Abstract:
OBJECTIVES:Older patients with asthma or chronic obstructive pulmonary disease are particularly susceptible to exacerbations that may be associated with incorrect use of inhalers. Educational programs with inhaler technique review seem to be effective, but no studies have addressed their cost-effectiveness in older adult patients. The objective was to perform a cost-effectiveness analysis of education programs in older patients and estimate the cost benefit of applying such a program in Portugal. DESIGN:We developed a decision tree analysis from a healthcare perspective, according to intervention costs and the exacerbation rates and costs described in a previous meta-analysis. A sensitivity analysis of worst and best case scenarios was performed to estimate thresholds for intervention affordable limits, as well as cost-saving estimations and incremental cost-effectiveness ratios (ICERs) for a Portuguese scenario. SETTING AND PARTICIPANTS:We estimated cost-effectiveness thresholds applicable in all settings and performed a sensitivity analysis of a theoretical intervention model in all patients including an inhaler technique review at an annual appointment with a doctor and a nurse. RESULTS:In the best case scenario, the intervention affordable budget could be up to almost 1800€ (US $1585.24) per patient per year. Mean intervention-associated savings in Portugal would be 311.88€ (US $274.68) per patient per year, representing annual savings up to €131 million (US $150 million) for the whole health system, already including intervention costs. ICERs for Portugal vary between 93.73€ (US $82.55) and 437.43€ (US $385.25) per exacerbation avoided. CONCLUSION:A model of an intervention program with an inhaler technique review in older adult patients suggests that this intervention is cost-effective and can generate significant savings. J Am Geriatr Soc 1-7, 2019.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Maricoto T,Marques-Gomes J,Correia-de-Sousa J,Taborda-Barata Ldoi
10.1111/jgs.15834subject
Has Abstractpub_date
2019-07-01 00:00:00pages
1430-1436issue
7eissn
0002-8614issn
1532-5415journal_volume
67pub_type
杂志文章abstract:OBJECTIVE:To evaluate the efficacy of Simulated Presence, a personalized approach to enhance well-being among nursing home residents with Alzheimer's disease and related dementia's (ADRD). DESIGN:Latin-Square, double blinded, 3-factor design with restrictive randomization of three treatments (the study intervention, a...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.1999.tb07237.x
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVES:To determine the priority that older adults with coexisting hypertension and fall risk give to optimizing cardiovascular outcomes versus fall- and medication symptom-related outcomes. DESIGN:Interview. SETTING:Community. PARTICIPANTS:One hundred twenty-three cognitively intact persons aged 70 and older wi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01815.x
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:To determine whether patient age is associated with differences in flexible bronchoscopy technique and tolerance. DESIGN:Prospective cohort study. SETTING:University hospital system. PARTICIPANTS:One thousand three hundred fifty-eight adults, including 219 (16.1%) aged 70 and older, undergoing bronchoscop...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1365-2389.2003.51303.x
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVES:To determine the frequency of vitamin D deficiency and secondary hyperparathyroidism in Australian hip fracture patients living in the community. PATIENTS:A total of 283 consecutive patients with hip fracture admitted over a 15-month period to a university teaching hospital in Western Australia. Included we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb03001.x
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:The study describes the prevalence of medical nursing home practice. Further, it examines the extent to which physician characteristics and local county health care resources predict nursing home involvement. This information is relevant to evaluating and devising strategies that address the future provision ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb02958.x
更新日期:1997-08-01 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:OBJECTIVE:To assess how dietary change affects gain in strength and muscle mass during heavy resistance training of elderly men. DESIGN:Randomized controlled trial. INTERVENTION:During 12 weeks of resistance training of knee extensors and flexors, a daily supplement of 560 +/- 16 kcal/day (17% energy from protein, 43...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1992.tb01937.x
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R). DESIGN:Cross-sectional cohort study. SETTING:Four participating health plan...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章,多中心研究
doi:10.1111/jgs.12062
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:Patients undergoing hip fracture surgery have a 10 times increased risk of stroke compared with the general population. We aimed to evaluate the association between the CHA2 DS2 -VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, previous stroke/TIA [transient ischemic attack]/systemic em...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16452
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:To assess how individual socioeconomic status and neighborhood deprivation affect frailty. DESIGN:Nationally representative population-based study, the English Longitudinal Study of Aging (ELSA), analyzed cross-sectionally. PARTICIPANTS:Four thousand eight hundred eighteen individuals aged 65 and older. M...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02480.x
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVES:To examine the prevalence of mobility device use in community-dwelling older adults in the United States and to investigate the incidence of falls and worry about falling according to type and number of mobility devices used. DESIGN:Analysis of cross-sectional and longitudinal data from the 2011-12 National...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13393
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:To determine whether potentially inappropriate medications (PIMs) or potentially inappropriate associations (PIAs) prescribed knowingly are associated with patient monitoring. DESIGN:Prospective observational study. SETTING:Geriatric units (n = 56) in 28 hospitals. PARTICIPANTS:Inpatients aged 75 and olde...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.15081
更新日期:2017-12-01 00:00:00
abstract::A history of systolic (greater than or equal to 160 mm Hg) or diastolic (greater than or equal to 90 mm Hg) hypertension, diabetes mellitus (fasting venous plasma glucose greater than or equal to 140 mg/dl), a history of cigarette smoking, fasting serum total cholesterol greater than or equal to 200 mg/dl and greater ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1987.tb01311.x
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of diabetes and examine its association with food intake, anthropometric and metabolic variables, and other coronary risk factors in urban and rural older Mexican populations. DESIGN:A cross-sectional study. SETTING:Three Mexican communities (urban areas of medium and low income ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb06005.x
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:To determine whether the association between impaired cognition and greater risk of incident stroke is also observed when cognitive impairment is defined using different criteria for mild cognitive impairment (MCI). DESIGN:Prospective cohort study with 10 years of follow-up. SETTING:Large multicentre study...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.14878
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To assess the utility of geriatric targeting criteria in predicting survival and health care utilization in a cohort of hospitalized older veterans. DESIGN:A prospective cohort study assessing geriatric targeting criteria, e.g., polypharmacy, falls, or confusion, with respect to adverse outcomes at 12 months...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb01860.x
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To assess the validity of several equations for estimating creatinine clearance in a large sample of high-functioning, community-dwelling elderly. DESIGN:Serum and 12-hour urine samples were collected and assayed for creatinine using the Jaffe total chromagen method. Fifteen clearance-estimating equations we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb07459.x
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:To determine the association between interleukin-6 (IL-6), IL-6 soluble receptor (sR), and soluble tumor necrosis factor receptor-1 (sTNF-R1) and cognitive status in the oldest-old women. DESIGN:Twenty-year longitudinal cohort study. SETTING:Four clinical sites in the United States. PARTICIPANTS:Women fro...
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.12739
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To determine the excess mortality associated with obesity (defined by body mass index (BMI)) in older people, with and without adjustment for other risk factors associated with mortality and for demographic factors. DESIGN:Retrospective cohort analysis of the Longitudinal Study of Aging (LSOA). SETTING:Nati...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49189.x
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVES:To describe longitudinal changes in the prevalence of major cardiovascular disease (CVD) risk factors in aging American Indians. DESIGN:Population-based ongoing epidemiological study. SETTING:The Strong Heart Study is a study of CVD and its risk factors. Standardized examinations were repeated in 1993 to 1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2006.01018.x
更新日期:2007-01-01 00:00:00
abstract::The effect of isobaric oxygenation on psychogeriatric subjects, with mild cognitive impairment was assessed in a single-blind controlled pilot study. Three of the 7 subjects were treated with a mixture of 97% oxygen plus 3% carbon dioxide, and 4 treated with compressed air. The oxygen or air was administered during tw...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1975.tb00389.x
更新日期:1975-02-01 00:00:00
abstract:OBJECTIVE:To clarify the neuropsychological function in patients with Charles Bonnet Syndrome. DESIGN:Control group comparison study. SETTING:University of Chicago Hospitals. PARTICIPANTS:The neuropsychological function of 15 older adults with presenting complaints of visual hallucinations who met criteria for Charl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1996.tb02937.x
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVES:To assess whether the relationship between antidepressant adherence and coronary artery disease (CAD) hospitalizations varied between older and younger adults with depression. DESIGN:Retrospective cohort study. SETTING:Department of Veterans Affairs outpatient clinics nationwide. PARTICIPANTS:Chronically ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12849
更新日期:2014-07-01 00:00:00
abstract::Logical bases (five of which are outlined) underlie action in nutrition and aging. First, nutrition, health, and aging form an integral triad affecting all. This basis has been applied to the conceptualization of the Nutrition Program for Older Americans (NPOA). Second, in North America, malnutrition is a sequitur of ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb01958.x
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVES:To examine transitions that individuals with dementia experience longitudinally and to identify points of care when transitions are highest and the factors that contribute to those transitions. DESIGN:Population-based 10-year retrospective cohort study from 2000 to 2011. SETTING:General community. PARTICI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14033
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:To determine whether serum calcium is associated with cognitive function in elderly individuals in the general population. DESIGN:Prospective follow-up study of two independent, population-based cohorts. SETTING:The Rotterdam Study (median follow-up 11 years) and the Leiden 85-plus Study (median follow-up ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01418.x
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVES:To examine the effect of obesity (body mass index (BMI)≥30.0 kg/m2 ) on outcomes of older adults admitted to skilled nursing facilities (SNFs) for hip fracture postacute care (PAC). DESIGN:Retrospective cohort study. SETTING:U.S. Medicare- and Medicaid-certified SNFs from 2008 to 2015. PARTICIPANTS:Medica...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15334
更新日期:2018-07-01 00:00:00
abstract::Pfeiffer's Short Portable Mental Status Questionnaire (SPMSQ) is a brief screening test for organic brain syndromes. The validity of the SPMSQ was evaluated in a random sample of 119 community residents and 282 consecutively admitted medical inpatients. The SPMSQ proved to be a sensitive and specific screening test fo...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1987.tb04662.x
更新日期:1987-05-01 00:00:00
abstract::The benefits of prophylactic aspirin therapy to prevent cardiovascular and cerebrovascular disease in asymptomatic individuals remains unclear. The rationale for developing a multicentered, double-blind, placebo-controlled clinical trial to determine whether low-dose aspirin (100 mg daily) prevents cardiovascular and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1991.tb02494.x
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Delirium in the intensive care units (ICUs) is prevalent, with both delirium duration and delirium severity associated with adverse outcomes. We designed a pragmatic trial to test the efficacy of a pharmacological management of delirium (PMD) bundle in improving delirium/coma-free days and reducing...
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.15781
更新日期:2019-05-01 00:00:00