Medicines optimisation in older people: Taking age and sex into account

Maturitas ◽  
2016 ◽  
Vol 93 ◽  
pp. 114-120 ◽  
Author(s):  
Catherine Lucas ◽  
Julie Byles ◽  
Jennifer H. Martin
Keyword(s):  
Older People ◽  
Medicines Optimisation ◽  
Age And Sex

Why is medicines optimisation vital for older people with frailty?

2020 ◽  
Vol 32 (2) ◽  
pp. 13-13
Author(s):  
Sue Lyne ◽  
Ceri McEwan
Keyword(s):  
Older People ◽  
Medicines Optimisation

scholarly journals An exploration of community pharmacists’ experience, knowledge and perspectives of frailty and medicines optimisation in frail older people: A qualitative study

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i6-i6
Author(s):  
L Faulkner ◽  
C M Hughes ◽  
H E Barry
Keyword(s):  
Older People ◽  
Older Patients ◽  
Frailty Index ◽  
External Validation ◽  
Community Pharmacists ◽  
Clinical Aspects ◽  
Frail Older People ◽  
Structured Interviews ◽  
Age Related ◽  
Medicines Optimisation

Abstract Introduction Frailty is a heightened state of vulnerability due to an accumulation of age-related defects in separate physiological systems (1). Frailty is becoming increasingly common, with up to 50% of older adults being diagnosed with mild, moderate or severe frailty (35%, 12% and 3% respectively) (2). Community pharmacists may often be the primary healthcare professional with whom frail older people have most frequent contact due to their convenience and accessibility. Therefore, it is hypothesised that community pharmacists could play a wider role in frailty identification and medicines optimisation for frail older people. Aim To explore community pharmacists’ knowledge of frailty and its assessment, their experiences and contact with frail older patients in the community pharmacy setting, and their perceptions of their role in optimising medicines for frail older people. Methods Two strategies were used to recruit community pharmacists registered in Northern Ireland (NI). Community pharmacists were recruited through the Pharmacy Forum NI bi-monthly newsletter and the School of Pharmacy Undergraduate Placement Network, followed by snowballing. The interview topic guide was developed based on the published literature, current frailty guidelines and through discussion within the research team; it was piloted with four pharmacists. Semi-structured interviews commenced in March 2020. Due to the Covid-19 pandemic, face-to-face interviews were logistically not possible, therefore telephone interviews were conducted at a time convenient to participants. All interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis. Results To date, 14 interviews have been conducted, lasting between 24 and 72 minutes. Apart from one interview, all were conducted over the telephone. Participant characteristics are summarised in Table 1. Analysis of interview transcripts is ongoing. Findings to date have highlighted the key role community pharmacists feel they play in assisting frail older patients with their medicines (especially during the current pandemic). Many saw themselves as a ‘point of contact’ for frail older people and highlighted the holistic approaches they used to care of such patients: “It’s easier to get in contact with us than other healthcare professionals and we tend to be the first port of call really” [CP2]. Interviews highlighted a lack of pharmacist knowledge surrounding frailty as a condition and its assessment, with participants primarily focusing on the physical aspects of frailty (e.g. weight loss, weakness) when observing or ‘informally assessing’ patients. None of the participants reported formally assessing their patients using validated frailty tools or checklists: “It’s not something that I’ve ever thought about. We don’t have any tools readily available to us that I know of and certainly nothing that would be standardised” [CP1]. Conclusion This study has highlighted that community pharmacists felt they could contribute to optimising medicines for frail older people. However, the findings emphasise the need for more formal training for community pharmacists about the clinical aspects of frailty, frailty assessment and future interventions to address the medicines-related issues they have encountered with this patient population. References 1. Shaw RL, Gwyther H, Holland C, Bujnowska M, Kurpas D, Cano A, et al. Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe. Ageing & Society. 2018;38(6): 1223–1252. 2. Hollinghurst J, Fry R, Akbari A, Clegg A, Lyons RA, Watkins A, et al. External validation of the electronic Frailty Index using the population of Wales within the Secure Anonymised Information Linkage Databank. Age and Ageing. 2019;48(6): 922–926.

scholarly journals Frailty of Māori, Pasifika, and Non-Māori/Non-Pasifika Older People in New Zealand: A National Population Study of Older People Referred for Home Care Services

2020 ◽  
Author(s):  
Rebecca Abey-Nesbit ◽  
Nancye M Peel ◽  
Hector Matthews ◽  
Ruth E Hubbard ◽  
Prasad S Nishtala ◽  
...  
Keyword(s):  
New Zealand ◽  
Home Care ◽  
Older People ◽  
Frailty Index ◽  
Indigenous Populations ◽  
Potential Range ◽  
Linear Regression Models ◽  
Care Assessment ◽  
The Mean ◽  
Age And Sex

Abstract Background Little is known about the prevalence of frailty in indigenous populations. We developed a frailty index (FI) for older New Zealand Māori and Pasifika who require publicly funded support services. Methods An FI was developed for New Zealand adults aged 65 and older who had an interRAI Home Care assessment between June 1, 2012 and October 30, 2015. A frailty score for each participant was calculated by summing the number of deficits recorded and dividing by the total number of possible deficits. This created a FI with a potential range from 0 to 1. Linear regression models for FIs with ethnicity were adjusted for age and sex. Cox proportional hazards models were used to assess the association between the FI and mortality for Māori, Pasifika, and non-Māori/non-Pasifika. Results Of 54 345 participants, 3096 (5.7%) identified as Māori, 1846 (3.4%) were Pasifika, and 49 415 (86.7%) identified as neither Māori nor Pasifika. New Zealand Europeans (48 178, 97.5%) constituted most of the latter group. Within each sex, the mean FIs for Māori and Pasifika were greater than the mean FIs for non-Māori and non-Pasifika, with the difference being more pronounced in women. The FI was associated with mortality (Māori subhazard ratio [SHR] 2.53, 95% CI 1.63–3.95; Pasifika SHR 6.03, 95% CI 3.06–11.90; non-Māori and non-Pasifika SHR 2.86, 95% CI 2.53–3.25). Conclusions This study demonstrated differences in FI between the ethnicities in this select cohort. After adjustment for age and sex, increases in FI were associated with increased mortality. This suggests that FI is predictive of poor outcomes in these ethnic groups.

scholarly journals The Development and Refinement of a Regional Model for Medicines Optimisation in Older People in the Intermediate Care Setting

2017 ◽  
Vol 17 (5) ◽  
pp. 120
Author(s):  
Ruth Miller ◽  
Carmel Darcy ◽  
Nuala McGeough ◽  
Anne Friel ◽  
Helen Graham ◽  
...  
Keyword(s):  
Older People ◽  
Care Setting ◽  
Regional Model ◽  
Intermediate Care ◽  
Medicines Optimisation

scholarly journals Developing a Regional Medicines Optimisation Model for Older People in Care Homes: Refinement and Reproducibility

2017 ◽  
Vol 17 (5) ◽  
pp. 121
Author(s):  
Ruth Miller ◽  
Hilary McKee ◽  
Anne Friel ◽  
Carmel Darcy ◽  
Rory McSorley ◽  
...  
Keyword(s):  
Older People ◽  
Care Homes ◽  
Optimisation Model ◽  
Medicines Optimisation

Assessment of grip strength in older people needs standardization by age and sex

2017 ◽  
Vol 17 (2) ◽  
pp. 352-354 ◽  
Author(s):  
Naoto Kamide ◽  
Yoshitaka Shiba ◽  
Haruhiko Sato
Keyword(s):  
Older People ◽  
Grip Strength ◽  
Age And Sex
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