scholarly journals How primary care providers promote active aging in community-dwelling older people with mental disorders: A qualitative study

2018 ◽  
Vol 7 (1) ◽  
pp. 31 ◽  
Author(s):  
Kedsaraporn Kenbubpha ◽  
Isabel Higgins ◽  
Amanda Wilson ◽  
Sally Wai-Chi Chan

The promotion of active aging in community-dwelling older people with mental disorders is an under-researched area. Primary care providers play an important role in engaging older people with mental health disorders to optimize active aging and increase their quality of life. This study explored how primary care providers apply the concept of active aging in community-dwelling older people with mental disorders and to identify factors that facilitate or hinder such application for promoting active aging in this group. Two focus groups were conducted. Fourteen primary care providers were recruited by purposive sampling from two primary care units located in Ubonratchathani province, the northeast region of Thailand. Content analysis was used to analyse the data. The study found that the majority of primary care providers were unfamiliar with the notion of active aging and that older people with mental disorders were not encouraged to join the health promotion activities organised by the community centre. Thai primary care providers need to be supported with training to enhance skills for promoting active ageing in this group. They also lack resources from the national and local government. The findings of this study were used to help develop a new instrument to measure perspectives of primary care providers in a quantitative study.

2008 ◽  
Vol 4 ◽  
pp. T175-T175
Author(s):  
Marieke Perry ◽  
René Melis ◽  
Steven Teerenstra ◽  
Irena Drašković ◽  
Theo van Achterberg ◽  
...  

2008 ◽  
Vol 23 (12) ◽  
pp. 1312-1319 ◽  
Author(s):  
M. Perry ◽  
R. J. F. Melis ◽  
S. Teerenstra ◽  
I. Drašković ◽  
T. van Achterberg ◽  
...  

Author(s):  
Noman Dormosh ◽  
Martijn C Schut ◽  
Martijn W Heymans ◽  
Nathalie van der Velde ◽  
Ameen Abu-Hanna

Abstract Background Currently used prediction tools have limited ability to identify community-dwelling older people at high risk for falls. Prediction models utilizing Electronic Heath Records (EHR) provide opportunities but up to now showed limited clinical value as risk stratification tool; because of among others the underestimation of falls prevalence. The aim of this study was to develop a fall prediction model for community-dwelling older people using a combination of structured data and free text of primary care EHR and to internally validate its predictive performance. Methods EHR data of individuals aged 65 or over. Age, sex, history of falls, medications and medical conditions were included as potential predictors. Falls were ascertained from the free text. We employed the Bootstrap-enhanced penalized logistic regression with the least absolute shrinkage and selection operator to develop the prediction model. We used 10-fold cross-validation to internally validate the prediction strategy. Model performance was assessed in terms of discrimination and calibration. Results Data of 36,470 eligible participants were extracted from the dataset. The number of participants who fell at least once was 4,778 (13.1%). The final prediction model included age, sex, history of falls, two medications and five medical conditions. The model had a median area under the receiver operating curve of 0.705 (IQR 0.700-0.714) . Conclusions Our prediction model to identify older people at high risk for falls achieved fair discrimination, and had reasonable calibration. It can be applied in clinical practice as it relies on routinely collected variables and does not require mobility assessment tests.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 335-335
Author(s):  
Yvonne Jonk ◽  
Heidi O'Connor ◽  
Karen Pearson ◽  
Zachariah Croll ◽  
John Gale

Abstract This study examines differences in opioid prescribing rates among a nationally representative sample of Medicare beneficiaries across rural and urban areas, as well as among beneficiaries with chronic overlapping pain conditions (COPCs). We assess whether prescribing patterns exceed the Centers for Disease Control and Prevention guidelines for dose and duration, and identify socioeconomic and health risk factors associated with opioid prescribing using logistic regression analyses. Data were from the 2010-2017 Medicare Current Beneficiary Survey files. Rural-Urban Commuting Area codes were used to identify patients’ residential location. The Area Health Resource Files were used to identify market characteristics such as primary care and mental health shortage areas. With the exception of 2010, over years 2011-2017, higher percentages of community-dwelling rural beneficiaries received opioid prescriptions (21.8-25.4%) compared to their urban counterparts (19.1-23.7%). During the same time period, facility-dwelling rural beneficiaries were more likely to receive opioid prescriptions (39.8-47.2%) compared to their urban counterparts (28.8-35.0%). Higher percentages (18.8%) of the community dwelling population in rural had COPCs compared to urban (15.2%), and a higher percentage of rural beneficiaries with COPCs (31.4%) received an opioid prescription than their urban counterparts (22.2%). Previous research points to other factors contributing to a lack of alternatives to opioids for pain management in rural areas, including greater reliance on primary care providers, lack of access to chronic pain specialists and alternative therapies, and travel barriers. Improving the capacity of rural primary care to deal with COPCs and expanding access to specialists via telehealth warrants further attention from policymakers.


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