Abstract:
OBJECTIVES:To test whether coordination of discharge from hospital reduces hospitalizations in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Randomized controlled clinical trial. SETTING:Specialized pulmonary hospital. PARTICIPANTS:Patients hospitalized for an acute exacerbation of COPD. INTERVENTION:Care as usual included routine patient education, supervised inhaler use, respiratory physiotherapy, and disease-related communication. The discharge coordinator intervention added assessment of patient situation and homecare needs. Patients and caregivers were actively involved and empowered in the discharge planning process, which was communicated with community medical professionals to provide continuity of care at home. MEASUREMENTS:The primary end-point of the study was the number of patients hospitalized because of worsening COPD. Key secondary end-points were time-to-COPD hospitalization, all-cause mortality, all-cause hospitalization, days alive and out of hospital, and health-related quality of life. RESULTS:Of 253 eligible patients (71 ± 9 years, 72% men, 87% GOLD III/IV), 118 were assigned to intervention and 135 to usual care. During a follow-up of 180 days, fewer patients receiving intervention were hospitalized for COPD (14% versus 31%, P = .002) or for any cause (31% versus 44%, P = .033). In time-to-event analysis, intervention was associated with lower rates of COPD hospitalizations (P = .001). A Cox model of proportional hazards, adjusted for sex, age, GOLD stage, heart failure, malignant disease, and long-term oxygen treatment, demonstrated that intervention reduced the risk of COPD hospitalization (hazard ratio 0.43, 95% confidence interval 0.24-0.77, P = .002). CONCLUSION:Among patients hospitalized for acute COPD exacerbation, discharge coordinator intervention reduced both COPD hospitalizations and all-cause hospitalizations.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Lainscak M,Kadivec S,Kosnik M,Benedik B,Bratkovic M,Jakhel T,Marcun R,Miklosa P,Stalc B,Farkas Jdoi
10.1016/j.jamda.2013.03.003subject
Has Abstractpub_date
2013-06-01 00:00:00pages
450.e1-6issue
6eissn
1525-8610issn
1538-9375pii
S1525-8610(13)00117-5journal_volume
14pub_type
杂志文章,随机对照试验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::The phenomenon of elderly sexual offenders is poorly catalogued, and is especially complex. In institutions, elderly people are often unrecognized victims of sexual abuse but are also at great risk for doing abuse toward vulnerable victims like children. The lack of attention to an elder's basic needs can endanger or ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.05.012
更新日期:2012-09-01 00:00:00
abstract::Urinary tract infection (UTI) is arguably the most common infection in the long term care (LTC) setting. Making the diagnosis of UTI and deciding when to initiate treatment with antimicrobial therapy is a challenge to all LTC providers. Widespread prevalence of asymptomatic bacteriuria, lack of an accepted clinical or...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.11.009
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To characterize Medicare skilled nursing facility (SNF) residents who become acutely ill with heart failure (HF) and assess the association between the outcomes of rehospitalization and mortality, and severity of the acute exacerbation, comorbidity, and processes of care. DESIGN:SNF medical record review of ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000073964.19754.C0
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:To determine whether single interventions (SI), multifactorial interventions (MI), or multiple component interventions (MCI) including vitamin D supplementation prevent the incidence of falls and fall risk factors among older adults who are community-dwelling or living in long-term care facilities. DESIGN:Sy...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2020.05.010
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:To assess whether using coronavirus disease 2019 (COVID-19) community activity level can accurately inform strategies for routine testing of facility staff for active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:In total, 59,...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.038
更新日期:2021-01-01 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 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:BACKGROUND:Anemia and frailty are both common in older people and are associated with adverse health outcomes. There have been some cross-sectional studies of anemia and frailty but no longitudinal studies. The objectives of this study were to examine cross-sectional and longitudinal associations between anemia and fra...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.02.014
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVES:Green House and other small nursing home (NH) models are considered "nontraditional" due to their size (10-12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer peo...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2021.01.069
更新日期:2021-01-26 00:00:00
abstract:OBJECTIVES:To evaluate whether STOPP/START v2 potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) are associated with 6-month mortality and unplanned hospitalization in hospital-discharged older patients. DESIGN:Multicenter prospective cohort observational study. SETTING AND PARTIC...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.03.023
更新日期:2019-11-01 00:00:00
abstract::Loneliness is a common problem in long-term care facilities (LTCF) and previous work has shown that animal-assisted therapy (AAT) can to some degree reverse loneliness. Here, we compared the ability of a living dog (Dog) and a robotic dog (AIBO) to treat loneliness in elderly patients living in LTCF. In comparison wit...
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.2007.11.007
更新日期:2008-03-01 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:The current treatment program for fragility hip fractures (HFx) emphasizes a combination of early surgery, rehabilitation, and tertiary prevention strategy for osteoporosis; however, the effect is unclear and little information is available on the risk factors predicting the occurrence of a second hip fractu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.010
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:The association between frailty and malnutrition is widely noted, but the common and distinct aspects of this relationship are not well understood. We investigated the prevalence of prefrailty/frailty and malnutrition/nutritional risk; their overlapping prevalence; compared their sociodemographic, physical, a...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.06.017
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To determine the short- (4 weeks) and long-term (6 month) effectiveness of Tibetan medicated bathing therapy in patients with post-stroke limb spasticity. DESIGN:Prospective, blinded, randomized controlled trial. SUBJECTS:Post-stroke patients with limb spasticity were recruited between December 2013 and Feb...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.10.018
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:Sarcopenia is a common geriatric syndrome, whose diagnosis implies the assessment of muscle mass. Dual-energy x-ray absorptiometry (DXA) is the reference method for clinical practice, but it is not universally available. We compared DXA with 2 anthropometry-based methods to assess muscle mass in older adults...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.05.016
更新日期:2018-09-01 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 relationship between health care expenditures and health care outcomes, such as life expectancy and mortality, is complex. Research outcomes show different and contradictory results on this relationship. How and why health care expenditures affect health outcomes is not clear. A causal link between the t...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.11.027
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To assess the prevalence of permanent atrial fibrillation (AF) in community-dwelling subjects aged 85 and to determine the anticoagulation therapy rate. DESIGN:Community-based survey of inhabitants aged 85 years. PARTICIPANTS:Participants were 328 people born in 1924 and assigned to 7 primary health care te...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2011.04.005
更新日期:2012-01-01 00:00:00
abstract::This is the seventh article in the series of Clinical Updates on Nursing Home Care. The topics covered are antiresorptive drugs, hip fracture, hypertension, orthostatic hypotension, depression, undernutrition, anorexia, cachexia, sarcopenia, exercise, pain, and behavioral and psychological symptoms of dementia. ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2013.09.015
更新日期:2013-12-01 00:00:00
abstract::More than 6 million adults in the United States are homebound or semi-homebound and would benefit from home-based medical care (HBMC). There is currently no nationally recognized quality of care framework for home-based medical care. We sought to capture diverse stakeholder perspectives on the essential aspects of qua...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.05.020
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:The objective of this study is to explore factors that elucidate reasons for psychotropic drug (PD) prescription for neuropsychiatric symptoms (NPS) in nursing home (NH) residents with dementia. DESIGN:A qualitative study using a grounded theory approach. SETTING:Twelve NHs in The Netherlands. PARTICIPANT...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.08.016
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics. DESIGN:Longitudinal study with paired measurements. SETTING:A community LTC facility and a university-affiliated, community-based internal medicine residency ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2006.05.009
更新日期:2007-02-01 00:00:00
abstract:IMPORTANCE:Currently there is no risk factor scale that identifies older persons at risk of frailty. OBJECTIVES:In this study, we identified significant multisystem risk factors of frailty, developed a simple frailty risk index, and evaluated it for use in primary care on an external validation cohort of community-liv...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.03.008
更新日期:2014-09-01 00:00:00
abstract::Antibiotics are among the most widely prescribed drugs in long-term care facilities, which highlights the importance of antibiotic stewardship (ABS) in this setting. In this article, we describe the experiences with ABS in nursing homes (NHs) from the perspective of 4 European countries: the Netherlands, Norway, Polan...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.10.005
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Delirium superimposed on dementia (DSD) is common, morbid, and costly, yet frequently undiagnosed. Our study aimed to develop a brief screening test to improve health care worker recognition of DSD. DESIGN/SETTING/PARTICIPANTS:Older hospitalized adults with dementia were prospectively enrolled from medical a...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.05.011
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To determine what variables separate community-dwelling elders from assisted living-dwelling elders. DESIGN:Cross-sectional. SETTING:Community and assisted living facilities in Connecticut. PARTICIPANTS:114 individuals (77 community dwelling, 37 assisted living). ASSESSMENTS:Nutritional survey, 6-minute w...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.07.006
更新日期:2010-02-01 00:00:00
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 m...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVES:Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings. DESIGN:Systematic review and meta-analysis. SETTING AND P...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2019.09.017
更新日期:2020-03-01 00:00:00