scholarly journals Identification of Risk of QT Prolongation by Pharmacists When Conducting Medication Reviews in Residential Aged Care Settings: A Missed Opportunity?

2019 ◽  
Vol 8 (11) ◽  
pp. 1866
Author(s):  
Louise Christensen ◽  
J. Rick Turner ◽  
Gregory M. Peterson ◽  
Mark Naunton ◽  
Jackson Thomas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Torsade De Pointes ◽  
Aged Care ◽  
Qt Prolongation ◽  
Further Education ◽  
Residential Aged Care ◽  
Qt Interval Prolongation ◽  
High Prevalence ◽  
Medication Reviews ◽  
Missed Opportunity

QT interval prolongation is associated with torsade de pointes and sudden cardiac death. QT prolongation can be caused by many drugs that are commonly prescribed in elderly residential aged care populations. The aim of this study was to investigate the prevalence of use of QT-prolonging drugs and to identify interventions made by pharmacists to reduce the risk of QT prolongation when conducting medication reviews in aged care. A retrospective analysis of 400 medication reviews undertaken by Australian pharmacists in aged care settings was conducted. The assessment included the risk of QT prolongation due to prescribed medications and other risk factors and the recommendations made by pharmacists to reduce the risk of QT prolongation. There was a high prevalence of the use of QT-prolonging medication, with 23% of residents (92 out of 400) taking at least one medication with a known risk of QT prolongation. Amongst the 945 prescribed drugs with any risk of QT prolongation, antipsychotics were the most common (n = 246, 26%), followed by antidepressants (19%) and proton pump inhibitors (13%). There appeared to be low awareness amongst the pharmacists regarding the risk of QT prolongation with drugs. Out of 400 reviews, 66 residents were categorised as high risk and were taking at least one medication associated with QT prolongation; yet pharmacists intervened in only six instances (9%), mostly when two QT-prolonging medications were prescribed. There is a need to increase awareness amongst pharmacists conducting medication reviews regarding the risk factors associated with QT prolongation, and further education is generally needed in this area.

scholarly journals The Impact of Musculoskeletal Conditions on Assessed Levels of Care Required by Older Australians

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Tiffany K Gill ◽  
Steve Wesselingh ◽  
Maria C Inacio
Keyword(s):  
Risk Factors ◽  
Residential Care ◽  
Chronic Conditions ◽  
Community Care ◽  
Care Service ◽  
Functional Limitations ◽  
Aged Care ◽  
Residential Aged Care ◽  
Musculoskeletal Conditions ◽  
The Impact

IntroductionMusculoskeletal problems, including conditions such as back pain, neck pain, rheumatoid arthritis, gout and osteoarthritis are common in the population and significant contributors to global disease burden. Age is one of the most common risk factors for musculoskeletal conditions and over 40% of older people accessing residential aged care have a musculoskeletal condition. It is not known whether individuals living in the community with musculoskeletal conditions have similar needs to those in permanent care and this is important to know in order to provide appropriate care. Objectives and ApproachThe objective of this study was to profile individuals with musculoskeletal conditions in different aged care service settings (i.e. permanent care, community care only, transition/ respite care, or no services). Specifically, we examined the concurrent chronic conditions, health risk factors and functional limitations of individuals by service setting. A cross-sectional evaluation of individuals in the National Historical Cohort of the Registry of Senior Australians (ROSA) between 2004 and 2014 was conducted. Multivariable logistic regression models estimated the factors associated with being in different aged care settings. Odds ratios (OR) and 95% confidence intervals (CI) were determined. Results401,026 (42.5%) individuals with musculoskeletal conditions were assessed for aged care service eligibility during the study period. Of these 197,181 (49.2%) accessed permanent care, 37,003 (9.2%) accessed home care, 54,826 (13.7%) transition/respite, and 112,016 (27.9%) - no care. Individuals accessing community care compared to residential care were more likely to be female, have pain and have difficulty maintaining their home, as were individuals accessing no services compared to residential care. Conclusion / ImplicationsCompared to those in residential care, individuals with musculoskeletal conditions in the community with or without assistance had few differences related to other chronic conditions and functional limitations. But the reasons why some had support, while others did not, are unclear.

Clinical characteristics of patients with drug-induced QT interval prolongation and torsade de pointes: identification of risk factors

2008 ◽  
Vol 98 (4) ◽  
pp. 208-212 ◽  
Author(s):  
Konstantinos P. Letsas ◽  
Michalis Efremidis ◽  
Stavros P. Kounas ◽  
Loukas K. Pappas ◽  
Gerasimos Gavrielatos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Qt Interval ◽  
Clinical Characteristics ◽  
Torsade De Pointes ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Qt Interval Prolongation

scholarly journals Assessing sarcopenic prevalence and risk factors in residential aged care: methodology and feasibility

2014 ◽  
Vol 5 (3) ◽  
pp. 229-236 ◽  
Author(s):  
Timothy R. Henwood ◽  
Justin W. Keogh ◽  
Natasha Reid ◽  
Will Jordan ◽  
Hugh E. Senior
Keyword(s):  
Risk Factors ◽  
Aged Care ◽  
Residential Aged Care

scholarly journals A case of hypoglycemiainduced QT prolongation leading to torsade de pointes and a review of pathophysiological mechanisms

2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Faris Hannoodi ◽  
Hashim Alwash ◽  
Kushal Shah ◽  
Israa Ali ◽  
Sarwan Kumar ◽  
...  
Keyword(s):  
Torsade De Pointes ◽  
Torsades De Pointes ◽  
Serum Glucose ◽  
Interesting Case ◽  
Qt Prolongation ◽  
Calcium Oscillations ◽  
Calcium Overload ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Life Threatening

<em>Torsades de pointes</em> is a life-threatening cardiac arrhythmia. Occurrence of this arrhythmia as a result of hypoglycemia has not been reported in the literature. We describe an interesting case of an insulindependent diabetic patient presenting with torsades de pointes resulting from hypoglycemia. A 62-year-old male was admitted to the hospital following an episode of severe insulin-induced hypoglycemia and a cardiac arrest. He was found to unresponsive at home after taking insulin. His serum glucose was found to be 18. He was given juice initially to normalize his glucose and was then transferred by EMS to ER where he was given 5% dextrose infusion. Analysis of the LifeVest rhythm recording showed torsades de pointes that was terminated by defibrillation of the LifeVest. Several mechanisms are responsible for torsade, including QT interval prolongation, adrenalin secretion and calcium overload leading to intracellular calcium oscillations. These mechanisms are a trigger to torsade de pointes. Predisposing factors were present leading torsade to occur.

scholarly journals The QT long syndrome: clinical and diagnostic aspect

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Constantin Martiniuc ◽  
◽  
Serghei Pisarenco ◽  
Iurie Simionica ◽  
◽  
...  
Keyword(s):  
Qt Interval ◽  
Torsade De Pointes ◽  
Qt Prolongation ◽  
Current Data ◽  
Polymorphic Ventricular Tachycardia ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Increased Risk ◽  
Wide Range ◽  
Life Threatening

QT interval prolongation is a predictor of the life-threatening cardiac arrhythmias — polymorphic ventricular tachycardia (torsade de pointes). Long QT syndrome may be congenital or acquired. It is known that a wide range of both antiarrhythmic and non-cardiac medications might lead to QT interval prolongation. List of drugs that cause QT prolongation is constantly growing and being updated. The review contains current data on the clinical significance of the control of QT interval duration within drug therapy. Clinical conditions associated with an increased risk of QT interval prolongation are described. Drugs that can induce QT prolongation are also discussed.

scholarly journals High prevalence of malnutrition and frailty among older adults at admission to residential aged care

2020 ◽  
Vol 12 (4) ◽  
pp. 305
Author(s):  
Idah Chatindiara ◽  
Jacqueline Allen ◽  
Dushanka Hettige ◽  
Stacey Senior ◽  
Marilize Richter ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Gait Speed ◽  
Short Form ◽  
Aged Care ◽  
Residential Aged Care ◽  
Cox Regression Analysis ◽  
Factors Associated ◽  
Frailty Status ◽  
High Prevalence

Abstract INTRODUCTIONMalnutrition is an under-recognised and under-treated problem often affecting older adults. AIMThe aim of this study was to evaluate the prevalence of and factors associated with malnutrition and frailty among older adults at early admission to residential aged care. METHODSA cross-sectional study was undertaken among eligible older adults within the first week of admission to residential aged care. Participants were assessed for malnutrition risk using the Mini Nutritional Assessment Short Form, frailty using the Fried phenotype criterion, muscle strength using a grip strength dynamometer and gait speed using a 2.4-m walk test. A Cox regression analysis was conducted to identify factors associated with malnutrition risk and frailty status. RESULTSOf 174 participants (mean age 85.5 years, 61% women), two-thirds (66%) were admitted to residential aged care from the community. Most (93%) were either malnourished (48%) or at risk of malnutrition (45%). A total of 76% of participants were frail and 24% were pre-frail. Forty-three percent were both malnourished and frail. Low risk of malnutrition was associated with increases in muscle strength [0.96 (0.93–0.99)], gait speed [0.27 (0.10–0.73)] and pre-frailty status [0.32 (0.12–0.83)]. DISCUSSIONThis study provides preliminary evidence for high prevalence of malnutrition and frailty at admission to residential aged care. Almost all participants were malnourished or at nutrition risk. Findings highlight the need for strategies to prevent, detect and treat malnutrition in community health care and support nutrition screening at admission to residential aged care.

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