Abstract：
OBJECTIVES:To identify patient characteristics associated with higher numbers of prescribed drugs or risk of receiving one or more inappropriate medications. DESIGN:A cross-sectional survey using chart reviews. PARTICIPANTS:A total of 414 long-stay residents of 20 nursing homes in three states MEASUREMENTS:Current medication orders, sociodemographic information, and diagnoses and health status information as indicated by the MDS. The number of routine, total, and inappropriate medications were tabulated. RESULTS:Higher numbers of medications were associated with higher total numbers of diseases. In addition, several diseases (congestive heart failure, hypertension, depression, anxiety, and diabetes) were associated with higher numbers of medications even after controlling for total disease burden. Cognitive impairment was associated with fewer medications after controlling for total number of diseases. Advanced age also attenuated the effect of disease burden on the number of total and routine medications. The only independent predictor of more inappropriate medications was higher numbers of routine medications. CONCLUSION:Several specific disease states predispose patients to prescription of higher numbers of medication, and, these patients must be managed more carefully to prevent adverse drug-drug or drug-disease interactions. Why patients with compromised cognitive status receive fewer medications requires further study.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Chiang L,Hirsch SH,Reuben DBkeywords:
subject
Has Abstractpub_date
2000-05-01 00:00:00pages
97-102issue
3eissn
1525-8610issn
1538-9375journal_volume
1pub_type
杂志文章abstract：BACKGROUND:Cognitive impairment is common in people living with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF); however, accurate estimates of prevalence are lacking. To date, there are no meta-analyses that have specifically investigated prevalence of mild cognitive impairment (MCI) in th...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jamda.2017.01.014
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:Dementia is a syndrome associated with stigma and social isolation. Forty-two percent of people with dementia in the United States and almost 40% in the United Kingdom live in assisted living and residential care facilities. Up to 90% of residents with dementia experience behavioral and psychological symptom...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2015.11.015
更新日期：2016-02-01 00:00:00
abstract：OBJECTIVES:This study examined the extent to which program site-based and Veteran characteristics were associated with potentially avoidable hospitalizations or other hospitalization of Veterans enrolled in the Veterans Affairs (VA) Home Based Primary Care (HBPC). DESIGN:Retrospective claims-based study. SETTING AND ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.12.033
更新日期：2021-01-29 00:00:00
abstract：OBJECTIVES:This study investigates the transitions of community-dwelling patients with a proximal femoral fracture towards recovery of independence using multistate modeling. The prognostic value of factors affecting the short-term rate of recovery of independence in activities of daily living was assessed for the resi...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.08.006
更新日期：2020-09-19 00:00:00
abstract：OBJECTIVE:The aim of this study was to evaluate the effect of sarcopenic obesity on activities of daily living and home discharge rates in adults undergoing convalescent rehabilitation. In addition, we evaluated diagnostic criteria for sarcopenic obesity to predict outcomes. DESIGN:A retrospective cohort study. SETTI...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.03.029
更新日期：2020-10-01 00:00:00
abstract：OBJECTIVE:To identify the differences of incidence of disability between frail older persons with and without slow walking speed. DESIGN:Prospective cohort study. SETTING:Japanese community. PARTICIPANTS:A total of l4,081 older adults aged ≥65 years living in the community, participated in a baseline assessment and ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.03.019
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVES:Early-onset Alzheimer's disease (EOAD), defined as onset of AD before the age of 65 years, is less common than the late-onset type, and little is known about the factors affecting disease progression. The aim of the study was to investigate factors influencing disease progression in people with EOAD. DESIGN...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.05.016
更新日期：2020-11-01 00:00:00
abstract：OBJECTIVES:To examine individual items of the SARC-F in predicting adverse outcomes. DESIGN:Prospective cohort study. SETTING:Community-dwelling older people in Hong Kong SAR China. PARTICIPANTS:A total of 4000 men and women aged 65 years and over, stratified in 3 age groups (65-69, 70-74, 75+ years of age). MEASUR...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.09.006
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVES:Patients discharged to a skilled nursing facility (SNF) for post-acute care have a high risk of hospital readmission. We aimed to develop and validate a risk-prediction model to prospectively quantify the risk of 30-day hospital readmission at the time of discharge to a SNF. DESIGN:Retrospective cohort stud...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.01.137
更新日期：2019-04-01 00:00:00
abstract：OBJECTIVE:To investigate if there is seasonal variation in cardiac deaths in older persons living in a nursing home in New York City. DESIGN:In a prospective study, the major clinical cause of death of all persons aged 60 years and older residing in a nursing home in New York City during a 15-year period was investiga...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2000-11-01 00:00:00
abstract：OBJECTIVE:To assess whether medical orders within Physician Orders for Life-Sustaining Treatment (POLST) forms reflect patients' preferences for care at the end of life. DESIGN:This cross-sectional study assessed the agreement between medical orders in POLST forms and the free-form text documentation of an advance car...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.10.016
更新日期：2020-11-13 00:00:00
abstract：OBJECTIVES:The purpose of this study was to examine the beneficial effects on cognitive function by a cognitive intervention program designed for dementia care called Learning Therapy in Japan and SAIDO Learning in the United States (hereinafter "SAIDO Learning," as appropriate). SAIDO Learning is a working memory trai...
journal_title：Journal of the American Medical Directors Association
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamda.2014.10.021
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:There is an increased demand for nursing homes (NHs) in middle-income countries such as Brazil. To monitor the quality of NHs, there is a need for reliable instruments to assess the extent to which the care provided meets the expectations and rights of residents and their families. PURPOSE:To evaluate the r...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.04.007
更新日期：2017-07-01 00:00:00
abstract：OBJECTIVE:Incident reports guide fall prevention efforts in long-term care (LTC) facilities, often based on descriptions of how falls occurred. The validity of these reports is poorly understood. We examined agreement on fall characteristics between fall incident reports and analysis of video footage of real-life falls...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.12.003
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVES:To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. METHODS:Qualitative, semistructu...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.01.072
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVE:Describe the care preference changes among nursing home residents receiving proactive Advance Care Planning (ACP) conversations from health care practitioners during the COVID-19 pandemic. DESIGN:Retrospective chart review. SETTING AND PARTICIPANTS:Nursing home residents (n = 963) or their surrogate decisio...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.11.011
更新日期：2021-01-01 00:00:00
abstract：OBJECTIVES:The purpose of this study was to examine whether a 12-week combined physical exercise training and nutritional intervention improves physical performance and enhances health-related quality of life (HRQOL) among prefrail elderly women living in the community. DESIGN:This was a randomized controlled trial in...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2014.12.005
更新日期：2015-03-01 00:00:00
abstract：OBJECTIVES:To quantify and characterize the chronic conditions of older Americans who live in nursing homes (NHs) but have minimal disability and might be able to live in less restrictive and less expensive settings. DESIGN:Secondary analysis of the 1999 National Nursing Home Survey. PARTICIPANTS:NH staff members fam...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2007.03.001
更新日期：2007-07-01 00:00:00
abstract：OBJECTIVES:To describe end-of-life care in Japanese nursing homes by comparing facility and characteristics of residents dying in nursing homes with those who had been transferred and had died in hospitals, and by comparing the quality of end-of-life care with hospitals and with their respective counterparts in the Uni...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.02.008
更新日期：2013-10-01 00:00:00
abstract：OBJECTIVES:The issue of subjects with mild cognitive impairment (MCI) reverting to normal cognition (NC) has to date been taken in limited consideration, and no conclusive data are available on the rate of reversion. We aimed at systematically reviewing available longitudinal studies on MCI and meta-analyzing data with...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jamda.2016.06.020
更新日期：2016-10-01 00:00:00
abstract：OBJECTIVE:To evaluate whether botulinum toxin can decrease the burden for caregivers of long term care patients with severe upper limb spasticity. METHOD:This was a double-blind placebo-controlled trial with a 24-week follow-up period. SETTING:A 250-bed long term care hospital, the infirmary units of 3 regional hospi...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2012.03.005
更新日期：2012-06-01 00:00:00
abstract：:Currently, the Agency for Healthcare Research and Quality (AHRQ) Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to saf...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2016.03.005
更新日期：2016-06-01 00:00:00
abstract：OBJECTIVES:To describe current practices of incontinence care in nursing homes (NHs) provided by certified nurse assistants (CNAs), and to evaluate the feasibility and acceptability of an integrated incontinence care product, the One Step Incontinence System (OSIS) in the NH setting. While the ultimate purpose of OSIS ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jamda.2006.10.001
更新日期：2007-05-01 00:00:00
abstract：OBJECTIVE:To determine the effects of dopaminergic medication withdrawal in an elderly, demented and minimally ambulatory nursing home population with parkinsonism in New York City. METHODS:In our double-blind, randomized study, 11 patients (7 males, 4 females) were randomized into 2 groups: one group underwent levodo...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2008.07.001
更新日期：2008-11-01 00:00:00
abstract：OBJECTIVES:Our study examined the proportion of skilled nursing facility (SNF) post-acute care residents who did not receive timely primary care provider (PCP) services following discharge, factors associated with lack of timely PCP services, and factors associated with perfect 30-day home time among those who did not ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.09.016
更新日期：2020-10-26 00:00:00
abstract：OBJECTIVES:To investigate the association between polypharmacy and medication regimen complexity with time to first hospitalization, number of hospitalizations, and number of hospital days over a 12-month period. DESIGN:A 12-month prospective cohort study. PARTICIPANTS AND SETTING:A total of 383 residents of 6 Austra...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.08.019
更新日期：2016-11-01 00:00:00
abstract：:Internists and family physicians are trained in evidence-based medicine (EBM). The philosophy of incorporating clinical research "evidence" into medical practice is taught at the undergraduate and graduate levels of medical training. Practicing physicians incorporate EBM into their practices in variable degrees depend...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：
更新日期：2004-09-01 00:00:00
abstract：BACKGROUND/OBJECTIVE:Falls are common in nursing homes and cause a high burden of injuries. The objective of this study was to analyze factors associated with serious consequences of falls in nursing home residents. DESIGN:Prospective observational study. SETTING:Falls were recorded over 1 year, covering all resident...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.03.015
更新日期：2014-08-01 00:00:00
abstract：OBJECTIVE:To determine if a facility-wide oral care educational program will improve the quality of routine oral care provided to nursing home residents. DESIGN:Single-blind, pre-post observational study of direct caregivers providing routine oral care to residents in 2 nursing homes. INTERVENTION:A 30-minute oral ca...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.09.001
更新日期：2009-11-01 00:00:00
abstract：OBJECTIVES:We sought to evaluate the effectiveness of the Fleetwood Model of pharmacy practice on improving resident outcomes and hypothesized that this model would reduce potentially inappropriate medication use, hospitalizations, and death. DESIGN:Demonstration project, pre-post design. SETTING:Twelve nursing homes...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.03.003
更新日期：2011-06-01 00:00:00
