Abstract:
OBJECTIVES:Older people approaching end of life are commonly prescribed multiple medications, many of which may be inappropriate or futile. Our objective was to examine the effect of applying the STOPPFrail, a recently developed deprescribing tool, to the medication regimens of older patients with advanced frailty. DESIGN:Randomized controlled trial. SETTING:Two acute hospitals in Ireland. PARTICIPANTS:Adults 75 years or older (n = 130) with advanced frailty and polypharmacy (five or more drugs), transferring to long-term nursing home care. INTERVENTION:A STOPPFrail-guided deprescribing plan was presented to attending physicians who judged whether or not to implement recommended medication changes. MEASUREMENTS:The primary outcome was the change in the number of regular medications at 3 months. Secondary outcomes included unscheduled hospital presentations, falls, quality of life, monthly medication costs, and mortality. RESULTS:Intervention (n = 65) and control group (n = 65) participants were prescribed a mean (plus or minus standard deviation [SD]) of 11.5 (±3.0) and 10.9 (±3.5) medications, respectively, at baseline. The mean (SD) change in the number of medications at 3 months was -2.6 (±2.73) in the intervention group and -.36 (±2.60) in the control group (mean difference = 2.25 ± .54; 95% confidence interval [CI] = 1.18-3.32; P < .001). The mean change in monthly medication cost was -$74.97 (±$148.32) in the intervention group and -$13.22 (±$110.40) in the control group (mean difference $61.74 ± $26.60; 95% CI = 8.95-114.53; P = .02). No significant differences were found between groups for any of the other secondary outcomes. CONCLUSION:STOPPFrail-guided deprescribing significantly reduced polypharmacy and medication costs in frail older people. No significant differences between groups were observed with regard to falls, hospital presentations, quality of life, and mortality, although the trial was likely underpowered to detect differences in these outcomes. J Am Geriatr Soc 68:762-769, 2020.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Curtin D,Jennings E,Daunt R,Curtin S,Randles M,Gallagher P,O'Mahony Ddoi
10.1111/jgs.16278subject
Has Abstractpub_date
2020-04-01 00:00:00pages
762-769issue
4eissn
0002-8614issn
1532-5415journal_volume
68pub_type
杂志文章abstract:OBJECTIVES:To investigate whether midlife and older women who reported prior-year physical abuse, verbal abuse, or both abuse types had higher mortality risk than peers who did not report prior-year abuse. DESIGN:Retrospective analysis. SETTING:Community. PARTICIPANTS:One hundred sixty-thousand six hundred seventy-s...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02429.x
更新日期:2009-10-01 00:00:00
abstract::Absorption of folates, vitamin B6, pantothenate, and riboflavin from a natural food source (yeast) and from synthetic folylmonoglutamate was studied in 24 elderly subjects (age range, 73 to 101 years) and in 12 healthy younger subjects (age range, 24 to 42 years). All subjects absorbed riboflavin, vitamin B6, and pant...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb01962.x
更新日期:1978-05-01 00:00:00
abstract:BACKGROUND:Coronary artery calcification (CAC) reflects the extent of coronary artery atherosclerosis. The extent of coronary artery calcification is not well described in older adults. OBJECTIVE:To determine the extent of CAC in older adults participating in a large population study of cardiovascular disease (CVD), e...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02643.x
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To develop and validate the Physical Performance and Mobility Examination (PPME), an observer-administered, performance-based instrument assessing 6 domains of physical functioning and mobility for hospitalized elderly. DESIGN:Development of a pass-fail and 3-level scoring system and training manuals for the...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06535.x
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of dehydroepiandrosterone (DHEA) combined with exercise on bone mass, strength, and physical function in older, frail women. DESIGN:Double-blind, randomized, placebo-controlled trial. SETTING:A major medical institution. PARTICIPANTS:Ninety-nine women (mean age 76.6 ± 6.0) 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.1532-5415.2010.03019.x
更新日期:2010-09-01 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:OBJECTIVE:To compare the sensitivity to atrial natriuretic peptide (ANP) in young and elderly subjects. DESIGN:Double-blind, random-order, placebo-controlled study using two different rates of ANP infusion. SUBJECTS:Eight healthy young (23 +/- 3 years, mean +/- SD) and eight healthy elderly (76 +/- 4 years) subjects ...
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.1532-5415.1993.tb07309.x
更新日期:1993-11-01 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:Many elderly persons have drug benefits with coverage gaps, such as in Medicare Part D. Because beneficiaries who have such gaps must pay all drug costs, an accurate knowledge of gap thresholds and communication with providers about exceeding caps is important for elderly persons to manage out-of-pocket drug...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02244.x
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:To determine the contribution of cognitive impairment, prefracture functional impairment, and treatment as predictors of functional status and mobility 6 months after discharge from rehabilitation for older adults with hip fracture. DESIGN:Longitudinal. SETTING:Inpatient rehabilitation units of two communi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14297
更新日期:2016-08-01 00:00:00
abstract::By 2050, the European population of 720 million will include 187 million (one quarter) octogenarians. Although living longer is a true privilege, care for the graying population suffering from chronic and disabling diseases will raise enormous challenges to healthcare systems and geriatric education. Are European coun...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01788.x
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:To determine the effect of patient characteristics and of specific guidelines that were developed for managing warfarin therapy in older adults and included in an in-house computer program on anticoagulation quality. DESIGN:Thirteen-month observational study. SETTING:Acute care, extended care, and rehabili...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02675.x
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES:To develop and validate a prognostic case finding tool that classifies the risk of emergency department (ED) use in an older home care population. DESIGN:Population-based retrospective cohort study using routinely collected data from home care clinical assessments linked prospectively to ED records. SETTIN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13336
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:To determine whether body mass index (BMI) is independently associated with cognitive function in postmenopausal women and the relationship between body fat distribution as estimated by waist-hip ratio (WHR). DESIGN:Cross-sectional data analysis. SETTING:Baseline data from the Women's Health Initiative (WH...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02969.x
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of influenza vaccine, rapid influenza testing, and influenza antiviral medication in nursing homes in the US to prevent and control outbreaks. METHODS:Survey questionnaires were sent to 1017 randomly selected nursing homes in nine states. Information was collected on influenza prevention,...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02606.x
更新日期:2000-10-01 00:00:00
abstract::Older adults with advanced chronic kidney disease (CKD) experience functional impairment that can complicate CKD management. Failure to recognize functional impairment may put these individuals at risk of further functional decline, nursing home placement, and missed opportunities for timely goals-of-care conversation...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14262
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Social media platforms are promising sources for large quantities of participant-driven research data and circumvent some common challenges when conducting dementia research. This study provides a summary of key considerations and recommendations about using these platforms as research tools for d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16790
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:To report use of breast cancer treatment (surgery, radiation, and chemotherapy) by patients with Alzheimer's disease (AD). DESIGN:Retrospective cohort study. SETTING:Surveillance, Epidemiology, and End Results (SEER) is a population-based cancer registry covering 14% of the U.S. population. PARTICIPANTS:F...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.00467.x
更新日期:2005-11-01 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:To determine the effectiveness of a behavior change intervention (BCI) with or without a pedometer in increasing physical activity in sedentary older women. DESIGN:Prospective randomized controlled trial. SETTING:Primary care, City of Dundee, Scotland. PARTICIPANTS:Two hundred four sedentary women aged 70...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2010.03127.x
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:To determine the association between complementary and alternative medicine (CAM) use and antihypertensive medication adherence in older black and white adults. DESIGN:Cross-sectional. SETTING:Patients enrolled in a managed care organization. PARTICIPANTS:Two thousand were hundred eighty black and white a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02639.x
更新日期:2010-01-01 00:00:00
abstract::The course of untreated mild hypothyroidism was followed in 67 nursing home residents (mean age 78 years). The diagnosis was based on a normal free thyroxine index (FTI) and elevated thyrotropin concentration (TSH 4.6 to 15.0 microIU/mL, nl less than or equal to 4.5 microIU/mL. FTI and FSH were measured in follow-up 4...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1991.tb01648.x
更新日期:1991-03-01 00:00:00
abstract::In a 78-year-old woman receiving perhexiline maleate for intractable angina pectoris, a syndrome of parkinsonism and peripheral neuropathy developed. The neuropathy was confirmed by electromyographic and nerve conduction studies. The parkinsonism and peripheral neuropathy disappeared when perhexiline maleate was disco...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb02188.x
更新日期:1981-06-01 00:00:00
abstract:OBJECTIVE:To determine whether low serum B12 levels are associated with an increased incidence of dementing illness. DESIGN:Longitudinal cohort study, 5-year follow-up. PARTICIPANTS:Volunteer cohort of 410 nondemented ambulatory subjects aged 75 to 85 years. MEASUREMENTS:Annual serum B12 determinations and neuropsyc...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06583.x
更新日期:1994-09-01 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 estimate the incidence of chronic activities of daily living (ADL) disability and to analyze the sociodemographic, health status, adverse lifestyle, and leisure-time physical activity predictors for chronic ADL disability. DESIGN:We recruited a cohort of community-dwelling older people in Taipei, Taiwan,...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb05231.x
更新日期:1999-09-01 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::The Physician Orders for Life-Sustaining Treatment (POLST) form is a palliative care tool that contains standardized, actionable medical orders. It is designed to ensure that patient treatment preferences are elicited, communicated, and honored throughout the healthcare system. A systematic review of the literature wa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.13248
更新日期:2015-02-01 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 test the efficacy of an individualized social activity intervention (ISAI) on decreasing daytime sleep, improving nighttime sleep, and lowering the day/night sleep ratio and to determine its cost. DESIGN:Pretest/posttest randomized with an experimental and control group. SETTING:Seven nursing homes. PA...
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.1532-5415.2005.53460.x
更新日期:2005-09-01 00:00:00