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 Australian long-term care facilities (LTCFs). MEASUREMENTS:The primary exposures were polypharmacy (≥9 regular medications) and the 65-item Medication Regimen Complexity Index (MRCI). Cox proportional hazards regression was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between polypharmacy and MRCI with time to first hospitalization. Poisson regression was used to compute incident rate ratios (IRR) and 95% CIs for the association between polypharmacy and MRCI with number of hospitalizations and number of hospital days. Models were adjusted for age, sex, length of stay in LTCF, comorbidities, activities of daily living, and dementia severity. RESULTS:There were 0.56 (95% CI 0.49-0.65) hospitalizations per person-year and 4.52 (95% CI 4.31-4.76) hospital days per person-year. In adjusted analyses, polypharmacy was associated with time to first hospitalization (HR 1.84; 95% CI 1.21-2.79), number of hospitalizations (IRR 1.51; 95% CI 1.09-2.10), and hospital days per person-year (IRR 1.39; 95% CI 1.24-1.56). Similarly, in adjusted analyses a 10-unit increase in MRCI was associated with time to first hospitalization (HR 1.17; 95% CI 1.06-1.29), number of hospitalizations (IRR 1.15; 95% CI 1.06-1.24), and hospital days per person-year (IRR 1.19; 95% CI 1.16-1.23). CONCLUSIONS:Polypharmacy and medication regimen complexity are associated with hospitalizations from LTCFs. This highlights the importance of regular medication review for residents of LTCFs and the need for further research into the risk-to-benefit ratio of prescribing in this setting.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Lalic S,Sluggett JK,Ilomäki J,Wimmer BC,Tan EC,Robson L,Emery T,Bell JSdoi
10.1016/j.jamda.2016.08.019subject
Has Abstractpub_date
2016-11-01 00:00:00pages
1067.e1-1067.e6issue
11eissn
1525-8610issn
1538-9375pii
S1525-8610(16)30371-1journal_volume
17pub_type
杂志文章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::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:
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abstract:OBJECTIVES:EHealth interventions are increasingly being applied in perioperative care but have not been adequately studied for older surgical patients who could potentially benefit from them. Therefore, we evaluated the feasibility of perioperative eHealth interventions for this population. DESIGN:A systematic review ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2020.05.035
更新日期:2020-12-01 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:OBJECTIVES:From 2013 to 2016, the Centers for Medicare and Medicaid Services Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents ("the Initiative") tested a series of clinical interventions and care models, through organizations called Enhanced Care and Coordination Providers (ECCPs), with ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.002
更新日期:2020-09-01 00:00:00
abstract:INTRODUCTION:Hospital admissions due to traumatic brain injuries (TBIs) in older persons are increasing. Falls are the leading mechanism of injury in this age group. TBIs are associated with unfavorable outcomes such as mortality and institutionalization. OBJECTIVES:To estimate rates of TBIs in older persons with seve...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.02.032
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:To determine what factors contribute to successful appeals of nursing home deficiencies in the Informal Dispute Resolution (IDR) process. DESIGN:We merged Centers for Medicare and Medicaid Services' data about IDRs with Online Survey, Certification, and Reporting data about nursing home characteristics. We ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.09.015
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To determine the association between hypertension at age 90 years, treatment, and 5-year mortality. DESIGN:A prospective observational study of a representative community-dwelling birth cohort (born 1920-1921) by the Jerusalem Longitudinal Study (1990-2015). SETTING:Home-assessment. PARTICIPANTS:480 subjec...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.12.076
更新日期:2017-03-01 00:00:00
abstract:INTRODUCTION:According to the World Health Organization (WHO) and FDI World Dental Federation (FDI), malnutrition and bad oral health are of great concern to global health, especially among the older population. This study aimed to assess the associations between oral health problems ([artificial] teeth problems, chewi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.05.022
更新日期:2017-11-01 00:00:00
abstract::Chronic indwelling catheters are used to manage urinary retention, especially in the presence of urethral obstruction, and to facilitate healing of incontinence-related skin breakdown. These indwelling foreign bodies become coated and sometimes obstructed by biofilm laden with bacteria and struvite crystals. Bacteria ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2006.01.020
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:To examine the differential morbidity/mortality associated with evacuation versus sheltering in place for nursing home (NH) residents exposed to the 4 most recent Gulf hurricanes. METHODS:Observational study using Medicare claims and NH data sources. We compared the differential mortality/morbidity for long-...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2011.07.011
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To investigate the ability of nurses to recognize delirium and its symptoms and to investigate the factors associated with undetected delirium. DESIGN:A prospective, observational study with repeated measurements over a 6-month period. SETTING:Seven long term care settings in Montreal and Quebec City, Canad...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.11.002
更新日期:2012-03-01 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: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: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:PURPOSE:Urinary incontinence (UI) is common but inadequately assessed and treated in nursing facility (NF) residents. The purpose of this study is two-fold: (1) to determine perceptions about the importance of UI and its management in the NF setting compared with other geriatric syndromes and (2) to compare barriers to...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.08.003
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:To assess the 30-day mortality predictive markers in the oldest patients with Clostridioides difficile infection (CDI) and to analyze the accuracy of the European severity risk markers in this population. DESIGN:Observational prospective multicenter cohort study conducted by the French Infectious Diseases S...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.07.002
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To assess all-cause mortality patients with dementia treated with typical and atypical antipsychotic drugs (APDs). DESIGN:Registry-based cohort study. SETTING AND PARTICIPANTS:A total of 58,412 patients diagnosed with dementia and registered in the Swedish Dementia Registry were included in the study. Of th...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.12.019
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:New guidelines recommend a target glycated hemoglobin (HbA1c) of 7.5% to 8.0% in elderly persons with type 2 diabetes mellitus (T2DM), but real-world data regarding outcomes associated with different HbA1c levels in the elderly are limited. This study assessed outcomes and their association with defined HbA1c...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.06.007
更新日期:2014-10-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated the polymorphisms of insulinlike growth factor-1 (IGF-1) and its binding protein-3 (IGFBP3) genes could affect the circulating IGF-1 level. Moreover, the serum IGF-1 level was correlated with muscle size. OBJECTIVES:This study aimed to explore the effect of polymorphisms o...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.11.015
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:Telomere length is associated with aging-related pathologies. Although the association between telomere length and frailty has been studied previously, only a few studies assessing longitudinal changes in telomere length and frailty exist. DESIGN:Longitudinal cohort study. SETTING AND PARTICIPANTS:A subpop...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.05.011
更新日期:2018-08-01 00:00:00
abstract::The aging population in China is growing rapidly and by the middle of this century will peak. In addition, in 2000, elderly people aged 80 and older accounted for 18% of the world's population of oldest old. We identify here ways to begin addressing China's unique aging population needs. Through improving geriatric an...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.06.007
更新日期:2009-09-01 00:00:00
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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:BACKGROUND:During aging, a shift of protein metabolism from muscle to splanchnic tissue contributes to increased muscle protein loss after a period of metabolic stress (eg, fasting). OBJECTIVE:To study the adaptation of protein metabolism in the whole body and tissue (ie, skeletal muscle and splanchnic area) to metabo...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.06.005
更新日期:2013-09-01 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 investigate the effectiveness of tai-chi in preventing falls among community-dwelling older people. DESIGN:Multisite parallel group individually randomized controlled trial. SETTING:Melbourne, Australia. PARTICIPANTS:Preclinically disabled community-dwelling people 70 + years (n = 503), without major me...
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.2015.01.089
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:This study assessed individual and organizational context (work environment) factors that influence use of best practices by care aides (nursing assistants) in nursing homes. Little scientific attention has been focused on understanding best practice use in nursing homes and almost none on care aides. SETTIN...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.03.009
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Most studies assessing the effect of central nervous system (CNS)-acting medicines on cognitive disturbances have focused on the use of individual medicines. The impact on cognitive function when another CNS-acting medicine is added to a patient's treatment regimen is not well known. OBJECTIVE:To determine ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.02.008
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:In the United States, home health agencies (HHAs) provide essential services for patients recovering from post-acute care and older adults who are aging in place. During the COVID-19 pandemic, HHAs may face additional challenges caring for these vulnerable patients. Our objective was to explore COVID-19 prep...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamda.2020.06.002
更新日期:2020-07-01 00:00:00