Abstract:
OBJECTIVES:To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN:Randomized clinical trial. SETTING:Primary care clinics at a Veterans Affairs Medical Center. PARTICIPANTS:Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128). INTERVENTION:TRIM extracts information on medications and chronic conditions from the EHR and contains data entry screens for information obtained from brief chart review and telephonic patient assessment. These data serve as input for automated algorithms identifying medication reconciliation discrepancies, potentially inappropriate medications (PIMs), and potentially inappropriate regimens. Clinician feedback reports summarize discrepancies and provide recommendations for deprescribing. Patient feedback reports summarize discrepancies and self-reported medication problems. MEASUREMENTS:Primary: subscales of the Patient Assessment of Care for Chronic Conditions (PACIC) related to shared decision-making; clinician and patient communication. Secondary: changes in medications. RESULTS:29.7% of TRIM participants and 15.6% of control participants provided the highest PACIC ratings; this difference was not significant. Adjusting for covariates and clustering of patients within clinicians, TRIM was associated with significantly more-active patient communication and facilitative clinician communication and with more medication-related communication among patients and clinicians. TRIM was significantly associated with correction of medication discrepancies but had no effect on number of medications or reduction in PIMs. CONCLUSION:TRIM improved communication about medications and accuracy of documentation. Although there was no association with prescribing, the small sample size provided limited power to examine medication-related outcomes.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Fried TR,Niehoff KM,Street RL,Charpentier PA,Rajeevan N,Miller PL,Goldstein MK,O'Leary JR,Fenton BTdoi
10.1111/jgs.15042subject
Has Abstractpub_date
2017-10-01 00:00:00pages
2265-2271issue
10eissn
0002-8614issn
1532-5415journal_volume
65pub_type
杂志文章,随机对照试验abstract:OBJECTIVES:To identify risk factors for new-onset geriatric epilepsy that may trigger clinicians to consider a differential diagnosis of epilepsy at symptom onset. DESIGN:Retrospective cohort study. SETTING:National Veterans Affairs (VA) databases. PARTICIPANTS:Veterans aged 66 and older in fiscal year 2000 (FY00) w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02124.x
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVES:To determine the frequency of aspiration pneumonitis in nursing home residents with an initial diagnosis of pneumonia and to compare the clinical characteristics, management, and outcome of aspiration pneumonitis with those of pneumonia. DESIGN:Retrospective chart review. SETTING:Hospital geriatric unit fo...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1034/j.1601-5215.2002.51004.x
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To estimate the motor vehicle crash rate in a cohort of older drivers from a rural community and to identify health-related conditions that increase their risk for crash involvement. DESIGN:Cohort study with 5 years of crash-record surveillance. SETTING:The Iowa 65+ Rural Health Study, one of four Establish...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb07049.x
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVES:To determine whether exercise-induced silent ischemia in older master athletes following a 3-month period of deconditioning is a predictor of future cardiovascular events. DESIGN:A longitudinal study of a cohort of master athletes. SETTING:The Geriatric Research Education and Clinical Center (GRECC), Balti...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb04722.x
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVES:To compare the costs of mobile and stationary mammography and examine the incremental cost-effectiveness of using mobile mammography to increase screening rates. DESIGN:A cost-effectiveness analysis was performed using effectiveness data from a randomized clinical trial and modeling of costs associated with...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2008.02105.x
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:Attention has recently been drawn to the potential dangers of firearm use among patients with dementia. However, little is known about the actual prevalence of firearms in households with demented family members. This study seeks to determine the prevalence and loaded status of firearms in households with a d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb05197.x
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVES:To develop and test the Function-Focused Care in Assisted Living (FFC-AL) intervention so as to alter the decline that older adults in AL experience. DESIGN:Cluster-randomized controlled trial using repeated measures to test the effect of FFC-AL. SETTING:Four AL facilities with at least 100 beds. PARTICIP...
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/j.1532-5415.2011.03699.x
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To identify age-related differences in the treatment of patients with acute myocardial infarction. DESIGN:Retrospective cohort study. SETTING:Two university-affiliated medical centers with integrated clinical programs. PATIENTS:329 patients admitted with acute myocardial infarction in 1988-1990 for whom co...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.1994.tb06553.x
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVES:To determine whether a home-based multicomponent physical activity counseling (PAC) intervention is effective in reducing glycemic measures in older outpatients with prediabetes mellitus. DESIGN:Controlled clinical trial. SETTING:Primary care clinics of the Durham Veterans Affairs (VA) Medical Center betwe...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2012.04119.x
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:To investigate whether atherosclerosis of the ascending aorta, internal carotid arteries, and coronary arteries is predictive of postoperative delirium in subjects undergoing coronary artery bypass graft (CABG) surgery. DESIGN:Prospective cohort study. SETTING:Boston Veterans Affairs Healthcare System. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53165.x
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:To investigate the effectiveness of an exercise program in improving ability to perform activities of daily living (ADLs), physical performance, and nutritional status and decreasing behavioral disturbance and depression in patients with Alzheimer's disease (AD). DESIGN:Randomized, controlled trial. SETTIN...
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/j.1532-5415.2007.01035.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Acute myocardial infarction (AMI) is an important cause of mortality and morbidity in older patients. The aim of this study was to determine the proportion of unselected admissions with AMI that is older than 75 years and to examine management and outcomes in this group. DESIGN:An historical cohort study of ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb02991.x
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVES:To compare the diagnosis and management of urinary tract infection (UTI) in hospitalized older people with clinical criteria and therapeutic guidelines. DESIGN:A retrospective case series of emergency hospital admissions collected over an 18-month period. SETTING:An acute general hospital in northwest Engl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02073.x
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To study patterns of transmission of epidemic keratoconjunctivitis (EKC) in a chronic care facility and to assess control measures and prevent future outbreaks in this setting. DESIGN:A retrospective cohort study. SETTING:A 120-bed, four-unit, skilled nursing facility. PATIENTS:Residents and employees of t...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1993.tb07299.x
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVES:To develop and validate a comprehensive quality assessment tool for emergency department (ED) geriatric care. DESIGN:Four-step study: (1) Content development of tool by a multidisciplinary panel, (2) survey of ED lead physicians and nurses, (3) development of subscales using principal component analysis and...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15137
更新日期:2018-02-01 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
doi:10.1111/j.1532-5415.1995.tb06618.x
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVES:To describe the medical decisions confronting healthcare proxies (HCPs) of nursing home (NH) residents with advanced dementia and to identify factors associated with greater decision-making satisfaction. DESIGN:Prospective cohort study. SETTING:Twenty-two Boston-area NHs. PARTICIPANTS:Three hundred twenty...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02304.x
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:Use of objectively measured physical activity (PA) in older adults to assess relationship between PA and risk of all-causes mortality is scarce. This study evaluated the associations of PA based on accelerometry and a questionnaire with the risk of mortality among older adults from a city in Southern Brazil....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16180
更新日期:2020-01-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15833
更新日期:2019-07-01 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.1532-5415.1989.tb06917.x
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVES:To estimate potential cost savings generated by a program of hip protectors in the nursing home from a Medicare perspective. DESIGN:A state-transition Markov model considering short-term and long-term outcomes of hip protectors for a hypothetical nursing home population, stratified by age, sex, and function...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53102.x
更新日期:2005-02-01 00:00:00
abstract::Japan implemented a mandatory social long-term care insurance (LTCI) system in 2000, making long-term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. Th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2007.01281.x
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVES:To determine the prognostic significance of subsyndromal delirium (SSD) presentations. DESIGN:Cohort study. SETTING:University-affiliated primary acute care hospital. PARTICIPANTS:One hundred sixty-four elderly medical inpatients who did not meet Diagnostic and Statistical Manual of Mental Disorders, Thir...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1365-2389.2003.51255.x
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVES:To compare the epidemiological and microbiological characteristics of bloodstream infection (BSI) between the young old (65-75), old (76-85), and old old (>85). DESIGN:Retrospective study. SETTING:Forty-six hospitals in southeast France. PARTICIPANTS:One thousand seven hundred forty patients aged 65 and o...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50458.x
更新日期:2002-10-01 00:00:00
abstract::Patients with dementia often manifest troublesome and disruptive behaviors in addition to intellectual impairments. This study evaluated behavioral disturbances in 126 demented patients examined sequentially, using questionnaires administered to primary caregivers to quantify the types and severity of behavioral distu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb04260.x
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the association between pressure-redistributing support surface (PRSS) use and incident pressure ulcers in older adults with hip fracture. DESIGN:Secondary analysis of data from prospective cohort with assessments performed as soon as possible after hospital admission and on alternating days for...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:To compare the cost-effectiveness of four influenza vaccines available in the United States for persons aged 65 and older: trivalent inactivated influenza vaccine (IIV3), quadrivalent inactivated influenza vaccine (IIV4), a more-expensive high-dose IIV3, and a newly approved adjuvanted IIV3. DESIGN:Cost-eff...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14323
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To compare the effectiveness of four falls risk assessment tools (STRATIFY, Downton, Tullamore, and Tinetti) by using them simultaneously in the same environment. DESIGN:Prospective, open, observational study. SETTING:Two acute medical wards admitting predominantly older patients. PARTICIPANTS:One hundred...
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
abstract::A case is presented of primary endolymphatic stromal sarcoma of the uterus in a debilitated elderly patient. Surgical intervention was contraindicated. Radium therapy was unsuccessful. A 4-month course of treatment with doxorubicin (Adriamycin) resulted in disappearance of the tumor. The patient is living 19 months af...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb03265.x
更新日期:1976-10-01 00:00:00
abstract:OBJECTIVES:Knowledge of male sexual function is somewhat limited because of a lack of current population-based data. This study provides information on sexual function and satisfaction in a population-based sample of men. METHODS:Men aged 40 to 79 years (n = 2115) were selected randomly from the Olmsted County populat...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb07009.x
更新日期:1995-10-01 00:00:00