Abstract:
UNLABELLED:Geriatric assessment units have improved pharmacotherapy for their patients by decreasing the number of medications prescribed. The Senior Care Study, a randomized controlled trial, compared a multidisciplinary-team approach to patient care to the standard medical practice of the institution. As a part of the trial, the effectiveness of an interdisciplinary team intervention in improving the use of medications was studied. Study goals were to decrease medications used, decrease unnecessary medications, and improve medication choices in our acutely ill inpatient population. A pharmacist interviewed all experimental patients and patient records, and presented medication concerns and recommendations at a team conference. MEDICATIONs were counted on admission and on the third day, sixth week, and third month after randomization. MEDICATIONs were paired with patient problems. MEDICATION:problem pairs were judged as inappropriate choices if there were potential side effects that would affect patient function, and if better alternatives were available. The 215 control and 221 experimental patients in the study were similar in age, sex, place of origin, and number of medications on admission. Experimental patients took fewer medications than controls on the third day (5.3 versus 5.9, P less than .05). Experimental patients received fewer multiple unpaired medications (11% versus 19%, P less than .025) and fewer inappropriate medication choices (20% versus 37%, P less than .005). The results suggest that the team intervention was effective in improving pharmacotherapy in the acute-care setting.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Owens NJ,Sherburne NJ,Silliman RA,Fretwell MDdoi
10.1111/j.1532-5415.1990.tb01369.xsubject
Has Abstractpub_date
1990-10-01 00:00:00pages
1082-7issue
10eissn
0002-8614issn
1532-5415journal_volume
38pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVES:To characterize Medicare expenditure and usage trends in individuals with a coded diagnosis of Alzheimer's disease and related dementia (ADRD) or mild cognitive impairment (MCI) during the periods leading up to and after diagnosis. DESIGN:Retrospective observational cohort study. SETTING:Five percent sampl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14227
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:To determine the effect of home-based primary care (HBPC) on Medicare costs and mortality in frail elders. DESIGN:Case-control concurrent study using Medicare administrative data. SETTING:HBPC practice in Washington, District of Columbia. PARTICIPANTS:HBPC cases (n = 722) and controls (n = 2,161) matched ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12974
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to report on the prevalence, incidence and prognosis of left ventricular hypertrophy (LVH) on the electrocardiogram (ECG) in a cohort of ambulatory older men and women. DESIGN:A prospective, longitudinal study of 10 years duration with ECGs obtained at baseline and on an annua...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb01437.x
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To identify presenting characteristics of older patients with subdural hematoma who are unlikely to survive hospitalization. DESIGN:A retrospective cohort. PATIENTS:All patients > or = 65 years of age hospitalized at a tertiary care center from 1985-1990 with the primary diagnosis of subdural hematoma. MEA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb07329.x
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:The American College of Cardiology (ACC) Geriatric Cardiology Section Leadership Council recently outlined 4 key domains (which are composed of 14 subdomains) that are important to assess in older adults with heart failure (HF). We sought to determine which geriatric domains/subdomains are routine...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16183
更新日期:2019-12-01 00:00:00
abstract::Thyroid disease in the aged, both hypothyroidism and hyperthyroidism, may be subtle or may be present with no clinical symptoms and signs, and is therefore difficult to diagnose on the basis of clinical evaluation. The help of the laboratory is essential in making the diagnosis of disease of the thyroid. Therapeutic s...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1993.tb06488.x
更新日期:1993-12-01 00:00:00
abstract::Drug prescribing for ambulatory patients greater than or equal to 85 years of age was studied using data from the 1980 National Ambulatory Medical Care Survey (NAMCS) on office visits to physicians. NAMCS is a survey by the US National Center for Health Statistics, which collected information on office visits and extr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb05855.x
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVES:To explore the effect of inflammation and undernutrition on the association between hypocholesterolemia and higher overall mortality in high-functioning older persons. DESIGN:Prospective cohort study. SETTING:Three U.S. communities. PARTICIPANTS:A cohort of 870 participants from the MacArthur Studies of S...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1034/j.1601-5215.2002.51014.x
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:Impact assessment of drug benefits policies is a growing field of research that is increasingly relevant to health care planning for older people. Some cost-containment policies are thought to increase noncompliance. This paper examines mechanisms that can produce spurious reductions in drug utilization meas...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50120.x
更新日期:2002-03-01 00:00:00
abstract::What ethical concerns regarding the application of new antidementia compounds are pertinent to the best interests of patients with Alzheimer's disease and their caregivers? Based on collected preliminary anecdotal accounts, these concerns are important and should be considered carefully by clinicians, researchers, and...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb03819.x
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of standardized neuropsychological tests in the psychometric differentiation of patients with very mild or mild Alzheimer's Disease (AD) and/or major depression presenting in a tertiary clinic with memory/attention complaints. DESIGN:Controlled prospective clinicoexperimental desig...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1995.tb07402.x
更新日期:1995-11-01 00:00:00
abstract::Hip fractures in older adults are a common event, leading to substantial morbidity and mortality. Hip fractures have been previously described as a "geriatric, rather than orthopedic disease." Patients with this condition have a high prevalence of comorbidity and a high risk of complications from surgery, and for this...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01770.x
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVES:To prioritize research topics relevant to the care of the growing population of older adults with multiple chronic conditions (MCCs). DESIGN:Survey of experts in MCC practice, research, and policy. Topics were derived from white papers, funding announcements, or funded research projects relating to older ad...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14943
更新日期:2017-07-01 00:00:00
abstract::The characteristic morphologic changes frequently observed in the brain of an old adult include a decrease in weight and volume, a change in the pattern of cerebral cortical convolutions, and an increase in ventricular size. Cell loss varies from region to region in the brain, and may be intensified in Alzheimer's dis...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1976.tb03246.x
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVES:To determine the prognostic value of apathy for mortality in patients of somatic (SC) and dementia special care (DSC) nursing home (NH) units. DESIGN:Longitudinal design, secondary analyses of a 2-year, cluster-randomized trial with six measurements, approximately 4 months in between. SETTING:SC and DSC-un...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/jgs.15007
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To assess use of urinary collection devices (external, intermittent, and indwelling catheters; pads or briefs) and examine predictors of indwelling catheters in skilled nursing facilities (SNFs). DESIGN:Retrospective cohort study. SETTING:SNFs in California, Florida, Michigan, New York, and Texas. PARTICI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01675.x
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To investigate the accuracy of cranial computerized tomography (CT) scans in distinguishing patients with Alzheimer's disease from those with other dementing conditions. DESIGN:Retrospective clinicopathological correlation with pre-mortem CT scans. SETTING:Urban and rural hospitals and nursing homes in the ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb02014.x
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVES:To assess the relative independent contribution of changes in executive control function (ECF) and memory to changes in functional status. DESIGN:Three-year longitudinal cohort study. SETTING:A comprehensive care retirement community. PARTICIPANTS:Five hundred forty-seven noninstitutionalized people aged ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53004.x
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect on outcomes of the Ohio Department of Public Safety statewide geriatric triage criteria, established in 2009 for emergency medical services (EMS) to use for injured individuals aged 70 and older. DESIGN:Retrospective cohort study of the Ohio Trauma Registry. SETTING:All hospitals in ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14376
更新日期:2016-10-01 00:00:00
abstract::Falls are among the most common unwanted events in older hospital inpatients, but evidence of effective prevention is still limited compared with that in the community and in long-term care facilities. This article describes a prevention program and its effects on the incidence of falls in geriatric hospital wards. It...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01424.x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVES:To identify fracture types in a series of older adults with pelvic fractures and to determine whether the type of pelvic fracture affected short-term outcomes and morbidity. DESIGN:Retrospective chart review. SETTING:Teaching hospital. PARTICIPANTS:One hundred eighty-one individuals aged 65 and older with...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03455.x
更新日期:2011-07-01 00:00:00
abstract::Physical health problems become more common as people age and are associated with a great deal of disability. Although racial and ethnic disparities have been reported in physical health, little is known about whether these disparities remain in the latest part of older adulthood. Accordingly, the current study sought...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.03033.x
更新日期:2010-10-01 00:00:00
abstract::The field has progressed to the point where a genetic investigation of the aging processes in Drosophila can be viewed as constituting both a serious and a feasible research program. There now exists at least one single gene mutant which yields an accelerated aging phenotype, at least two single gene null mutants affe...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1989.tb02240.x
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVES:To examine in cognitively normal elderly adults whether vascular factors predict cognitive decline and whether these associations are mediated by magnetic resonance imaging (MRI) measures of subclinical vascular brain injury. DESIGN:Prospective multisite longitudinal study of subcortical ischemic vascular d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2011.03839.x
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:To estimate the independent effect of hospitalization for ischemic stroke on change in functional status, subsequent hospitalization, and mortality. DESIGN:Secondary analysis of the nationally representative Longitudinal Study on Aging. Baseline (1984) interview data were linked to Medicare hospitalization ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01073.x
更新日期:1998-05-01 00:00:00
abstract::To help determine whether or not the elderly are at unusually high risk for hospital-related complications, a study was made of consecutive admissions involving 48 patients less than 65 years old (mean 50.3 years) and 174 patients more than 65 years old (mean 73.1 years). They were prospectively followed during their ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb02837.x
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVES:To establish the comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults using the network meta-analysis approach. DESIGN:Systematic review and network meta-analysis. PARTICIPANTS:Individuals aged 60 and older. MEASUREMENT...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析
doi:10.1111/jgs.13395
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:To assess the frequency of diagnostic errors in older adults presenting to the emergency department (ED) with symptoms suggestive of Chikungunya virus infection (CVI) and to compare the rates of misdiagnosis of older and younger adults. DESIGN:Cross-sectional study performed in the University Hospitals of M...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15492
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:To explore changes in care goals and treatment orders around the occurrence of pneumonia and intake problems, and whether hospitalization is in line with earlier agreed-upon do-not-hospitalize orders. DESIGN:Data were collected as part of the Dutch End of Life in Dementia study (2007-2011), a longitudinal o...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14667
更新日期:2017-04-01 00:00:00
abstract::Capitated or salaried managed care systems offer an important opportunity to provide high quality, cost-effective end-of-life care. However, capitated healthcare delivery systems have strong incentives to avoid patient populations in need of such care. Care currently provided at the end of life in fee-for-service prac...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01047.x
更新日期:1998-03-01 00:00:00