Abstract:
OBJECTIVES:To perform a systematic review to determine the effectiveness of interventions designed to reduce potentially inappropriate prescribing (PIP) in community-dwelling older adults. DESIGN:Systematic review and narrative synthesis. SETTING:Primary and community care. PARTICIPANTS:Community-dwelling older adults. MEASUREMENTS:The primary outcome was change in PIP measured using implicit or explicit tools. Studies were grouped into organizational, professional, financial, regulatory, and multifaceted interventions. RESULTS:Twelve randomized controlled trials were identified with baseline PIP prevalence of 18% to 100%. Four of six organizational interventions reported a reduction in PIP, particularly through pharmacists conducting medication reviews. Evidence of the effectiveness of multidisciplinary teams was weak. Both of the two professional (targeting prescriber's directly) interventions were computerized clinical decision support interventions and were effective in decreasing new PIP but not existing PIP. Three of four multifaceted approaches were effective in reducing PIP. The risk of bias was often high, particularly in reporting selection bias. CONCLUSION:Interventions including organizational (pharmacist interventions), professional (computerized clinical decision support systems), and multifaceted approaches appear beneficial in terms of reducing PIP, but the range of effect sizes reported was modest, and it is unclear whether such interventions can result in clinically significant improvements in patient outcomes. Ongoing assessment of interventions to reduce PIP is needed in community-dwelling older adults, particularly in relation to preventing initiation of PIP.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Clyne B,Fitzgerald C,Quinlan A,Hardy C,Galvin R,Fahey T,Smith SMdoi
10.1111/jgs.14133subject
Has Abstractpub_date
2016-06-01 00:00:00pages
1210-22issue
6eissn
0002-8614issn
1532-5415journal_volume
64pub_type
杂志文章,评审abstract::Studies in experimental animal models provide a convincing rationale for a role for ERT in the treatment and prevention of dementia. These studies establish the role of estrogen in the regeneration and preservation of neuronal elements within the CNS that are analogous to those regions of the brain most sensitive to t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1996.tb03749.x
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVES:To develop a prediction model for kidney transplantation (KT) outcomes specific to older adults with end-stage renal disease (ESRD) and to use this model to estimate the number of excellent older KT candidates who lack access to KT. DESIGN:Secondary analysis of data collected by the United Network for Organ...
journal_title:Journal of the American Geriatrics Society
pub_type: 社论,多中心研究
doi:10.1111/j.1532-5415.2011.03652.x
更新日期:2012-01-01 00:00:00
abstract::Pretreatment with a somatostatin analogue, octreotide (SMS 201-995), prevents postprandial blood pressure reduction in the elderly. We hypothesized that this beneficial effect on blood pressure is caused by an octreotide-induced suppression of insulin secretion. We studied the effects of octreotide and insulin adminis...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb06677.x
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVES:To test the effects of a communication skills training intervention on older patients' discourse during a primary care interview. DESIGN:A quasi-experimental design involving two intervention conditions. SETTING:The Family Practice Center of a university-based clinic. PARTICIPANTS:Thirty-three patients av...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.4911244.x
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVES:To describe the prevalence of and characteristics associated with major and minor depression in older medical inpatients and to compare associated characteristics by sex and history of depression. DESIGN:Cross-sectional study of two patient samples, with and without a screening diagnosis of major or minor d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53404.x
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVES:To determine whether there is racial variation in hospice enrollees in rates of hospitalization and hospice disenrollment and, if so, whether systematic differences in hospice provider patterns explain the variation. DESIGN:Longitudinal cohort study. SETTING:Hospice. PARTICIPANTS:Medicare beneficiaries (N...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15228
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVES:To estimate outcomes according to attained blood pressure (BP) in the oldest adults treated for hypertension in routine family practice. DESIGN:Cohort analysis of primary care inpatient and death certificate data for individuals with hypertension. SETTING:Primary care practices in England (Clinical Practic...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14712
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:To ascertain whether a safe-transportation program can change driving exposure while maintaining community participation of older drivers. DESIGN:Randomized controlled trial. SETTING:Northwest Sydney. PARTICIPANTS:Drivers aged 75 and older (mean 80 ± 4) (n = 380). INTERVENTION:Intervention group particip...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.14550
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVES:To compare the prevalence and predictors of caregiver esteem and burden during two different stages of care recipients' illnesses-advanced chronic illness and the last year of life. DESIGN:Longitudinal, observational cohort study. SETTING:Community sample recruited from outpatient clinics at Duke Universit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12841
更新日期:2014-06-01 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:OBJECTIVE:To describe a broad range of physical disability by examining the association between a four-level measure of disability, based on self-report of difficulty in performing functional activities, and previously identified risk factors for disability. DESIGN:Cross-sectional. SETTING:Community-based. PARTICIPA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb04065.x
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVES:To cross-sectionally quantify the contribution of proxy measures of cognitive reserve reflective of the lifespan, such as education, socioeconomic status (SES), reading ability, and cognitive activities, in explaining late-life cognition. DESIGN:Prospective observational cohort study of aging. SETTING:Reti...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03499.x
更新日期:2011-08-01 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::The 143 physicians who returned to Temple University Medical School a questionnaire on knowledge of prescribing for the elderly constituted 25% of a stratified random sample of general practitioners (GPs), family practitioners (FPs), and practitioners in internal medicine (IMs) reimbursed under Medicare in Pennsylvani...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb06318.x
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVES:To describe the association between frailty and health status, the progression of frailty, and the relationship between frailty and mortality in older men. DESIGN:Cross-sectional and prospective cohort study. SETTING:Six U.S. clinical centers. PARTICIPANTS:Five thousand nine hundred ninety-three community...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2007.01259.x
更新日期:2007-08-01 00:00:00
abstract::Identifying impairments in the capacity to make and execute decisions is critical to the assessment and remediation of elder self-neglect. Few capacity assessment tools are available for use outside of healthcare settings, and none have been validated in the context of elder self-neglect. Health and social services pr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2008.01979.x
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:To estimate prescribing tends of and correlates independently associated with high-risk anticholinergic prescriptions in adults aged 65 and older in office-based outpatient visits. DESIGN:Repeated cross-sectional analysis. SETTING:National Ambulatory Medical Care Survey (NAMCS). PARTICIPANTS:A national sa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15357
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To explore the risk of developing Alzheimer's disease (AD) in individuals with diabetes mellitus treated with metformin or other antidiabetic drugs. DESIGN:Case-control study. SETTING:The United Kingdom-based General Practice Research Database (GPRD), a well-established primary care database. PARTICIPANTS...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.03916.x
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of dental problems in Paget's patients and in a control population without Paget's disease. The relationship of localization of bony involvement of Paget's disease with the prevalence of dental, auditory, visual, and smell changes is examined. DESIGN:Cross-sectional national surve...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:1995-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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更新日期:2014-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15371
更新日期:2018-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53316.x
更新日期:2005-06-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2004.52320.x
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVES:Several studies have demonstrated that a large percentage of older people are inadequately immunized against tetanus. The aim of this study was to assess the immunity against tetanus in a group of individuals aged 69 and older and to examine the immune response to a single dose of tetanus toxoid. DESIGN:A c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb06893.x
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:To examine the effect of mode of survey administration on response rates and response tendencies for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey and develop appropriate adjustments. DESIGN:Survey response data were obtained after sampling and fielding of the CAHPS Hosp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15265
更新日期:2018-03-01 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:OBJECTIVE:To examine the relationship between restraint use and falls while controlling for the effect of psychoactive drug use among nursing home residents, including subgroups of nursing home residents with high rates of restraint use and/or falls. DESIGN:Secondary analysis of data from a longitudinal clinical trial...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.1996.tb01822.x
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To determine patient factors that predict use of physical or occupational therapy (PT/OT) services by elderly people. DESIGN:Time-series study of the relationship of PT/OT use to a variety of characteristics present at baseline. PARTICIPANTS:Eight-hundred nine community-dwelling men and women aged 65 and ol...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb02131.x
更新日期:1992-04-01 00:00:00
abstract::Neurotoxic effects of habitual alcohol consumption were investigated by correlating the subjects' estimates of abstinence or frequency and amount of alcohol consumed with measurements of gray matter blood flow utilizing the 133Xe inhalation method. Two hundred and twenty-two subjects were studied, including 136 health...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb02198.x
更新日期:1983-09-01 00:00:00