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Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao 2016 Butler University

Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao

Thomas L. Shaffer

Objective—Antipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality.

Design—Retrospective analysis using sequential multivariate Cox proportional hazards models.

Setting—Medicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files.

Participants—A total of 2,363 LTC Medicare beneficiaries, 1999 ...


Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao 2016 Butler University

Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao

Thomas L. Shaffer

Objective—Antipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality.

Design—Retrospective analysis using sequential multivariate Cox proportional hazards models.

Setting—Medicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files.

Participants—A total of 2,363 LTC Medicare beneficiaries, 1999 ...


Spinal Compression Fractures: No Additional Pain Relief With Use Of Back Braces, Kayla A. Berigan, Brandon Baker, Zakaria Ahmad, Aaron Simpson 2016 Wayne State University School of Medicine

Spinal Compression Fractures: No Additional Pain Relief With Use Of Back Braces, Kayla A. Berigan, Brandon Baker, Zakaria Ahmad, Aaron Simpson

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Li M, Law SW, Cheng J, Kee HM, Wong MS. A comparison study on the efficacy of SpinoMed® and soft lumbar orthosis for osteoporotic vertebral fracture. J. Prosthet. Orthot. Int. 2015;39(4):270-276. doi: 10.1177/0309364614528204


Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane 2016 University of Massachusetts Medical School

Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Background: The prevalence of untreated pain in nursing home residents with cancer is unacceptably high. Hospice may increase the likelihood of receiving pain management at the end of life.

Objectives: To estimate whether receipt of hospice in nursing homes increases the receipt of pain management for nursing home residents with cancer at the end of life.

Methods: We conducted a cross-sectional study on a national sample of Medicare decedents who had cancer and were nursing home residents during the last 90 days of life in 2011–2012. We used the last Minimum Data Set (MDS) 3.0 assessment before death ...


Age And Sex Differences In Long-Term Outcomes Following Implantable Cardioverter-Defibrillator Placement In Contemporary Clinical Practice: Findings From The Cardiovascular Research Network, Frederick A. Masoudi, Jerry H. Gurwitz, Robert J. Goldberg 2016 University of Colorado

Age And Sex Differences In Long-Term Outcomes Following Implantable Cardioverter-Defibrillator Placement In Contemporary Clinical Practice: Findings From The Cardiovascular Research Network, Frederick A. Masoudi, Jerry H. Gurwitz, Robert J. Goldberg

Robert J. Goldberg

BACKGROUND: Patient sex and age may influence rates of death after receiving an implantable cardioverter-defibrillator for primary prevention. Differences in outcomes other than mortality and whether these differences vary by heart failure symptoms, etiology, and left ventricular ejection fraction are not well characterized.

METHODS AND RESULTS: We studied 2954 patients with left ventricular ejection fraction < /=0.35 undergoing first-time implantable cardioverter-defibrillator for primary prevention within the Cardiovascular Research Network; 769 patients (26%) were women, and 2827 (62%) were aged > 65 years. In a median follow-up of 2.4 years, outcome rates per 1000 patient-years were 109 for death, 438 for hospitalization, and 111 for heart failure hospitalizations. Procedure-related complications occurred in 8.36%. In multivariable models, women had significantly lower risks of death (hazard ...


Potentially Inappropriate Medication Use In Older Patient With Breast And Colorectal Cancer, Meghan S. Karuturi 2016 The University of Texas Graduate School of Biomedical Sciences at Houston

Potentially Inappropriate Medication Use In Older Patient With Breast And Colorectal Cancer, Meghan S. Karuturi

UT GSBS Dissertations and Theses (Open Access)

Our objective was to determine predictors of potentially inappropriate medication (PIM) use and its impact on outcomes (including ER visits, hospitalization, all cause death, and composite of three) in breast and colorectal cancer patients receiving chemotherapy. We used data from the SEER database linked to Medicare claims. Our cohort included patients ≥ 66 years diagnosed with of Stage II/III breast or colorectal cancer between 7/1/2007-12/31/2009. Baseline PIM was defined using the Drugs to Avoid in the Elderly list (DAE) or Beers criteria. Univariate and multivariable logistic regression were used to determine the associations of baseline PIMs ...


Patient Satisfaction With The Annual Wellness Visit, Maria Espiridion, Raghavendra Mulinti, MD, Suzanne E. Kemper, MPH, Lynne J. Goebel, MD 2016 Marshall University

Patient Satisfaction With The Annual Wellness Visit, Maria Espiridion, Raghavendra Mulinti, Md, Suzanne E. Kemper, Mph, Lynne J. Goebel, Md

Marshall Journal of Medicine

OBJECTIVES - To determine patient satisfaction with the Annual Wellness Visit (AWV)

DESIGN – Survey

SETTING- Charleston Area Medical Center and Marshall Health

PARTICIPANTS – 66 volunteers, average age 74 years

MEASUREMENTS – Patient satisfaction was assessed with a 13 item survey.

RESULTS - Of 1,537 eligible patients, 211 (14%) of these agreed to schedule their AWV. From 66 patients surveyed, 87% of patients said the visit “met expectations,” “would recommend to friends,” and “would do it again.” Only 5 (8%) were disappointed that new problems were not addressed and 2 (3%) were dissatisfied that physical exams and blood tests were not included.

CONCLUSION ...


Compositions And Methods For Treating Ischemia, Gregory J. Bix 2016 University of Kentucky

Compositions And Methods For Treating Ischemia, Gregory J. Bix

Sanders-Brown Center on Aging Faculty Patents

The presently-disclosed subject matter provides methods for preventing ischemia in a cell, treating ischemia in a subject, and preventing an infarction in a subject that utilize α5β1 integrin inhibitor. In some instances, α5β1 integrin inhibitor is administered to a subject prior to, during, or after the onset of ischemia to treat the ischemia and/or prevent infarction. In some instances the present methods prevent the occurrence of an infarction. In some instances the present methods restores perfusion to organs and tissues.


Malnourished Older Adults With Informal Caregivers Admitted To Rural Rehabilitation Units Remain Malnourished During And After Rehabilitation: A Prospective Cohort Study Of Current Practice, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring 2016 Bond University

Malnourished Older Adults With Informal Caregivers Admitted To Rural Rehabilitation Units Remain Malnourished During And After Rehabilitation: A Prospective Cohort Study Of Current Practice, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

Understanding the nutritional journey older adults make from rehabilitation to home may help to engage and support the patient and their informal caregiver during this process. This study aimed to determine the change in nutritional status, physical function and health-related quality of life (HRQoL) amongst malnourished older adults (≥65years) with informal caregivers admitted to rural rehabilitation and 12 weeks post-discharge to the community.


Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring 2016 Bond University

Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

No abstract provided.


Malnourished Older Adults Admitted To Rehabilitation In Rural New South Wales Remain Malnourished Throughout Rehabilitation And Once Discharged Back To The Community: A Prospective Cohort Study, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring 2016 Bond University

Malnourished Older Adults Admitted To Rehabilitation In Rural New South Wales Remain Malnourished Throughout Rehabilitation And Once Discharged Back To The Community: A Prospective Cohort Study, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

No abstract provided.


Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Liz Isenring 2016 Bond University

Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Liz Isenring

Skye Marshall

There is strong evidence showing malnutrition is under-recognized and underdiagnosed in the rehabilitation setting. Accurate identification and management of malnutrition is essential so that patient outcomes may be improved and resources used efficaciously.The Scored PG-SGA and MNA require evaluation of their validity in diagnosing malnutrition in rehabilitation. In addition, the prevalence of malnutrition and associated patient outcomes in rural Australian populations has not been reported.


Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone 2016 Department of Geriatrics, Aurora Health Care

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Ariba Khan, MD, MPH

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium ...


Prognostic Indices For Hospitalized Older Adults: A Meta-Analysis And Systematic Review, Ariba Khan, Ayesha Maria, James Hocker, Maharaj Singh, Michelle Simpson 2016 Department of Geriatrics, Aurora UW Medical Group

Prognostic Indices For Hospitalized Older Adults: A Meta-Analysis And Systematic Review, Ariba Khan, Ayesha Maria, James Hocker, Maharaj Singh, Michelle Simpson

Ariba Khan, MD, MPH

Background: A prognostication predictive model incorporated into the electronic health record (EHR) may be useful in assisting the health care team in accurately predicting mortality and may be used in appropriately allocating palliative care services.

Purpose: To systematically review and summarize current medical literature regarding the factors predictive of mortality in an inpatient population above 65 years of age.

Methods: Nondisease-specific prognostication indices that predict 1-year mortality in an inpatient population of adults over age 65 were included. We excluded studies that estimated intensive care unit, disease-specific or in-hospital mortality. A MEDLINE, CINAHL, Ovid and Cochrane literature search of English-language ...


An Automated Model Using Electronic Health Record Data To Identify Delirium Among Hospitalized Older Adults: A Pilot Project, Ariba Khan, Maharaj Singh, Hina Singh, Ayesha Maria, Michelle Simpson 2016 Department of Geriatrics, Aurora UW Medical Group

An Automated Model Using Electronic Health Record Data To Identify Delirium Among Hospitalized Older Adults: A Pilot Project, Ariba Khan, Maharaj Singh, Hina Singh, Ayesha Maria, Michelle Simpson

Ariba Khan, MD, MPH

Background: Delirium is a serious change in mental status with adverse outcomes, but remains underrecognized. The electronic health record (EHR) may assist in the identification of delirium.

Purpose: This study was performed to generate an automated delirium identification model using data from the EHR among hospitalized older adults.

Methods: Inpatients 65 years and older were included in this cross-sectional study. The researchers used “confusion assessment method” as the gold standard to identify delirium. Four categories of variables were obtained from the EHR on the day of and the day prior to researcher assessment: 1) hypoactive delirium (any one of the ...


Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone 2016 Department of Geriatrics, Aurora Health Care

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Michael Malone, MD

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium ...


A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson 2016 University of San Diego

A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson

Doctor of Nursing Practice Projects

HF is a fatal condition affecting more than 5 million Americans leading to frequent hospitalizations, poor quality of life and death. The annual cost to the healthcare system is approximately $38 billion, ranking HF as one of the costliest conditions to manage. Significant evidence exists that HF self-care management programs improve patient self-care and decrease HF-related readmissions. Current guidelines recommend health professionals provide comprehensive HF education focused on knowledge, skills of management, and self-care behaviors.

The Iowa Model of Evidence Based Practice provided the foundation for the practice change. Structured telephonic support (STS) was based on Bandura’s Self- Efficacy ...


Workplace Predictors Of Perceived Quality Of Care In Nursing Homes, Winnie Chin, Laura Punnett, Rebecca Gore, Laura Kernan 2016 University of Massachusetts Lowell

Workplace Predictors Of Perceived Quality Of Care In Nursing Homes, Winnie Chin, Laura Punnett, Rebecca Gore, Laura Kernan

UMass Center for Clinical and Translational Science Research Retreat

Nursing home quality of care (QOC) is a matter of public concern and public policy. Higher nurse-to-patient ratios have been shown to decrease rates of adverse outcomes. Positive nurse-doctor relationships also have a positive effect, which might translate to other clinical staff, such as nursing aides, who perform the majority of direct care tasks in nursing homes. This cross-sectional study examined whether workplace factors in nursing homes were associated with QOC as evaluated by staff members themselves. Surveys were distributed to personnel in 24 nursing home facilities in the Northeast U.S. A total of 1463 respondents provided ratings of ...


Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane 2016 University of Massachusetts Medical School

Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane

UMass Center for Clinical and Translational Science Research Retreat

Background: The prevalence of untreated pain in nursing home residents with cancer is unacceptably high. Hospice may increase the likelihood of receiving pain management at the end of life.

Objectives: To estimate whether receipt of hospice in nursing homes increases the receipt of pain management for nursing home residents with cancer at the end of life.

Methods: We conducted a cross-sectional study on a national sample of Medicare decedents who had cancer and were nursing home residents during the last 90 days of life in 2011–2012. We used the last Minimum Data Set (MDS) 3.0 assessment before death ...


Show Back: Evaluation Of Scoresheet For Identifying Self-Management Medication Problems Of Older Adults, Laura Sanford, Janice B. Foust, Maureen Sarno, Alok Kapoor 2016 University of Massachusetts Medical School

Show Back: Evaluation Of Scoresheet For Identifying Self-Management Medication Problems Of Older Adults, Laura Sanford, Janice B. Foust, Maureen Sarno, Alok Kapoor

UMass Center for Clinical and Translational Science Research Retreat

Purpose The study purpose was to test the feasibility of a scoresheet to screen for problems older adults may have managing medications after discharge from a hospital or nursing home facility.

Background Adverse drug events (ADE) prevention is an important patient safety priority, with ADEs accounting for an estimated one-third of hospital adverse events and approximately 280,000 hospital admissions annually. Home healthcare nurses work with older adults to avoid ADEs and promote self-management of medications. Few, if any, studies have described older adults’ cognitive and psychomotor abilities to manage their medications after being discharged home.

Methods We enrolled patients ...


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