Original Contribution - Clinical Investigation : Assessment of Physical Decline , Social Health Status and Prescribing Patterns for Elderly Patients Attending Ambulatory Primary Care Clinic ...

Introduction: Chronic kidney disease (CKD) emerges to be an important geriatric health issue. It may progress to end stage renal failure and affect the quality of life. However, little is known about the associated factors of CKD. So this study aimed to determine the associated factors of CKD among hyponatraemic elderly. Methods: This is a retrospective study of hyponatraemic patients aged ≥ 60 years attending outpatient clinic in 2014. Blood test results of glucose, potassium, creatinine, medical history, blood pressure, medication and demographic data were captured from patient records. Each patient’s estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI Creatinine Equation. CKD is defined as eGFR of < 60 ml/min/1.73m2. SPSS 21 was used to do the analysis. Results: Totally 257 patients with mean age of 72.9 ± 7.3 years were enrolled in this study. Of them 73 (28.4 %) elderly had CKD. The mean eGFR was 72.62 ± 24.14 ml/min/1.73m2, mean BP was (135.75 ± 18/10) mmHg. Of the participants, 134 (52.1 %) were men, 151 (58.8 %) were diabetics, 247 (96.1 %) had hypertension. The independent associated factors of CKD were increasing age (OR 1.08; 95 % CI 1.03-1.13; p = 0.002), hyperglycaemia (OR 1.10; 95 % CI 1.02-1.18; p = 0.017) and the use of loop diuretics (OR 5.15; 95 % CI 1.52-17.38; p = 0.008). Conclusion: Hyperglycaemia and loop diuretics usage are found to be significantly associated with CKD among elderly patients attending a primary care clinic. Hence every effort should be made to optimise glucose control and cautious in the usage of loop diuretics to retard the decline in renal function.

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Profile and correlates of functional status in elderly patients presenting at a primary care clinic in Nigeria

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v7i1.810 ◽

2015 ◽

Vol 7 (1) ◽

Cited By ~ 2

Author(s):

Samuel A. Ajayi ◽

Lawrence A. Adebusoye ◽

Adetola M. Ogunbode ◽

Joshua O. Akinyemi ◽

Ayodeji M. Adebayo

Keyword(s):

Primary Care ◽

Elderly Patients ◽

Functional Status ◽

Functional Disability ◽

Demographic Data ◽

Primary Care Clinic ◽

The Elderly ◽

Personal Hygiene ◽

Care Clinic ◽

Family Unit

Background: Assessing the functional status of elderly patients is central in measuring their health outcome. Little is known about the functional status of elderly patients attending our primary care clinic in Nigeria.Objective: To assess the correlates of functional status in elderly patients presenting at the General Outpatient Clinic of the University College Hospital, Ibadan, Nigeria.Method: A cross-sectional study of 360 randomly selected patients aged 60 years and above was undertaken to assess their functional status by scoring their basic activities of daily living (BADL) using the Modified Bathel Index. An interviewer-administered questionnaire was used to obtain the socio-demographic data, anthropometric measurements and morbidities of each patient.Results: The mean age was 69.1 ± 6.6 years with a female-to-male ratio of 1.9: 1. The prevalence of overall functional disability (defined as when assistance was sought in the performance of at least one of the components of BADL) was 88.3%. The highest prevalence of functionaldisability was experienced in the area of personal hygiene and grooming (95.3%) and transferring from bed to chair (95.3%). Overall functional disability significantly increasedwith increasing age (χ2 for trend=14.004, p < 0.0001), living in a polygamous family unit (p = 0.025), and lack of formal education (p = 0.020).Conclusion: Functional disability was high amongst the elderly in this setting. Age, education, and living in a polygamous type of family unit had significant influence on the functional status. High premium should, therefore, be placed on considering these factors in reducing functional disability in the elderly.

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Physical Functionality and Self-Rated Health Status of Adult Patients with Knee Osteoarthritis Presenting in a Primary Care Clinic

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v24i4.7 ◽

2014 ◽

Vol 24 (4) ◽

pp. 319 ◽

Cited By ~ 7

Author(s):

AM Ogunbode ◽

LA Adebusoye ◽

OO Olowookere ◽

TO Alonge

Keyword(s):

Primary Care ◽

Health Status ◽

Knee Osteoarthritis ◽

Primary Care Clinic ◽

Adult Patients ◽

Care Clinic ◽

Self Rated Health ◽

Physical Functionality

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Prescribing patterns of antihypertensive medications and blood pressure control among hypertensive patients in a primary care setting in Malaysia

Progress in Drug Discovery & Biomedical Science ◽

10.36877/pddbs.a0000055 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Jun-Ming Ng ◽

Kok Pim Kua ◽

Shaun Wen Huey Lee

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Blood Pressure Control ◽

Primary Care Clinic ◽

Care Facility ◽

Pressure Control ◽

Prescribing Patterns ◽

Antihypertensive Medications ◽

Care Clinic ◽

Utilisation Data

Aims: This study aims to describe the prescribing patterns of antihypertensive medications and short term outcomes of these patients, defined as repeat blood pressure measurements by a medical professional within 6 months, in a primary care facility in Puchong, located within the state of Selangor in Malaysia. Methods: This study was a cross-sectional, retrospective analysis of patients with essential hypertension, aged 18 and above, with blood pressure recorded at least twice within a 6-month period in an urban primary care clinic in Malaysia. Patients with history of co-morbidities were excluded. The prescribing patterns of antihypertensive medications and proportion of patients who achieved blood pressure control of less than 140/90 mmHg were ascertained. Results: A total of 200 prescriptions were analysed, including 52.5% females taking a mean of 1.7 (0.7) antihypertensive medications with a mean age of 57.9 (12.4) years. Most of the patients were prescribed either a single medication (n=90, 45.0%) or two medications (n=90; 45.0%) to control their blood pressure. Only 20 patients (10.0%) were prescribed three antihypertensive medications. A total of 127 (63.5%) patients met the blood pressure target of less than 140/90 mmHg. All participants exhibited a significant drop in systolic blood pressure, reducing from 143.0 (16.0) mmHg at baseline to 135.3 (14.8) mmHg at the end of 6 months (p<0.001). Diastolic blood pressure also decreased significantly from 83.5 (11.7) mmHg at baseline to 79.0 (10.2) mmHg at the end of 6 months (p<0.001). The choice of antihypertensive medications by the prescribers was compliant with the hypertension guidelines of Malaysia. Conclusion: The most commonly prescribed antihypertensive class was calcium channel blockers. Significant reduction in blood pressure was observed in patients from baseline to the follow-up visit. Further research of larger sample size and longer monitoring period is necessary to provide more robust epidemiology and drug utilisation data.

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The Prevalence of Limited Health Literacy and Its Associated Factors among Elderly Patients Attending an Urban Academic Primary Care Clinic in Malaysia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179044 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9044

Author(s):

Siti Nur Hidayah Abd-Rahim ◽

Mohamed-Syarif Mohamed-Yassin ◽

Suraya Abdul-Razak ◽

Mohamad Rodi Isa ◽

Noorhida Baharudin

Keyword(s):

Primary Care ◽

Health Literacy ◽

Elderly Patients ◽

Associated Factors ◽

Medical Information ◽

Primary Care Clinic ◽

Care Clinic ◽

Limited Health Literacy ◽

Academic Primary Care ◽

Limited Health

Limited health literacy (HL) is linked to many negative health outcomes, including poor self-management of chronic diseases and medication adherence among patients. There are a lack of data regarding HL in the elderly population in Malaysia. This study aimed to determine the prevalence of limited HL levels and its associated factors among elderly patients in an urban academic primary care clinic in Selangor, Malaysia. A cross-sectional study was conducted among 413 elderly patients (≥60 years old) who attended this academic primary care clinic between January 2020 and January 2021. Sociodemographic data, clinical characteristics, and health literacy scores were collected. Descriptive statistics (median with interquartile ranges (IQR), frequency, and percentages) and multiple logistic regression were utilized. The prevalence of limited HL in our population was 19.1% (95% CI: 15.3, 23). The middle-old (70–79 years) and very-old (≥80 years) age groups were more likely to have limited HL (aOR 4.05; 95% CI: 2.19, 7.52 and aOR 4.36; 95% CI: 1.02, 18.63, respectively). Those with at least secondary school education (aOR 0.06; 95% CI: 0.02, 0.24) and those who found medical information via the internet/television (aOR 0.21; 95% CI: 0.05, 0.93) had lower odds of having limited HL. In conclusion, having limited HL levels was not common among elderly patients in this primary care clinic. Further studies involving rural and larger primary care clinics in Malaysia are required to support these findings.

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Physician and Nurse Perspectives of an Interprofessional and Integrated Primary Care-Based Program for Seniors

Journal of Research in Interprofessional Practice and Education ◽

10.22230/jripe.2013v3n1a95 ◽

2013 ◽

Vol 3 (1) ◽

Cited By ~ 1

Author(s):

Ainsley Elizabeth Moore ◽

Kalpana Nair ◽

Christopher Patterson ◽

Joy White ◽

Shelly House ◽

...

Keyword(s):

Primary Care ◽

Elderly Patients ◽

Primary Care Clinic ◽

The Elderly ◽

Major Theme ◽

Integrated Models ◽

Front Line ◽

Care Clinic ◽

Multidisciplinary Program ◽

Primary Care Practitioners

Background: In Canada, primary care practitioners provide the majority of care for elderly patients. Increasing volume and complexity of care compounded by a shortage of specialized geriatric services has lead to problems of fragmented, inefficient,and often ineffective service for this population. Integrated models that bridge primary and secondary care have emerged as a major theme in health reform to address such challenges for care of the elderly. Although primary care practitioners are important stakeholders necessary for successful uptake and sustainability of such integrated models, this perspective has been largely unexplored. Methods and Findings: We used a qualitative thematic approach to bring forward front-line perspectives of nurses and physicians who referred their patients to a newly developed integrated, multidisciplinary program for seniors that was introduced into their primary care clinic. Referrers experienced improved care processes, improved quality of care, as well as an enhanced experience when managing their elderly patients. Unclear assignment of roles and responsibilities created confusion for referring practitioners and their patients.Conclusions: Understanding benefits, limitations, and changes to front-line practitioner experience provides insight into important factors contributing to buy-in and sustainability of integrated programming for the elderly in this setting.

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