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Multimorbidity

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https://www.readbyqxmd.com/read/28437317/dementia-comorbidity-and-physical-function-in-the-program-of-all-inclusive-care-for-the-elderly
#1
Jason R Falvey, Allison M Gustavson, Lisa Price, Lucine Papazian, Jennifer E Stevens-Lapsley
BACKGROUND: Participants in the Program of All-Inclusive Care for the Elderly (PACE) are a unique clinical population of medically complex and highly disabled older adults who qualify for nursing home level care but receive services in the community. A main goal of PACE programs is to prevent further declines in physical function that may necessitate costly institutionalization. This study evaluates how multimorbidity and dementia impact both self-selected gait speed and Timed Up and Go (TUG) in this population...
April 21, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28436185/predictive-factors-for-dementia-and-cognitive-impairment-among-residents-living-in-the-veterans-retirement-communities-in-taiwan-implications-for-cognitive-health-promotion-activities
#2
Liang-Yu Chen, Yi-Hui Wu, Chung-Yu Huang, Li-Kuo Liu, An-Chun Hwang, Li-Ning Peng, Ming-Hsieh Lin, Liang-Kung Chen
AIM: To identify potentially modifiable risk factors for cognitive decline among veterans' home residents in Taiwan METHODS: The present retrospective cohort study was part of the Veteran Affairs-Comprehensive Geriatric Assessment study that retrieved data of the comprehensive geriatric assessment for 946 residents living at four veterans' homes in Taiwan. The study participants were interviewed every 3-6 months from January 2012 and December 2014. Demographic characteristics,multimorbidity by Charlson's Comorbidities Index, physical function by the Barthel Index, cognition by the Mini-Mental State Examination (MMSE), depression by the five-item Geriatric Depression Scale and nutritional status by the Mini-Nutrition Assessment-Short Form were collected for analysis...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28435789/aerococcus-urinae-an-emerging-cause-of-urinary-tract-infection-in-older-adults-with-multimorbidity-and-urologic-cancer
#3
Andrew Higgins, Tullika Garg
Aerococcus urinae is a rare organism isolated from urine cultures. We present a case of an 80 year-old male with bladder cancer and multimorbidity who developed A. urinae infection. A. urinae may cause simple and complicated UTIs, bacteremia, and endocarditis in older adults with multimorbidity, chronic urinary retention, or indwelling catheters. A. urinae treatment should employ penicillin, amoxicillin, and nitrofurantoin. Due to increasing antibiotic resistance, urine culture should include antibiotic susceptibility testing...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28434390/how-preferences-for-continuity-and-access-differ-between-multimorbidity-and-healthy-patients-in-a-team-care-setting
#4
Katherine M Ehman, Mark Deyo-Svendsen, Zachary Merten, Anne Marie Kramlinger, Gregory M Garrison
INTRODUCTION: Team-based care has become an essential part of modern medical practice. Patient-centered medical homes often struggle to balance the dual competing goals of acute access and continuity of care. Multimorbidity patients may value continuity more than healthy patients, and thus may prefer to wait to see their primary care physician (PCP). METHODS: A total of 1700 randomly selected healthy adults and multimorbidity patients were asked to rate satisfaction with care and presented with 4 acute and 4 chronic scenarios to choose an access and continuity preference in an anonymous mailed survey...
April 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28427915/-multimorbidity-in-general-practice-and-the-ariadne-principles-a-person-centred-approach
#5
Alexandra Prados-Torres, Isabel Del Cura-González, Juan Daniel Prados-Torres, Francisca Leiva-Fernández, Juan Antonio López-Rodríguez, Amaia Calderón-Larrañaga, Christiane Muth
Multimorbidity, defined as the coexistence of two or more chronic conditions in one same individual, has negative consequences for people suffering from it and it poses a real challenge for health systems. In primary care, where most of these patients are attended, the clinical management of multimorbidity can be a complex task due, among others, to the high volume of clinical information that needs to be handled, the scarce scientific evidence available to approach multimorbidity, and the need for coordination among multiple health providers to guarantee continuity of care...
April 17, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28421953/multiple-morbidities-assessment
#6
Erin Dean
Essential facts Multimorbidity, when a person has two or more long-term health conditions, is associated with a reduced quality of life, higher mortality, polypharmacy and high treatment burden, higher rates of adverse drug events, and much greater health service use.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28420324/evaluation-of-a-technology-enhanced-integrated-care-model-for-frail-older-persons-protocol-of-the-spec-study-a-stepped-wedge-cluster-randomized-trial-in-nursing-homes
#7
Hongsoo Kim, Yeon-Hwan Park, Young-Il Jung, Hyoungshim Choi, Seyune Lee, Gi-Soo Kim, Dong-Wook Yang, Myunghee Cho Paik, Tae-Jin Lee
BACKGROUND: Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes. METHODS/DESIGN: SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate...
April 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28412945/multimorbidity-associated-with-functional-independence-among-community-dwelling-older-people-a-cross-sectional-study-in-southern-china
#8
Xiao-Xiao Wang, Wei-Quan Lin, Xu-Jia Chen, Ying-Yu Lin, Ling-Ling Huang, Sheng-Chao Zhang, Pei-Xi Wang
BACKGROUND: Multimorbidity, the coexistence of two or more chronic diseases, is common in older adults. And it may lead to many adverse health outcomes, such as disability. However, data on multimorbidity and its relationship with functional independence are scarce in Asian countries. Therefore, this study aims to investigate the relationship between multimorbidity and functional status among older people in China. METHODS: Based on a cross-sectional survey, the information regarding 2705 older adults, who were of at least 60 years of age, was collected through interviews and analyzed...
April 17, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28410780/analyzing-interactions-on-combining-multiple-clinical-guidelines
#9
Veruska Zamborlini, Marcos da Silveira, Cedric Pruski, Annette Ten Teije, Edwin Geleijn, Marike van der Leeden, Martijn Stuiver, Frank van Harmelen
Accounting for patients with multiple health conditions is a complex task that requires analysing potential interactions among recommendations meant to address each condition. Although some approaches have been proposed to address this issue, important features still require more investigation, such as (re)usability and scalability. To this end, this paper presents an approach that relies on reusable rules for detecting interactions among recommendations coming from various guidelines. It extends a previously proposed knowledge representation model (TMR) to enhance the detection of interactions and it provides a systematic analysis of relevant interactions in the context of multimorbidity...
April 11, 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28409741/impact-of-comorbidities-among-medicaid-enrollees-with-chronic-obstructive-pulmonary-disease-united-states-2009
#10
Gloria Westney, Marilyn G Foreman, Junjun Xu, Marshaleen Henriques King, Eric Flenaugh, George Rust
INTRODUCTION: Multimorbidity, the presence of 2 or more chronic conditions, frequently affects people with chronic obstructive pulmonary disease (COPD). Many have high-cost, highly complex conditions that have a substantial impact on state Medicaid programs. We quantified the cost of Medicaid-insured patients with COPD co-diagnosed with other chronic disorders. METHODS: We used nationally representative Medicaid claims data to analyze the impact of comorbidities (other chronic conditions) on the disease burden, emergency department (ED) use, hospitalizations, and total health care costs among 291,978 adult COPD patients...
April 13, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28401138/prevalence-of-symptoms-at-the-end-of-life-in-an-acute-care-hospital-a-retrospective-cohort-study
#11
Daniel Kobewka, Paul Ronksley, Dan McIsaac, Sunita Mulpuru, Alan Forster
BACKGROUND: There is currently debate over the benefits and harms of physician-assisted death. One of the factors influencing this debate is concern about symptoms in the days before death. The objective of this study was to describe the frequency of symptoms before death and determine patient characteristics associated with these symptoms. METHODS: We reviewed the medical record of every patient who died at a multisite academic teaching hospital over a 3-month period...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28397994/prevalence-of-obesity-hypoventilation-syndrome-in-ambulatory-obese-patients-attending-pathology-laboratories
#12
Jean-Christian Borel, Fabrice Guerber, Ingrid Jullian-Desayes, Marie Joyeux-Faure, Nathalie Arnol, Nellie Taleux, Renaud Tamisier, Jean-Louis Pépin
BACKGROUND AND OBJECTIVE: The prevalence of obesity hypoventilation syndrome (OHS) in the unselected obese is unknown. Our objectives were: (i) to determine the prevalence of OHS in ambulatory obese patients not previously referred to a pulmonologist for suspicion of sleep breathing disorders and (ii) to assess whether venous bicarbonate concentration [HCO3(-)v ] can be used to detect OHS. METHODS: In this prospective multicentric study, we measured [HCO3(-)v ] in consenting obese patients attending pathology analysis laboratories...
April 11, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28396706/a-scoping-review-of-frailty-and-acute-care-in-middle-aged-and-older-individuals-with-recommendations-for-future-research
#13
REVIEW
David B Hogan, Colleen J Maxwell, Jonathan Afilalo, Rakesh C Arora, Sean M Bagshaw, Jenny Basran, Howard Bergman, Susan E Bronskill, Caitlin A Carter, Elijah Dixon, Brenda Hemmelgarn, Kenneth Madden, Arnold Mitnitski, Darryl Rolfson, Henry T Stelfox, Helen Tam-Tham, Hannah Wunsch
There is general agreement that frailty is a state of heightened vulnerability to stressors arising from impairments in multiple systems leading to declines in homeostatic reserve and resiliency, but unresolved issues persist about its detection, underlying pathophysiology, and relationship with aging, disability, and multimorbidity. A particularly challenging area is the relationship between frailty and hospitalization. Based on the deliberations of a 2014 Canadian expert consultation meeting and a scoping review of the relevant literature between 2005 and 2015, this discussion paper presents a review of the current state of knowledge on frailty in the acute care setting, including its prevalence and ability to both predict the occurrence and outcomes of hospitalization...
March 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28396693/prevalence-of-non-communicable-diseases-and-access-to-health-care-and-medications-among-yazidis-and-other-minority-groups-displaced-by-isis-into-the-kurdistan-region-of-iraq
#14
Valeria Cetorelli, Gilbert Burnham, Nazar Shabila
BACKGROUND: The increasing caseload of non-communicable diseases (NCDs) in displaced populations poses new challenges for humanitarian agencies and host country governments in the provision of health care, diagnostics and medications. This study aimed to characterise the prevalence of NCDs and better understand issues related to accessing care among Yazidis and other minority groups displaced by ISIS and currently residing in camps in the Kurdistan Region of Iraq. METHODS: The study covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28396366/comorbidity-and-polypharmacy-in-chronic-heart-failure-a-large-cross-sectional-study-in-primary-care
#15
Bosco Baron-Franco, Gary McLean, Frances S Mair, Veronique L Roger, Bruce Guthrie, Stewart W Mercer
BACKGROUND: Comorbidity is common in heart failure, but previous prevalence estimates have been based on a limited number of conditions using mainly non-primary care data sources.Aim To compare prevalence rates of comorbidity and polypharmacy in those with and without chronic heart failure due to left ventricular systolic dysfunction (LVSD).Design and setting A cross-sectional study of 1.4 million patients in primary care in Scotland. METHOD: Data on the presence of LVSD, 31 other physical, and seven mental health comorbidities, and prescriptions were extracted from a database of 1 424 378 adults...
April 10, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28390184/outcomes-in-older-adults-with-multimorbidity-associated-with-predominant-provider-of-care-specialty
#16
Julie P W Bynum, Chiang-Hua Chang, Andrea Austin, Don Carmichael, Ellen Meara
OBJECTIVES: To determine whether receiving the predominance of ambulatory visits from a primary care provider compared to a specialty provider is associated with better outcomes in older adults with multi morbidity. DESIGN: Observational study using propensity score matching. SETTING: Medicare fee-for-service, 2011-12. PARTICIPANTS: Beneficiaries aged 65 and older with multimorbidity. MEASUREMENTS: The independent variable was an indicator for having a specialty (versus primary care) as the predominant provider of care (PPC)...
April 8, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28389529/older-patients-perspectives-on-managing-complexity-in-ckd-self-management
#17
C Barrett Bowling, Ann E Vandenberg, Lawrence S Phillips, William M McClellan, Theodore M Johnson, Katharina V Echt
BACKGROUND AND OBJECTIVES: Patients with CKD are asked to perform self-management tasks including dietary changes, adhering to medications, avoiding nephrotoxic drugs, and self-monitoring hypertension and diabetes. Given the effect of aging on functional capacity, self-management may be especially challenging for older patients. However, little is known about the specific challenges older adults face maintaining CKD self-management regimens. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted an exploratory qualitative study designed to understand the relationship among factors facilitating or impeding CKD self-management in older adults...
April 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28386651/exercise-for-multimorbid-patients-in-primary-care-one-prescription-for-all
#18
Philipe de Souto Barreto
The purpose of this article was to discuss guidelines for the management of the most prevalent chronic diseases treated by primary care physicians (PCPs) in order to identify the best exercise regimen for each clinical population, and to provide preliminary guidance for primary care providers on exercise counselling in the 'real-world' context of multimorbidity. After a search of the PubMed electronic database, the 11 most prevalent conditions currently treated by PCPs were identified. The recommendations provided by recognised learned/scientific societies for the management of each disease were then examined and any recommendations involving physical activity and exercise were identified...
April 6, 2017: Sports Medicine
https://www.readbyqxmd.com/read/28384178/prevalence-of-multimorbidity-in-the-brazilian-adult-population-according-to-socioeconomic-and-demographic-characteristics
#19
Januse Nogueira de Carvalho, Ângelo Giuseppe Roncalli, Marianna de Camargo Cancela, Dyego Leandro Bezerra de Souza
Knowledge on the occurrence of multimorbidity is important from the viewpoint of public policies, as this condition increases the consumption of medicines as well as the utilization and expenses of health services, affecting life quality of the population. The objective of this study was to estimate prevalence of self-reported multimorbidity in Brazilian adults (≥18 years old) according to socioeconomic and demographic characteristics. A descriptive study is presented herein, based on data from the National Health Survey, which was a household-based survey carried out in Brazil in 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28384084/strengthening-integrated-care-through-population-focused-primary-care-services-international-experiences-outside-the-united-states
#20
Rene Loewenson, Sarah Simpson
Many high- and middle-income countries (HMICs) are experiencing a burden of comorbidity and chronic diseases. Together with increasing patient expectations, this burden is raising demand for population health-oriented innovation in health care. Using desk review and country case studies, we examine strategies applied in HMICs outside the United States to address these challenges, with a focus on and use of a new framework for analyzing primary care (PC). The article outlines how a population health approach has been supported by focusing assessment on and clustering services around social groups and multimorbidity, with support for community roles...
March 20, 2017: Annual Review of Public Health
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