Abstract:
OBJECTIVE:To describe, using data from the Newcastle 85+ cohort study, the use of primary care and other healthcare services by 85-year-olds as they age. DESIGN:Longitudinal population-based cohort study. SETTING:Newcastle on Tyne and North Tyneside, UK. PARTICIPANTS:Community dwelling and institutionalised men and women recruited through general practices (n=845, 319 men and 526 women). RESULTS:Contact was established with 97% (n=1409/1459) of eligible 85-year-olds, consent obtained from 74% (n=1042/1409) and 851 agreed to undergo the multidimensional health assessment and a general practice medical records review. A total of 845 participants had complete data at baseline for this study (319 male, 526 female), with 344 (118 male, 226 female) reinterviewed at 60 months. After adjusting for confounders, all consultations significantly increased over the 5 years (incidence rate ratio, IRR=1.03, 95% CI 1.01 to 1.05, P=0.001) as did general practitioner (GP) consultations (IRR=1.03, 95% CI 1.01 to 1.05, P=0.006). Significant increases were also observed in inpatient and day hospital use over time, though these disappeared after adjustment for confounders. CONCLUSIONS:Our study of primary, secondary and community care use by the very old reveals that, between the ages of 85 and 90 years, older people are much more likely to consult their GP than any other primary healthcare team members. With a rapidly ageing society, it is essential that both current and future GPs are appropriately skilled, and adequately supported by specialist colleagues, as the main healthcare provider for a population with complex and challenging needs.
journal_name
BMJ Openjournal_title
BMJ openauthors
Yadegarfar ME,Jagger C,Duncan R,Fouweather T,Hanratty B,Parker S,Robinson Ldoi
10.1136/bmjopen-2017-019218subject
Has Abstractpub_date
2018-01-24 00:00:00pages
e019218issue
1issn
2044-6055pii
bmjopen-2017-019218journal_volume
8pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVE:Evidence on the impact of legislative changes on individual alcohol consumption is limited. Using an observational study design, we assessed trends in individual alcohol consumption of a Swiss adult population following the public policy changes that took place between 1993 and 2014, while considering individ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-014828
更新日期:2017-03-15 00:00:00
abstract:OBJECTIVE:To investigate the effects of vitreomacular adhesion (VMA), vitreomacular separation (VMS) and absence of vitreous gel due to vitrectomy on macular thickness measured in the spectral domain optical coherence tomographic (SD-OCT) images. DESIGN:A longitudinal, retrospective, observational study. SETTING:Seco...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2016-012972
更新日期:2016-09-30 00:00:00
abstract:OBJECTIVE:To complete a systematic review of the literature describing associations between all environmental exposures and asthma symptoms and exacerbations in children up to mean age of 9 years. DESIGN:Systematic review. SETTING:Reference lists of identified studies and reviews were searched for all articles publis...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2013-003827
更新日期:2014-02-12 00:00:00
abstract:OBJECTIVE:Proton pump inhibitors (PPIs) are widely used, and their use is associated with increased risk of adverse events. However, whether PPI use is associated with excess risk of death is unknown. We aimed to examine the association between PPI use and risk of all-cause mortality. DESIGN:Longitudinal observational...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-015735
更新日期:2017-07-04 00:00:00
abstract:INTRODUCTION:Cardiovascular disease (CVD) and cancer are leading causes of death globally. Early detection of cancer and risk factors for CVD may improve health outcomes and reduce mortality. General practitioners (GPs) are accessed by the majority of the population and play a key role in the prevention and early detec...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001405
更新日期:2012-07-02 00:00:00
abstract:INTRODUCTION:Chronic obstructive pulmonary disease (COPD) exacerbations progress the course of disease and impair lung function. Inhaled maintenance therapy reduces exacerbations. It is not yet established which inhaled therapy combination is best to reduce exacerbations, lung function decline and symptom burden. METH...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025048
更新日期:2019-02-20 00:00:00
abstract:OBJECTIVE:To analyse the spatial-temporal clustering of the HIV/AIDS epidemic in Chongqing and to explore its association with the economic indices of AIDS prevention and treatment. METHODS:Data on the HIV/AIDS epidemic and economic indices of AIDS prevention and treatment were obtained from the annual reports of the ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006669
更新日期:2015-03-27 00:00:00
abstract:INTRODUCTION:Published in 2018, the 5C scale is psychometrically validated to assess five psychological antecedents of vaccination (confidence, complacency, constraints, calculation and collective responsibility). The original version offers a validated English and German scale to assess these determinants with a short...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034869
更新日期:2020-03-10 00:00:00
abstract:OBJECTIVES:Identification of patients at increased mortality risk is important in the context of increasing multimorbidity and an ageing population, to help facilitate the planning and delivery of services. The aim of this study was to examine 1-year all-cause mortality in a cohort of primary care patients in whom infl...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036027
更新日期:2020-10-15 00:00:00
abstract:INTRODUCTION:Transdisciplinary teams are increasingly regarded as integral to conducting effective research. Similarly, knowledge translation is often seen as a solution to improving the relevance and benefits of health research. Yet, whether, how, for whom and under which circumstances transdisciplinary research influ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-021775
更新日期:2018-04-07 00:00:00
abstract:OBJECTIVES:In 2012, Australia was the first country in the world to introduce plain or standardised tobacco packaging, coupled with larger graphic health warnings. This policy was fiercely opposed by industry. Media coverage can be an influential contributor to public debate, and both public health advocates and indust...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023485
更新日期:2018-09-17 00:00:00
abstract:INTRODUCTION:Knee osteoarthritis (OA) is one of the most common chronic diseases worldwide and is associated with significant pain and disability. Clinical practice guidelines consistently recommend weight management as a core aspect of care for overweight and obese patients with knee OA; however, provision of such car...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2015-010203
更新日期:2016-03-03 00:00:00
abstract:INTRODUCTION:Insomnia is a highly prevalent, often debilitating and economically burdensome sleep disorder with limited effective therapies. Few data are available to understand which of the therapeutic alternatives is the most effective for patients with insomnia, especially for Traditional Chinese Medicine (TCM). Chi...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2015-008459
更新日期:2016-02-02 00:00:00
abstract:OBJECTIVES:To establish the minimally important difference (MID) that would prompt parents and clinicians to use probiotics for prevention of paediatric antibiotic-associated diarrhoea (AAD) and to obtain parent and clinician opinion about the most important outcomes in clinical trials of AAD. METHODS:In this survey, ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024651
更新日期:2019-04-02 00:00:00
abstract:OBJECTIVE:To explore how patients who are wait-listed for or who have received a kidney transplant understand the current UK kidney allocation system, and their views on ways to allocate kidneys in the future. DESIGN:Qualitative study using semistructured interviews and thematic analysis based on a pragmatic approach....
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013896
更新日期:2017-01-27 00:00:00
abstract:OBJECTIVE:Our cross-sectional study aimed at evaluating the diagnostic performance of Focused Assessment with Sonography for HIV-associated tuberculosis (FASH) to detect extrapulmonary tuberculosis in extremely resource-limited settings, with visceral leishmaniasis as a differential diagnosis with overlapping sonograph...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027179
更新日期:2019-04-02 00:00:00
abstract:INTRODUCTION:Pancreatic cancer is a devastating disease with an exceptionally poor prognosis. Complete resection of the primary tumour followed by adjuvant chemotherapy is the current standard treatment for patients with resectable disease and the only curative treatment option. However, long-term survival remains rare...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028696
更新日期:2019-08-20 00:00:00
abstract:OBJECTIVES:To explore the views and experiences of patients on the care they have received while enrolled on the Northumberland High Risk Patient Programme (NHRPP). This programme involved case finding of frail patients using a multidisciplinary team (MDT)-led community case management programme, and support of patient...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012019
更新日期:2016-09-09 00:00:00
abstract:OBJECTIVES:To investigate the impact of first eye and second eye cataract surgery on the level of physical activity undertaken by older adults with bilateral cataract. DESIGN:Prospective cohort study. SETTING:Three public ophthalmology clinics in Western Australia. PARTICIPANTS:Fifty-five older adults with bilateral...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-024491
更新日期:2019-03-20 00:00:00
abstract:OBJECTIVES:An increasing number of studies had shown that air pollution exposure may aggravate blood glucose control in patients with diabetes, an independent risk factor for colorectal cancer (CRC) proposed by some researchers. This study aimed to investigate the impact of exposure to ambient particulate matter with a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-036955
更新日期:2020-10-28 00:00:00
abstract::Aims To study long-term sick-listed patients' self-estimated ability to return to work after experiences of healthcare encounters that made them feel either respected or wronged. Methods A cross-sectional and questionnaire-based survey was used to study a sample of long-term sick-listed patients (n=5802 respondents)....
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000246
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:Social Autopsy (SA) is an innovative strategy where a trained facilitator leads community groups through a structured, standardised analysis of the physical, environmental, cultural and social factors contributing to a serious, non-fatal health event or death. The discussion stimulated by the formal process ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-010490
更新日期:2016-08-23 00:00:00
abstract:INTRODUCTION:Knee osteoarthritis (KOA) is a common, disabling and costly medical condition. The patellofemoral joint is a critical source of pain in individuals with KOA, and coexistence of patellofemoral osteoarthritis (PFOA) and tibiofemoral osteoarthritis (TFOA) is sometimes observed. The identification of subgroups...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019103
更新日期:2018-03-14 00:00:00
abstract:OBJECTIVES:To describe the long-term clinical outcomes after cataract surgery with and without capsular tension ring (CTR) in a group of patients with retinitis pigmentosa (RP). DESIGN:A retrospective study. SETTING:Tertiary referral centre. PARTICIPANTS:52 eyes (46 patients) with RP. INTERVENTIONS:Cataract surgery...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-002616
更新日期:2013-04-26 00:00:00
abstract:PURPOSE:We have established a prospective cohort of 1959 patients with chronic Chagas cardiomyopathy to evaluate if a clinical prediction rule based on ECG, brain natriuretic peptide (BNP) levels, and other biomarkers can be useful in clinical practice. This paper outlines the study and baseline characteristics of the ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011181
更新日期:2016-05-04 00:00:00
abstract:OBJECTIVE:To describe a Norwegian low-threshold HIV testing service targeting men who have sex with men (MSM). DESIGN AND SETTING:After the HIV testing consultation, all users of the HIV testing service were invited to answer the study questionnaire. The study setting included the sites where testing was performed, th...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017598
更新日期:2017-10-06 00:00:00
abstract:OBJECTIVES:The current COVID-19 pandemic, as well as the measures taken to control it, have a profound impact on healthcare. This study was set up to gain insights into the consequences of the COVID-19 outbreak on the core competencies of general practice, as they are experienced by general practitioners (GPs) on the f...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039674
更新日期:2020-06-17 00:00:00
abstract:INTRODUCTION:Dementia and Imagination is a multidisciplinary research collaboration bringing together arts and science to address current evidence limitations around the benefits of visual art activities in dementia care. The research questions ask: Can art improve quality of life and well-being? If it does make a diff...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011634
更新日期:2016-11-02 00:00:00
abstract:OBJECTIVE:The aim is to explore the trends of hypertension incidence and regional variations in China from 1991 to 2015. DESIGN:A dynamic prospective cohort study. SETTING:China Health and Nutrition Survey 1991-2015. PARTICIPANTS:12 952 Chinese adults aged 18+ years. PRIMARY OUTCOME MEASURES:Incident hypertension f...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-042053
更新日期:2021-01-13 00:00:00
abstract:INTRODUCTION:The optimal management of patent ductus arteriosus (PDA) remains contentious. The medications used to treat PDA are often non-steroidal anti-inflammatory drugs, which are associated with a number of unwanted adverse effects. Paracetamol is a medication with an excellent safety profile in infants and has be...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031428
更新日期:2019-10-30 00:00:00