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Comprehensive geriatric assessment

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https://www.readbyqxmd.com/read/27933555/pharmacist-s-comprehensive-geriatric-assessment-introduction-and-evaluation-at-elderly-patient-admission
#1
Faiza Rhalimi, Mounir Rhalimi, Alain Rauss
BACKGROUND: The role of the clinical pharmacist within the healthcare system remains unclear. OBJECTIVE: Our objective was to describe a pharmacist's comprehensive geriatric assessment (pCGA) at admission of elderly patients and to assess its relevance in terms of medication compliance and pharmacist interventions (PIs). METHODS: We conducted a prospective interventional study over 29 months in a 34-bed medical/rehabilitation geriatric ward in a French geriatric hospital...
December 8, 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27927586/rituximab-bendamustine-and-low-dose-cytarabine-as-induction-therapy-in-elderly-patients-with-mantle-cell-lymphoma-a-multicentre-phase-2-trial-from-fondazione-italiana-linfomi
#2
Carlo Visco, Annalisa Chiappella, Luca Nassi, Caterina Patti, Simone Ferrero, Daniela Barbero, Andrea Evangelista, Michele Spina, Annalia Molinari, Luigi Rigacci, Monica Tani, Alice Di Rocco, Graziella Pinotti, Alberto Fabbri, Renato Zambello, Silvia Finotto, Manuel Gotti, Angelo M Carella, Flavia Salvi, Stefano A Pileri, Marco Ladetto, Giovannino Ciccone, Gianluca Gaidano, Marco Ruggeri, Maurizio Martelli, Umberto Vitolo
BACKGROUND: The combination of rituximab, bendamustine, and cytarabine (R-BAC) was highly active in a pilot trial of mantle cell lymphoma, but its use was restricted by high haematological toxicity. We aimed to assess the efficacy and safety of an R-BAC regimen with low-dose cytarabine (RBAC500). METHODS: In this multicentre, phase 2 trial, we recruited previously untreated patients with an established histological diagnosis of mantle cell lymphoma from 29 Fondazione Italiana Linfomi centres in Italy...
December 2, 2016: Lancet Haematology
https://www.readbyqxmd.com/read/27913598/describing-visible-acute-injuries-development-of-a-comprehensive-taxonomy-for-research-and-practice
#3
Tony Rosen, Christopher Reisig, Veronica M LoFaso, Elizabeth M Bloemen, Sunday Clark, Thomas J McCarthy, Estomih P Mtui, Neal E Flomenbaum, Mark S Lachs
BACKGROUND: Little literature exists classifying and comprehensively describing intentional and unintentional acute injuries, which would be valuable for research and practice. In preparation for a study of injury patterns in elder abuse, our goal was to develop a comprehensive taxonomy of relevant types and characteristics of visible acute injuries and evaluate it in geriatric patients. METHODS: We conducted an exhaustive review of the medical and forensic literature focusing on injury types, descriptions, patterns and analyses...
December 2, 2016: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/27913511/treatment-of-the-elderly-patient-with-mantle-cell-lymphoma
#4
Pierre Soubeyran, Rémy Gressin
Treatment options for mantle cell lymphomas have expanded considerably over recent years, offering hematologists solutions for older patients with an appropriate risk-to-benefit ratio. Indeed, unfit older patients are exposed to a higher risk of toxicity with a standard treatment. Although new treatments have generally good safety profiles, they may lead to unexpected consequences in unfit older patients. Involving geriatricians and a comprehensive geriatric assessment in patient care could help hematologists address these vulnerabilities...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913500/fitness-in-the-elderly-how-to-make-decisions-regarding-acute-myeloid-leukemia-induction
#5
Arati V Rao
Acute myeloid leukemia (AML) is a disease of the elderly, but less than half of these patients are offered therapy despite the evidence of better survival with treatment in this patient population. Assessing fit, vulnerable, and frail older adults with AML remains a challenge for the treating oncologist. A majority of AML patients are elderly and often have significant comorbidities, lack of social support, and older caregivers. Performance status (PS), a subjective measure of how a patient will tolerate cancer chemotherapy, has been strongly correlated with mortality in older AML patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27896467/audit-of-geriatric-hip-fracture-care-a%C3%A2-slovenian-trauma-center-analysis
#6
Dejan Krušič, Drago Brilej, Colin Currie, Radko Komadina
BACKGROUND: The aim was to describe an audit of hip fracture patient care and outcomes in a Slovenian healthcare setting prior to the implementation of the Geriatric Fracture Center (GFC) model of care. METHODS: The Fragility Fracture Network (FFN) hip fracture audit database was used to collect data on hip fracture care in elderly patients. Epidemiological data were submitted as well as fracture type, prefracture residence and mobility prior to the fracture. The timeline of events and acute care data were also collected...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27883167/frailty-is-a-geriatric-syndrome-characterized-by-multiple-impairments-a-comprehensive-approach-is-needed
#7
L-K Chen, A-C Hwang, L-K Liu, W-J Lee, L-N Peng
OBJECTIVE: To evaluate the prevalence of frailty and the associated multimorbidity and functional impairments among community-dwelling middle-aged and elderly people in Taiwan. DESIGN: a cross-sectional study. SETTING: communities in I-Lan County of Taiwan. PARTICIPANTS: 1839 community-dwelling people aged 50 years and older. INTERVENTION: None. MEASUREMENTS: Frailty defined by Fried's criteria, Charlson's comorbidity index (CCI), Functional Autonomy Measurement System (SMAF), Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Nutrition Assessment (MNA), Mini-Mental State Examination (MMSE), and Short Form-12 quality of life questionnaire...
2016: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/27879983/delirium-a-survey-of-healthcare-professionals-knowledge-beliefs-and-practices
#8
Liron Sinvani, Andrzej Kozikowski, Renee Pekmezaris, Meredith Akerman, Gisele Wolf-Klein
OBJECTIVES: To evaluate knowledge, beliefs, and practices regarding delirium of physicians, nurse practitioners (NPs), and registered nurses (RNs). DESIGN: Anonymous cross-sectional paper survey. SETTING: New York metropolitan area tertiary care hospital. PARTICIPANTS: RNs, NPs, and physicians (N = 164). MEASUREMENTS: The survey assessed knowledge, beliefs, and practices regarding delirium and prior delirium or geriatric training...
November 23, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27874939/health-status-correlates-of-malnutrition-in-the-polish-elderly-population-results-of-the-polsenior-study
#9
R Krzyminska-Siemaszko, J Chudek, A Suwalska, M Lewandowicz, M Mossakowska, R Kroll-Balcerzak, B Wizner, S Tobis, K Mehr, K Wieczorowska-Tobis
OBJECTIVE: The aim of the study was to analyze health-related factors associated with poor nutritional status (PNS) of a representative group of Polish older people, based on data from the PolSenior project (the first nation-wide study of Polish senior citizens). PATIENTS AND METHODS: Nutritional status was assessed in 3751 community-dwelling older people (1770 females, mean age: 77.4±8.0 years) using the Mini Nutritional Assessment - Short Form. Elements of comprehensive geriatric assessment (cognitive and mood screening), selected medical data were analyzed in relation to the nutritional status...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27866323/measuring-compassion-in-healthcare-a-comprehensive-and-critical-review
#10
REVIEW
Shane Sinclair, Lara B Russell, Thomas F Hack, Jane Kondejewski, Richard Sawatzky
BACKGROUND: There is international concern about the lack of compassion in healthcare systems. A valid and reliable tool for measuring compassion in healthcare systems and educational institutions is required. This comprehensive and critical narrative synthesis identified and compared existing measures of compassionate care in clinical settings. METHODS: PubMed, MEDLINE, CINAHL and PsycINFO databases and grey literature were searched to identify studies that report information on instruments that measure compassion or compassionate care in clinicians, nurses, healthcare students and patients...
November 19, 2016: Patient
https://www.readbyqxmd.com/read/27864240/new-horizons-in-orthostatic-hypotension
#11
REVIEW
James Frith, Steve W Parry
BACKGROUND: orthostatic hypotension (OH) is a common disabling condition associated with increased morbidity and mortality. Much of the evidence available is derived from younger populations with chronic neurological disease leading to uncertainty for the diagnosis and management of older people. OBJECTIVE: to provide an overview of recent and emerging evidence for the diagnosis, management and prognosis of OH in older persons. METHODS: a narrative review of recent studies, emerging therapies and relevant regulatory updates...
November 17, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27860034/understanding-help-seeking-in-older-people-with-urinary-incontinence-an-interview-study
#12
Natalie Vethanayagam, Alison Orrell, Lena Dahlberg, Kevin J McKee, Susan Orme, Stuart G Parker, Mary Gilhooly
The prevalence of urinary incontinence (UI) increases with age and can negatively affect quality of life. However, relatively few older people with UI seek treatment. The aim of this study was to explore the views of older people with UI on the process of seeking help. Older people with UI were recruited to the study from three continence services in the north of England: a geriatrician-led hospital outpatient clinic (n = 18), a community-based nurse-led service (n = 22) and a consultant gynaecologist-led service specialising in surgical treatment (n = 10)...
November 16, 2016: Health & Social Care in the Community
https://www.readbyqxmd.com/read/27847786/use-of-a-comprehensive-geriatric-assessment-to-predict-short-term-postoperative-outcome-in-elderly-patients-with-colorectal-cancer
#13
Yoon Hyun Lee, Heung-Kwon Oh, Duck-Woo Kim, Myong Hoon Ihn, Jee Hyun Kim, Il Tae Son, Sung Il Kang, Gwang Il Kim, Soyeon Ahn, Sung-Bum Kang
PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA...
October 2016: Annals of Coloproctology
https://www.readbyqxmd.com/read/27846818/asymptomatic-and-yet-c-difficile-toxin-positive-prevalence-and-risk-factors-of-carriers-of-toxigenic-clostridium-difficile-among-geriatric-in-patients
#14
Klaus Nissle, Daniel Kopf, Alexander Rösler
BACKGROUND: Clostridium difficile infections (CDI) are the most frequent cause of diarrhoea in hospitals. Geriatric patients are more often affected by the condition, by a relapse and complications. Therefore, a crucial question is how often colonization with toxigenic Clostridium difficile strains occurs in elderly patients without diarrhoea and whether there is a "risk pattern" of colonized patients that can be defined by geriatric assessment. Furthermore, the probability for those asymptomatic carriers to develop a symptomatic infection over time has not been sufficiently explored...
November 15, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27843646/the-nps-role-of-assessing-and-intervening-with-older-adult-drivers
#15
Tamatha Arms
As the silver tsunami continues, assessing and intervening with older adult drivers are becoming an essential aspect of the comprehensive geriatric exam. The current lack of time efficient clinical guidelines is a concern and barrier for NPs. The purpose of this study was to identify strategies currently used by NPs. The critical incident technique was used to obtain data from a convenience sample of NPs. A total of 89 incidents were collected. The perspective of the NP can provide important information for developing clinical guidelines to promote individual and community safety...
2016: Nursing Research and Practice
https://www.readbyqxmd.com/read/27828887/comprehensive-geriatric-assessment-for-trauma-operationalizing-the-trauma-quality-improvement-program-directive
#16
Stephanie Devore, Sara E Parli, Douglas R Oyler, Andrew Bernard
Elderly patients are the fastest growing trauma demographic and present some of the most complicated clinical challenges. This feasibility study employed observational data from a geriatric cohort. Comprehensive geriatric assessments (CGAs) were performed biweekly on eligible patients, 65 years or older, who met screening criteria. Mobility, activities of daily living impairment, frailty, and depression were screened and documented, and along with summative recommendations, were entered into the medical record, communicated to the patient's primary care provider, and discussed with family...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27827291/-general-practitioner-and-specialist-elderly-care-medicine-paramount-a-strong-pairing-in-the-care-of-the-vulnerable-elderly
#17
C M P M Verheugt, J F Bastiaans
The Dutch National Care for the Elderly Programme (NPO) was launched as a large-scale project, in which screening for vulnerability, followed by a comprehensive geriatric assessment, played an important role. An oft-cited explanation for the poor effects of the NPO projects is the high quality of Dutch primary care. However, the complexity of frail elderly care raises the question as to whether the competence of a nurse or practice nurse is sufficient to ensure proper care and treatment. Moreover, studies used vulnerability as a risk status, as if vulnerability were reversible...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27822023/inappropriate-nutrients-intake-is-associated-with-lower-functional-status-and-inferior-quality-of-life-in-older-adults-with-depression
#18
Agnieszka Guligowska, Małgorzata Pigłowska, Elizaveta Fife, Joanna Kostka, Bartłomiej K Sołtysik, Łukasz Kroc, Tomasz Kostka
OBJECTIVES: The study is a case-control analysis of whether depression impairs physical and cognitive functioning and quality of life, and whether there is a relationship between nutrient deficiencies and these adverse changes. PATIENTS AND METHODS: A total of 130 older subjects participated in the study: 65 with diagnosed depression (16 men and 49 women) and 65 age- and sex-matched controls without depression. All patients underwent comprehensive geriatric assessment...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27820976/use-of-a-screening-tool-and-primary-health-care-gerontology-nurse-specialist-for-high-needs-older-people
#19
Anna King, Michal Boyd, Lynelle Dagley
OBJECTIVES: To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. METHOD: The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist...
November 20, 2016: Contemporary Nurse
https://www.readbyqxmd.com/read/27812859/palliative-care-of-cancer-in-the-older-patient
#20
REVIEW
Lodovico Balducci, Dawn Dolan
The scope of palliative care includes goal setting, symptom management, and care of the care giver. Palliative care is essential for patient-centered care of the older cancer patients. The diversity of this population in terms of life expectancy, treatment tolerance, function, disability, and social support mandates personalized treatment plans. The assessment of physiologic age is currently based on a comprehensive geriatric assessment (CGA). A number of biologic markers of aging including the inflammatory index, the genomic clock, the expression of p16INKa4, and the circulating levels of vitamin D may complement the CGA and fine-tune the determination of physiologic age...
December 2016: Current Oncology Reports
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