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https://www.readbyqxmd.com/read/29330585/potentially-inappropriate-medications-in-community-dwelling-older-adults-undertaken-as-a-comprehensive-geriatric-risk-assessment
#1
Sharmin S Bala, Sujita W Narayan, Prasad S Nishtala
PURPOSE: The prescription of potentially inappropriate medications (PIMs) is associated with an increase in adverse events, prescribing cascades, high health-care costs, morbidity, and mortality in the elderly. The overarching objective of this study is to examine the prevalence of PIMs in the elderly, applying the 2012 American Geriatrics Society Beers criteria for the study period 2012-2014, and the updated 2015 Beers criteria for 2015. METHODS: The study population (N = 70,479) included a continuously recruited national cohort of community-dwelling older (aged ≥ 65 years) New Zealanders who had undertaken the International Resident Assessment Instrument-Home Care (interRAI-HC) assessments between September 2012 and October 2015...
January 12, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29306338/adverse-events-in-home-care-identifying-and-responding-with-interrai-scales-and-clinical-assessment-protocols
#2
Chi-Ling Joanna Sinn, Raquel Souza Dias Betini, Jennifer Wright, Lorri Eckler, Byung Wook Chang, Sophie Hogeveen, Luke Turcotte, John P Hirdes
Outcomes of adverse events in home care are varied and multifactorial. This study tested a framework combining two health measures to identify home care recipients at higher risk of long-term care placement or death within one year. Both measures come from the Resident Assessment Instrument-Home Care (RAI-HC), a standardized comprehensive clinical assessment. Persons scoring high in the Method for Assigning Priority Levels (MAPLe) algorithm and Changes in Health, End-stage disease, Signs and Symptoms (CHESS) scale were at the greatest risk of placement or death and more than twice as likely to experience either outcome earlier than others...
January 8, 2018: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/29251260/clinical-profile-of-persons-with-multiple-sclerosis-across-the-continuum-of-care
#3
Luke A Turcotte, Ruth Ann Marrie, Scott B Patten, John P Hirdes
BACKGROUND: This study is part of the Innovations in Data, Evidence and Applications for Persons with Neurological Conditions project to understand the strengths, preferences, and needs of persons with neurological conditions living in Canada. OBJECTIVE: To estimate the prevalence and describe the sociodemographic and clinical characteristics of persons with multiple sclerosis in Canadian home care, nursing home, Complex Continuing Care hospitals, and inpatient mental health care settings...
December 18, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29232761/profile-of-ethnicity-living-arrangements-and-loneliness-amongst-older-adults-in-aotearoa-new-zealand-a-national-cross-sectional-study
#4
Hamish A Jamieson, Helen M Gibson, Rebecca Abey-Nesbit, Annabel Ahuriri-Driscoll, Sally Keeling, Philip J Schluter
OBJECTIVE: To explore the patterns of living arrangements, ethnicity and loneliness amongst older adults (aged 65+ years) living at home. METHODS: National interRAI-HC (International Residential Assessment Instrument-Home Care) assessments conducted between 1 September 2012 and 31 January 2016 were analysed. Analysis focused on the associations between loneliness and both ethnic groups and living arrangements. RESULTS: There were 71 859 eligible participants, with average age 82...
December 12, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29231914/determinants-of-late-life-depression-in-residents-of-long-term-care-facility
#5
Urszula Horwath, Katarzyna Szczerbińska
Mental disorders, such as dementia and depression, are beside chronic somatic diseases, the most common problem in residents of longterm care facilities (LTCF). Late-life depression refers to depressive symptoms that arise in adults older than 65 years. According to literature review, older people tend to differ from middle-aged adults in presentation of depression. AIM: Mental disorders, such as dementia and depression, are beside chronic somatic diseases, the most common problem in residents of longterm care facilities (LTCF)...
November 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29222667/drug-burden-and-its-association-with-falls-among-older-adults-in-new-zealand-a-national-population-cross-sectional-study
#6
Hamish A Jamieson, Prasad S Nishtala, Richard Scrase, Joanne M Deely, Rebecca Abey-Nesbit, Martin J Connolly, Sarah N Hilmer, Darrell R Abernethy, Philip J Schluter
BACKGROUND: Adverse outcomes associated with advanced diseases are often exacerbated by polypharmacy. OBJECTIVES: The current study investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confounders. METHODS: We conducted a retrospective cross-sectional study of a continuously recruited national cohort of community-dwelling New Zealanders aged 65 years and over...
December 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29178868/derivation-and-validation-of-the-personal-support-algorithm-an-evidence-based-framework-to-inform-allocation-of-personal-support-services-in-home-and-community-care
#7
Chi-Ling Joanna Sinn, Aaron Jones, Janet Legge McMullan, Nancy Ackerman, Nancy Curtin-Telegdi, Leslie Eckel, John P Hirdes
BACKGROUND: Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. METHODS: The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016...
November 25, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29165543/identification-of-older-adults-with-frailty-in-the-emergency-department-using-a-frailty-index-results-from-a-multinational-study
#8
Audrey-Anne Brousseau, Elsa Dent, Ruth Hubbard, Don Melady, Marcel Émond, Éric Mercier, Andrew P Costa
Objective: frailty is a central concept in geriatric medicine, yet its utility in the Emergency Department (ED) is not well understood nor well utilised. Our objectives were to develop an ED frailty index (FI-ED), using the Rockwood cumulative deficits model and to evaluate its association with adverse outcomes. Method: this was a large multinational prospective cohort study using data from the interRAI Multinational Emergency Department Study. The FI-ED was developed from the Canadian cohort and validated in the multinational cohort...
November 20, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29130513/falls-and-hip-fractures-associated-with-urinary-incontinence-among-older-men-and-women-with-complex-needs-a-national-population-study
#9
Philip J Schluter, Edwin P Arnold, Hamish A Jamieson
AIMS: To determine if urinary incontinence (UI) was an independent risk factor for falls and hip fractures in community-dwelling older men and women with complex needs, after controlling for confounders. METHODS: Since 2012, all community care recipients in New Zealand have undergone standardized needs assessments using the Home Care International Residential Assessment Instrument (interRAI-HC). The interRAI-HC elicits information over multiple domains, including UI frequency and falls...
November 11, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29030309/hearing-the-voice-of-the-resident-in-long-term-care-facilities-an-internationally-based-approach-to-assessing-quality-of-life
#10
John N Morris, Anja Declercq, John P Hirdes, Harriet Finne-Soveri, Brant E Fries, Mary L James, Leon Geffen, Vahe Kehyayan, Kai Saks, Katarzyna Szczerbińska, Eva Topinkova
OBJECTIVES: interRAI launched this study to introduce a set of standardized self-report measures through which residents of long-term care facilities (LTCFs) could describe their quality of life and services. This article reports on the international development effort, describing measures relative to privacy, food, security, comfort, autonomy, respect, staff responsiveness, relationships with staff, friendships, and activities. First, we evaluated these items individually and then combined them in summary scales...
October 10, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29024219/the-determinants-of-service-complexity-in-children-with-intellectual-disabilities
#11
S L Stewart, K Falah Hassani, J Poss, J Hirdes
BACKGROUND: To date, little is known about the predictors of healthcare service utilisation in children with intellectual disability (ID). The aim of this study was to identify the factors associated with service complexity in children with ID in Ontario, Canada. METHODS: The population of this cross-sectional study consisted of 330 children with ID ages 4 to 18 years who accessed mental health services from November of 2012 to June of 2016 in four agencies. All participants completed the interRAI Child and Youth Mental Health and Developmental Disability Assessment Instrument, which is a semi-structured clinician-rated assessment that covers a range of common issues in children with ID...
November 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28950742/evaluation-of-the-national-minimum-data-set-for-neurological-conditions-in-older-adults
#12
Sujita W Narayan, Hamish A Jamieson, Prasad S Nishtala
AIM: To evaluate the National Minimum Data Set (NMDS) against the International Resident Assessment Instrument-Home Care (interRAI-HC) in diagnosing dementia or Parkinson disease (PD). METHOD: The NMDS data were matched with interRAI-HC for all older individuals in New Zealand. Dementia or PD was compared within 90 and 180 days and 1 to 4 years preceding and subsequent to the date of diagnosis in interRAI-HC. Consistency was measured through sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), weighted kappa (κ), and McNemar test...
January 1, 2017: Journal of Geriatric Psychiatry and Neurology
https://www.readbyqxmd.com/read/28943479/clinical-characteristics-and-patterns-of-health-deficits-of-centenarians-receiving-home-care-and-long-term-care-services
#13
Shannon Freeman, Joshua J Armstrong, Suzanne L Tyas, Eva Neufeld
Centenarians (persons aged 100years and older) are one of the fastest growing cohorts in countries across the world. With the increasing prevalence of centenarians and growing amount of clinical information in large administrative health databases, it is now possible to more fully characterize the health of this unique and heterogeneous population. This study described patterns of health deficits in the centenarian population receiving care from community-based home care services and long-term care facilities (LTCFs) in Ontario, Canada...
December 1, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28882127/derivation-of-a-frailty-index-from-the-resident-assessment-instrument-home-care-adapted-for-switzerland-a-study-based-on-retrospective-data-analysis
#14
Catherine Ludwig, Catherine Busnel
BACKGROUND: The screening of frail individuals at risk for functional health decline and adverse health outcomes lies in the evolving agenda of home care providers. Such a screening can be based on a frailty index (FI) derived from data collected with interRAI instruments used in clinical routines to define care plans. The objective of this study was to assess the feasibility of deriving an FI from the Resident Assessment Instrument - Home Care adapted for Switzerland (Swiss RAI-HC). METHODS: Data were collected by the Geneva Institution for Homecare and Assistance in clinical routines...
September 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28832897/reliability-of-an-online-geriatric-assessment-procedure-using-the-interrai-acute-care-assessment-system
#15
COMPARATIVE STUDY
Melinda G Martin-Khan, Helen Edwards, Richard Wootton, Steven R Counsell, Paul Varghese, Wen Kwang Lim, Peteris Darzins, Lucy Dakin, Kerenaftali Klein, Leonard C Gray
OBJECTIVES: To determine whether geriatric triage decisions made using a comprehensive geriatric assessment (CGA) performed online are less reliable than face-to-face (FTF) decisions. DESIGN: Multisite noninferiority prospective cohort study. Two specialist geriatricians assessed individuals sequentially referred for an acute care geriatric consultation. Participants were allocated to one FTF assessment and an additional assessment (FTF or online (OL)), creating two groups-two FTF (FTF-FTF, n = 81) or online and FTF (OL-FTF, n = 85)...
September 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28791517/psychometric-evaluation-of-the-interrai-child-and-youth-mental-health-disruptive-aggression-behaviour-scale-dabs-and-hyperactive-distraction-scale-hds
#16
Chloe Lau, Shannon L Stewart, Donald H Saklofske, Paul F Tremblay, John Hirdes
The present study aims to validate the interRAI Child and Youth Mental Health (interRAI ChYMH), Disruptive/Aggression Behaviour Scale (DABS) and Hyperactive/Distraction Scale (HDS). Data were collected from children/youth aged 4-18 (N = 3464) across 39 mental health agencies in Ontario, Canada. Unrestricted factor analysis using polychoric correlation matrices and Samejima's graded item response theory (IRT) parameterizations were conducted for both measures. Scores on the HDS and DABS were also compared amongst children/youth diagnosed with attention-deficit hyperactivity disorder (ADHD) and disruptive behaviour disorder (DBD) respectively using DSM-IV criteria...
August 8, 2017: Child Psychiatry and Human Development
https://www.readbyqxmd.com/read/28762377/fecal-incontinence-is-associated-with-mortality-among-older-adults-with-complex-needs-an-observational-cohort-study
#17
Hamish A Jamieson, Philip J Schluter, Juno Pyun, Ted Arnold, Richard Scrase, Rebecca Nisbet-Abey, Vincent Mor, Joanne M Deely, Len Gray
OBJECTIVES: Fecal incontinence (FI) is a problem in growing older populations. Validating a suspected association between FI and mortality in community dwelling older adults could lead to improved planning for and management of the increasing complex older population. In a large cohort of New Zealand older adults, we assessed the prevalence of FI, urinary incontinence (UI), combined FI and UI, and their associations with mortality. METHODS: This study consisted of a retrospective analysis of international standardized geriatric assessment-home care (InterRAI-HC) data from community-dwelling adults aged 65 years or older, who met the criteria required for the InterRAI-HC, having complex needs and being under consideration for residential care...
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28758354/an-examination-of-correlates-for-adolescent-engagement-in-nonsuicidal-self-injury-suicidal-self-injury-and-substance-use
#18
Janell A Klassen, Chloe A Hamza, Shannon L Stewart
Little research has examined potential risk factors for direct versus indirect self-injury among adolescents. To address this limitation, 541 clinically referred adolescents were assessed using the interRAI Child and Youth Mental Health Assessment. Logistic regression analyses revealed that older females who experienced heightened depressive symptoms and neighborhood violence were at increased risk for direct self-injury, specifically nonsuicidal and suicidal self-injury. Additionally, adolescents who experienced higher levels of caregiver distress were at greater risk of suicidal self-injury...
July 31, 2017: Journal of Research on Adolescence: the Official Journal of the Society for Research on Adolescence
https://www.readbyqxmd.com/read/28677869/an-epidemiological-profile-of-bipolar-disorder-among-older-adults-with-complex-needs-a-national-cross-sectional-study
#19
Philip J Schluter, Cameron Lacey, Richard J Porter, Hamish A Jamieson
OBJECTIVES: Research on bipolar disorder (BD) among community-living older adults is scant and often suffers from important methodological limitations. Using a national database, this study presents an epidemiological profile of BD in older community residents within New Zealand. METHODS: Since 2012, all New Zealand community care recipients have undergone a standardized needs assessment using the Home Care International Residential Assessment Instrument (interRAI-HC)...
August 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28635539/an-old-challenge-with-new-promises-a-systematic-review-on-comprehensive-geriatric-assessment-in-long-term-care-facilities
#20
Francesco Panza, Vincenzo Solfrizzi, Madia Lozupone, Maria Rosaria Barulli, Francesca D'Urso, Roberta Stallone, Vittorio Dibello, Alessia Noia, Cristina Di Dio, Antonio Daniele, Antonello Bellomo, Davide Seripa, Antonio Greco, Giancarlo Logroscino
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by settings where the CGA is performed [i.e., hospital, posthospital discharge/long-term care facilities (LTCFs), or community/home] as well as the specific clinical conditions of older frail individuals...
July 28, 2017: Rejuvenation Research
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