obstruction and there was no significant difference in the success rates of performing endonasal DCR with silicone or without silicone stents.

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Back Pain and Heart Failure in Older Adults: Findings From the Health ABC Study

Innovation in Aging ◽

10.1093/geroni/igaa057.656 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 203-203

Author(s):

Jie Chen ◽

Yiming Zhang ◽

Eleanor Simonsick ◽

Angela Starkweather ◽

Ming-Hui Chen ◽

...

Keyword(s):

Heart Failure ◽

Older Adults ◽

Back Pain ◽

Negative Impact ◽

Smoking Status ◽

The Elderly ◽

Epidemiological Studies ◽

Negative Influence ◽

Epidemiologic Studies ◽

The Impact

Abstract Both back pain and heart failure (HF) have negative influence on all aspects of life. Little is known about the impact of back pain on older adults with HF. We include 1295 older adults who had data collected in the 11th year (2007-2008) of the Health, Aging and Body Composition (Health ABC) study to evaluate the effect of back pain on health status among older adults with and without HF. The participants aged 79-91, 54.8% were female and 34.8% were African American. Among 94 participants with HF, 63 (67.0%) had back pain; among 1201 participants without HF, 649 (54.0%) had back pain. Females reporting back pain had 4.76 (95% CI: 1.83, 12.37) times the odds of having HF compared to those without back pain. Male with back pain, compared to those without back pain, had 1.14 times (95% CI: 0.65, 2.02) the odds of having HF. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CES-D) scale. Performance and functions were measured by the Established Populations for Epidemiologic Studies in the Elderly (EPESE) performance score, the Health ABC performance battery score and self-reported difficulty with functional tasks. These symptom and performance measures were significantly associated with both back pain and HF, but not the interaction terms of back pain and HF after adjusting demographic variables including gender, race, smoking status and BMI category. The high incidence and negative impact of back pain highlighted the needs of developing strategies in pain management among older adults with and without HF.

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Marital Status, Sex and Utilisation of Healthcare Service Among the Older Adults in India

10.21203/rs.3.rs-78097/v1 ◽

2020 ◽

Author(s):

Babul Hossain ◽

K.S. James ◽

Md Juel Rana

Keyword(s):

Older Adults ◽

Health Care ◽

Health Services ◽

Marital Status ◽

Strong Association ◽

The Elderly ◽

Healthcare Services ◽

Health Care Utilisation ◽

Sample Survey ◽

Significant Difference

Abstract Background: The association between marital status and health status among the elderly has been at the forefront of investigation for a long time. However, the study on the effects of marital status on health care utilisation is limited. This study assesses the association between use of inpatient health services and marital status among older adults in India from the perspective of sex. Methods: Data used in the study have been obtained from the 75th Round of National Sample Survey (NSS) on "Social Consumption: Health" with the sample size of 42,762 individuals aged 60 years or above. The study implements the Andersen's behavioural framework controlling the predisposing, enabling, and need characteristics and uses binary logistic regression models to assess the effect of marital status on inpatient health service. Results: There is a significant difference in inpatient healthcare use between married and widowed elderly by age, educational level, perceived health and mobility for both sexes. The unadjusted regression analysis shows that widowed are more likely to use inpatient health services both for women (OR=1.57; CI 95%= 1.47, 1.68) and men (OR=1.11; CI 95%= 1.02, 1.2). However, after controlling the predisposing, enabling, and need factors, a strong association between healthcare services and marital status has been found for women, but not for men. Widowed women (OR=1.43; CI 95%=1.33, 1.54) are more likely to use inpatient health care than married women. Conclusion: The present study has reported the association between the utilisation of inpatient health services and marital status for the elderly in India. Our study advocates that there is a sex difference in the utilisation of inpatient health services by the marital Status in India. Older widowed women should get more focus on health and elderly policy perspectives.

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Evaluation of the clinical-functional vulnerability index in older adults

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562019022.190222 ◽

2019 ◽

Vol 22 (6) ◽

Author(s):

Arthur Alexandrino ◽

Ellen Karolaine Lucena da Cruz ◽

Pedro Yan Dantas de Medeiros ◽

Caio Bismarck Silva de Oliveira ◽

Djaine Silva de Araújo ◽

...

Keyword(s):

Older Adults ◽

Family Health ◽

Multiple Linear Regression Model ◽

The Elderly ◽

Vulnerability Index ◽

P Value ◽

Cross Sectional ◽

Health Strategy ◽

Significant Difference ◽

Family Health Strategy

Abstract Objective: To evaluate the clinical-functional vulnerability index (CFVI) of older adults and its relationship with socioeconomic, behavioral, clinical and therapeutic indicators. Method: A cross-sectional epidemiological study with a quantitative design was performed with 318 randomly drawn older adults registered with the Family Health Strategy. Data were collected through the CFVI-20 questionnaire and analysis was supported by descriptive, bivariate and multivariate statistics, with results with p-value <0.05 considered significant. Results: most older adults (59.1%) were considered frail or potentially frail. Among the groups studied, there was a statistically significant difference in the CFVI for the variables age group (p<0.001), functional literacy (p=0.001), alcohol consumption (p<0.001), physical exercise (p<0.001), self-reported health problems (p<0.001) and medication use (p<0.001), as well as a positive correlation with stress (r=0.135; p=0.016). In the multiple linear regression model, the set of sociodemographic predictor variables explained the frailty of the elderly by 30.4% (R2=0.304). Conclusions: The advancement of age, as a non-controllable variable, indicates a need to encourage the maintenance of functionality in old age, based on the health care strategies that prolong longevity with safety, autonomy and vitality.

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