keyword
MENU ▼
Read by QxMD icon Read
search

Multimorbidity

keyword
https://www.readbyqxmd.com/read/28821233/latent-class-analysis-of-multimorbidity-patterns-and-associated-outcomes-in-spanish-older-adults-a-prospective-cohort-study
#1
Beatriz Olaya, Maria Victoria Moneta, Francisco Félix Caballero, Stefanos Tyrovolas, Ivet Bayes, José Luis Ayuso-Mateos, Josep Maria Haro
BACKGROUND: This study sought to identify multimorbidity patterns and determine the association between these latent classes with several outcomes, including health, functioning, disability, quality of life and use of services, at baseline and after 3 years of follow-up. METHODS: We analyzed data from a representative Spanish cohort of 3541 non-institutionalized people aged 50 years old and over. Measures were taken at baseline and after 3 years of follow-up. Latent Class Analysis (LCA) was conducted using eleven common chronic conditions...
August 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28815153/high-risk-drug-drug-interactions-between-clinical-practice-guidelines-for-management-of-chronic-conditions
#2
Geoffrey J Tso, Samson W Tu, Mark A Musen, Mary K Goldstein
Clinicians and clinical decision-support systems often follow pharmacotherapy recommendations for patients based on clinical practice guidelines (CPGs). In multimorbid patients, these recommendations can potentially have clinically significant drug-drug interactions (DDIs). In this study, we describe and validate a method for programmatically detecting DDIs among CPG recommendations. The system extracts pharmacotherapy intervention recommendations from narrative CPGs, normalizes the terms, creates a mapping of drugs and drug classes, and then identifies occurrences of DDIs between CPG pairs...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28813696/effects-of-standardized-home-training-in-patients-with-cognitive-impairment-following-geriatric-rehabilitation-a-randomized-controlled-pilot-study
#3
Klaus Hauer, Phoebe Ullrich, Ilona Dutzi, Rainer Beurskens, Sylvia Kern, Jürgen Bauer, Michael Schwenk
BACKGROUND: Post-ward geriatric rehabilitation programs have hardly been developed and validated, which leaves a substantial gap in rehabilitative care in older adults and hinders full exploitation of maintained, but often unrecognized rehabilitation potentials. Geriatric rehabilitation patients with cognitive impairment represent a highly vulnerable population which is often affected by a lack of an ongoing support at the intersection between ward-based and post-ward rehabilitation. OBJECTIVE: To determine the effect of a standardized home-based training program in geriatric patients with cognitive impairment following ward-based rehabilitation...
August 17, 2017: Gerontology
https://www.readbyqxmd.com/read/28811281/multimorbidity-dementia-and-health-care-in-older-people-a-population-based-cohort-study
#4
Marcello Tonelli, Natasha Wiebe, Sharon Straus, Martin Fortin, Bruce Guthrie, Matthew T James, Scott W Klarenbach, Helen Tam-Tham, Richard Lewanczuk, Braden J Manns, Hude Quan, Paul E Ronksley, Peter Sargious, Brenda Hemmelgarn
BACKGROUND: Little is known about how multimorbidity, dementia and increasing age combine to influence health outcomes or utilization. Our objective was to examine the joint associations between age, dementia and burden of morbidity with mortality and other clinical outcomes. METHODS: We did a retrospective population-based cohort study of all adults aged 65 years and older residing in Alberta, Canada, between 2002 and 2013. We used validated algorithms applied to administrative and laboratory data from the provincial health ministry to assess the presence/absence of dementia and 29 other morbidities, and their associations with mortality (our primary outcome), other clinical outcomes (emergency department visits, all-cause hospital admissions) and a proxy for loss of independent living (discharge to long-term care)...
August 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28810277/-concepts-to-optimize-home-care-of-patients-with-mechanical-ventilation
#5
Miranda Nafe, Kristian Herberger, Barbara Wiesner, Christian Grohé
The care of patients with extraclinical mechanical ventilation has to be improved particularly with regard to their specialist care. One care option is the empowering of clinicians at the respiratory centers to enable ambulant care of patients and home visits. An intersectoral linkage in the form of transfer management is the basis for competent coordination. Aim is to ensure the necessary multidisciplinary collaboration in the outpatient care of multimorbid chronically ill patients. For the optimal care of chronically ill patients, sectoral limits should become more permeable...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28807456/post-hospitalization-experiences-of-older-adults-diagnosed-with-diabetes-it-was-daunting
#6
Jacqueline B La Manna, Angeline Bushy, Denise Gammonley
Multimorbidity combined with geriatric syndromes in older adults with diabetes exacerbate their risks for poor post-discharge outcomes. The purpose of this study was to examine self-described hospital-to-home transition challenges encountered by older adults with a diagnosis of diabetes within the first 30 days following discharge. The qualitative responses for this paper emerged from a larger mixed methods study (n = 96) in which participants provided free responses specifying transition challenges during follow-up telephone interviews on the 7th day (n = 67) and 30th day (n = 55) post-discharge...
August 11, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28806363/clinical-epidemiology-of-single-versus-multiple-substance-use-disorders-polysubstance-use-disorder
#7
Ish P Bhalla, Elina A Stefanovics, Robert A Rosenheck
OBJECTIVE: While research on substance abuse has largely focused on people who have a single substance use disorder (SUD), many people abuse multiple substances. Studies have yet to examine the distinctive characteristics of patients diagnosed with more than 1 SUD and how those with polysubstance use disorder (PSUD) differ from those with a single SUD. METHODS: National Veterans Health Administration data from fiscal year 2012 were used to compare veterans diagnosed 1 SUD to veterans diagnosed with 2-3, and >3 SUDs on demographic characteristics, psychiatric and medical diagnoses, medical and psychiatric service utilization, and psychotropic medication fills...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28803493/health-related-quality-of-life-of-people-with-multimorbidity-at-a-community-based-interprofessional-student-assisted-clinic-implications-for-assessment-and-intervention
#8
Zephanie Tyack, Suzanne Kuys, Petrea Cornwell, Kerrie-Anne Frakes, Steven McPhail
Objective This study examined the relationship between the number of comorbidities and health-related quality of life (HRQoL) and between select physical conditions and HRQoL. Differences in HRQoL in comparison to a normative sample were also examined. Method A cross-sectional study among people with multimorbidity ( n = 401) attending a community-based, interdisciplinary health clinic was conducted. HRQoL was measured using the eight dimensions of the SF-36. Multiple linear regression and t-tests were used to analyse the data...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28802519/espen-guidelines-on-nutritional-support-for-polymorbid-internal-medicine-patients
#9
Filomena Gomes, Philipp Schuetz, Lisa Bounoure, Peter Austin, María Ballesteros-Pomar, Tommy Cederholm, Jane Fletcher, Alessandro Laviano, Kristina Norman, Kalliopi-Anna Poulia, Paula Ravasco, Stephane M Schneider, Zeno Stanga, C Elizabeth Weekes, Stephan C Bischoff
BACKGROUND & AIMS: Polymorbidity (also known as multimorbidity) - defined as the co-occurrence of at least two chronic health conditions - is highly prevalent, particularly in the hospitalized population. Nonetheless, clinical guidelines largely address individual diseases and rarely account for polymorbidity. The aim of this project was to develop guidelines on nutritional support for polymorbid patients hospitalized in medical wards. METHODS: The methodology used for the development of the current project follows the standard operating procedures for ESPEN guidelines...
July 24, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28797526/psychotic-experiences-and-disability-findings-from-the-collaborative-psychiatric-epidemiology-surveys
#10
Hans Oh, Ai Koyanagi, Ian Kelleher, Jordan DeVylder
Psychotic experiences are associated with a number of poor clinical outcomes, including multimorbid psychopathology, suicidal behavior, and poor treatment response. We wished to investigate the relationship between psychotic experiences and disability, including the following domains: cognition, mobility, self-care, social interaction, role functioning, and days out of role. We used three nationally representative and racially/ethnically diverse samples of the general US adult population: the National Comorbidity Survey Replication (NCS-R), the National Latino and Asian American Survey (NLAAS), and the National Survey of American Life (NSAL)...
August 7, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28797241/hospital-treatment-costs-and-length-of-stay-associated-with-hypertension-and-multimorbidity-after-hemorrhagic-stroke
#11
Adrian V Specogna, Tanvir C Turin, Scott B Patten, Michael D Hill
BACKGROUND: Previous studies have identified various treatment and patient characteristics that may be associated with higher hospital cost after spontaneous intracerebral hemorrhage (ICH); a devastating type of stroke. Patient morbidity is perhaps the least understood of these cost-driving factors. We describe how hypertension and other patient morbidities affect length of stay, and hospital treatment costs after ICH using primary and simulated data. We also describe the relationship between cost and length of stay within these patients...
August 10, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28779943/integration-of-naturopathic-medicine-into-acute-inpatient-care-an-approach-for-patient-centred-medicine-under-diagnosis-related-groups
#12
Tobias Romeyke, Elisabeth Nöhammer, Hans Christoph Scheuer, Harald Stummer
BACKGROUND: The integration of naturopathic methods into acute inpatient care has been the subject of very few scientific studies. Patient expectations of the service received in hospital are increasing, and the integration of naturopathy into clinical practice can serve as Unique Selling Proposition. MATERIALS AND METHODS: The present study was conducted over a period of two years. In total, over 1700 patients were included in the study. The setting is an acute hospital specialising in a multimodal, patient-centred approach to treatment...
August 2017: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/28777716/research-priorities-in-subspecialty-palliative-care-policy-initiatives
#13
Lynn F Reinke, Diane E Meier
Palliative care demonstrably improves quality of life for the seriously ill in a manner that averts preventable health crises and their associated costs. Because of these outcomes, palliative care is now broadening its reach beyond hospitals, and hospice care for those near death, to patients and their families living in the community with chronic multimorbidities that have uncertain or long expected survival. In this article, we address research needed to enable policies supportive of palliative care access and quality, including changes in regulatory, accreditation, financing, and training approaches in the purview of policy makers...
August 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28776873/the-systematic-tool-to-reduce-inappropriate-prescribing-strip-combining-implicit-and-explicit-prescribing-tools-to-improve-appropriate-prescribing
#14
A Clara Drenth-van Maanen, Anne J Leendertse, Paul A F Jansen, Wilma Knol, Carolina J P W Keijsers, Michiel C Meulendijk, Rob J van Marum
Inappropriate prescribing is a major health care issue, especially regarding older patients on polypharmacy. Multiple implicit and explicit prescribing tools have been developed to improve prescribing, but these have hardly ever been used in combination. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) combines implicit prescribing tools with the explicit Screening Tool to Alert physicians to the Right Treatment and Screening Tool of Older People's potentially inappropriate Prescriptions criteria and has shared decision-making with the patient as a critical step...
August 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28774296/does-the-impact-of-case-management-vary-in-different-subgroups-of-multimorbidity-secondary-analysis-of-a-quasi-experiment
#15
Jonathan Stokes, Søren Rud Kristensen, Kath Checkland, Sudeh Cheraghi-Sohi, Peter Bower
No abstract text is available yet for this article.
August 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28772096/prospective-identification-of-patients-at-risk-for-unwarranted-variation-in-treatment
#16
Amy S Kelley, Evan Bollens-Lund, Kenneth E Covinsky, Jonathan S Skinner, R Sean Morrison
BACKGROUND: Understanding factors associated with treatment intensity may help ensure higher value healthcare. OBJECTIVE: To investigate factors associated with Medicare costs among prospectively identified, seriously ill older adults and examine if baseline prognosis influences the impact of these factors. DESIGN/SUBJECTS: Prospective observation of Health and Retirement Study cohort with linked Medicare claims. MEASUREMENTS: We identified people with incident serious illness (a serious medical condition, for example, metastatic cancer or functional impairment); calculated subjects' one-year mortality risk; and then followed them for one year...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28771854/integrative-review-of-the-social-determinants-of-health-in-older-adults-with-multimorbidity
#17
REVIEW
Melissa Northwood, Jenny Ploeg, Maureen Markle-Reid, Diana Sherifali
AIM: To examine how the social determinants of health have been considered in conceptualizations of multimorbidity in older adults in the literature and to identify implications for nursing practice, research and health-care planning and policy. BACKGROUND: The common conceptualization of multimorbidity is the presence of multiple chronic conditions where one is not more central than others. DESIGN: The integrative review methodology of Whittemore and Knafl was employed...
August 3, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28766816/improving-adherence-to-multiple-medications-in-older-people-in-primary-care-selecting-intervention-components-to-address-patient-reported-barriers-and-facilitators
#18
Deborah E Patton, Cathal A Cadogan, Cristín Ryan, Jill J Francis, Gerard J Gormley, Peter Passmore, Ngaire Kerse, Carmel M Hughes
BACKGROUND: Medication adherence is vital to ensuring optimal patient outcomes, particularly amongst multimorbid older people prescribed multiple medications. Interventions targeting adherence often lack a theoretical underpinning and this may impact on effectiveness. The theoretical domains framework (TDF) of behaviour can aid intervention development by systematically identifying key determinants of medication adherence. OBJECTIVES: This study aimed to (i) identify determinants (barriers, facilitators) of adherence to multiple medications from older people's perspectives; (ii) identify key domains to target for behaviour change; and (iii) map key domains to intervention components [behaviour change techniques (BCTs)] that could be delivered in an intervention by community pharmacists...
August 1, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28765416/the-physician-s-role-in-perioperative-management-of-older-patients-undergoing-surgery
#19
Adam L Gordon, Barry J Evans, Jugdeep Dhesi
Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28764753/supporting-prescribing-in-older-people-with-multimorbidity-and-significant-polypharmacy-in-primary-care-sppire-a-cluster-randomised-controlled-trial-protocol-and-pilot
#20
Caroline McCarthy, Barbara Clyne, Derek Corrigan, Fiona Boland, Emma Wallace, Frank Moriarty, Tom Fahey, Carmel Hughes, Paddy Gillespie, Susan M Smith
BACKGROUND: Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care...
August 1, 2017: Implementation Science: IS
keyword
keyword
4612
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"