scholarly journals Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care

2001 ◽  
Vol 60 (2) ◽  
pp. 91-97 ◽  
Author(s):  
G Peat
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Knee Pain ◽  
Primary Health

scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cohort Study ◽  
Primary Health Care ◽  
Rio Grande ◽  
Cognitive Testing ◽  
Rio Grande Do Sul ◽  
Primary Health ◽  
The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

scholarly journals District nurses’ experiences of using a clinical decision support system and an assessment tool at elderly care units in primary health care: a qualitative study

2021 ◽  
Vol 22 ◽  
Author(s):  
Annica Lagerin ◽  
Lena Törnkvist ◽  
Johan Fastbom ◽  
Lena Lundh
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Decision Support ◽  
Clinical Decision Support System ◽  
Elderly Care ◽  
Medication Use ◽  
Clinical Decision ◽  
Primary Health ◽  
District Nurses

Abstract Aim: The present study aimed to describe the experience of district nurses (DNs) in using a clinical decision support system (CDSS) and the safe medication assessment (SMA) tool during patient visits to elderly care units at primary health care centres. Background: In Swedish primary health care, general practitioners (GPs) prescribe and have the responsibility to regularly review older adults’ medications, while DN (nurses specialised in primary health care) play an important role in assessing older adults’ ability to manage their medications, detecting potential drug-related problems and communicating with patients and GPs about such problems. In a previous feasibility study, we found that DNs who use a combination of a CDSS and the SMA tool identified numerous potentially harmful or dangerous factors and took a number of nursing care actions to improve the safety and quality of patients’ medication use. In telephone interviews, patients indicated that they were positive towards the assessment and interventions. Methods: Individual interviews with seven DNs who worked at six different primary health care centres in Region Stockholm were carried out in 2018. In 2019, an additional group interview was conducted with two of the seven DNs so they could discuss and comment on preliminary findings. Qualitative content analysis was used to analyse the interview transcripts. Findings: Using the tools, the DNs could have a natural conversation about medication use with older adults. They could get a clear picture of the older adults’ medication use and thus obtain information that could facilitate collaboration with GPs about this important component of health care for older adults. However, for the tools to be used in clinical practice, some barriers would have to be overcome, such as the time-consuming nature of using the tools and the lack of established routines for interprofessional collaboration regarding medication discussions.

scholarly journals Nutritional Care for older adults in Primary Health Care, from the perspective of health professionals

2020 ◽  
Vol 23 (6) ◽  
Author(s):  
Carolina Lou de Melo ◽  
Maria Angélica Tavares de Medeiros
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Healthy Aging ◽  
Structured Interview ◽  
Cross Sectional ◽  
Nutritional Care ◽  
Primary Health ◽  
Theoretical Saturation

Abstract Objective: to characterize and analyze Nutritional Care (NC) for older adults in Primary Health Care (PHC), identifying how food and nutrition actions (F&N) were performed and the conceptions that guided them. Methods: a cross-sectional, quantitative and qualitative study was performed in PHC in Santos, São Paulo, Brazil, in two phases: i) a census study was carried out of health units, N=28 (100%), with managers who answered a structured interview to assess NC; followed by descriptive analysis. ii) a deeper investigation of this diagnosis was performed, using semi-structured interviews with key informants (interviewees) of care for older adults; being a nutritionist was not a criteria, as there were only three such professionals throughout the entire PHC, and one of the health regions studied was not served by a nutrition professional. The concept of theoretical saturation was used for the sampling plan; content analysis was carried out and the inferences were supported by references of integrality and aging. Results: NC for older adults was highlighted by individual care, predominant in all the services studied (28) (100%); nutritionists participated in this activity in just nine units (32.1%). Theoretical saturation was achieved with nine interviews. According to the discourse analysis, F&N actions were generic, focused on the treatment of diseases, influenced by negative aspects attributed to aging, there was no planning based on the needs of the territory, and health professionals identified themselves as information transmitters, leaving the responsibility of acting on such information to the older adults themselves. Conclusion: F&N actions were guided by the biomedical paradigm, fragmented, restricted to disease management, imputing the responsibility for health to the individual themselves. Thus, NC distanced itself from the promotion of healthy aging, weakening its strategic role in the quest for integrated care.

scholarly journals Family Health Strategy, Primary Health Care, and Social Inequalities in Mortality Among Older Adults in Bagé, Southern Brazil

2021 ◽  
pp. e1-e10
Author(s):  
Marciane Kessler ◽  
Elaine Thumé ◽  
Michael Marmot ◽  
James Macinko ◽  
Luiz Augusto Facchini ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Social Inequalities ◽  
Family Health ◽  
Primary Health ◽  
Health Strategy ◽  
Family Health Strategy ◽  
Inequalities In Mortality

Objectives. To investigate the role of the Family Health Strategy (FHS) in reducing social inequalities in mortality over a 9-year follow-up period. Methods. We carried out a population-based cohort study of individuals aged 60 years and older from the city of Bagé, Brazil. Of 1593 participants at baseline (2008), 1314 (82.5%) were included in this 9-year follow-up (2017). We assessed type of primary health care (PHC) coverage and other variables at baseline. In 2017, we ascertained 579 deaths through mortality registers. Hazard ratios and their 95% confidence intervals modeled time to death estimated by Cox regression. We also tested the effect modification between PHC and wealth. Results. The FHS had a protective effect on mortality among individuals aged 60 to 64 years, a result not found among those not covered by the FHS. Interaction analysis showed that the FHS modified the effect of wealth on mortality. The FHS protected the poorest from all-cause mortality (hazard ratio [HR] = 0.59; 95% confidence interval [CI] = 0.36, 0.96) and avoidable mortality (HR = 0.46; 95% CI = 0.25, 0.85). Conclusions. FHS coverage reduced social inequalities in mortality among older adults. Our findings highlight the need to guarantee universal health coverage in Brazil by expanding and strengthening the FHS to promote health equity. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306146 )

scholarly journals Gender Differences in Health Self-Perception in Older Adults in Primary Health Care in Brazil

2018 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Maria Vieira de Lima Saintrain ◽  
Rosendo Freitas de Amorim ◽  
Flaviano da Silva Santos
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Gender Differences ◽  
Primary Health Care ◽  
Self Perception ◽  
Primary Health

0

75 Functional Mobility and Balance Confidence as Correlates of Fall Risk in Older Adults Attending a Primary Health Care Clinic

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Pavapriya Ponvel ◽  
Devinder Kaur Ajit Singh ◽  
Ee San Ng ◽  
Sheela Bai Pannir Selvam
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Fall Risk ◽  
Functional Mobility ◽  
Care Clinic ◽  
Balance Confidence ◽  
Primary Health Care Clinic ◽  
Primary Health ◽  
Abc Scale

Abstract Background Fall is one of the leading cause of unintentional injury among older adults. Information regarding functional mobility and balance confidence as correlates of fall risk in older adults attending a primary health care clinic is limited. This information is vital for fall screening and prevention. We aimed to examine if functional mobility and balance confidence were correlates of fall risk in older adults attending a primary health care clinic. Methods 106 older adults (≥60 years old) attending a primary health care clinic at Cheras, Malaysia participated in this cross-sectional study. Socio-demographic details and falls history were obtained using a structured questionnaire. Functional mobility and balance confidence were assessed using Timed Up and Go (TUG) test and Activities-Specific Balance Confidence (ABC) scale respectively. Fallers were categorised based on history of at least a fall in the past 12 months. Differences between faller and non-faller groups were distinguished using Independent T and Mann Whitney tests. Binomial logistic regression and receiver operating curve were performed to identify if functional mobility and balance confidence were correlates of falls risk and the cut off values for measures were obtained. Results TUG test and ABC scores differed significantly between the two groups (p&lt; 0.05). Both TUG test and ABC scale were identified as correlates of falls risk with r, R2 of 0.98, 0.26 (p&lt; 0.001) and 0.95, 0.12 (p&lt; 0.05) respectively. Cut off value of 9.02 seconds and above for TUG test and 82.81% and below for ABC score were identified as risk factor of falls among older adults. Conclusion The cut off values obtained from our study can be used as reference to screen older adults at risk of falls in Malaysian primary health care settings. Early fall risk screening and management is a part of falls prevention strategy in older adults.

scholarly journals Hospitalization in older adults: association with multimorbidity, primary health care and private health plan

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Bruno Pereira Nunes ◽  
Mariangela Uhlmann Soares ◽  
Louriele Soares Wachs ◽  
Pâmela Moraes Volz ◽  
Mirelle de Oliveira Saes ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Health Plan ◽  
Family Health ◽  
Care Model ◽  
Primary Health ◽  
Health Strategy ◽  
Family Health Strategy ◽  
Health Care Model

ABSTRACT OBJECTIVE Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. METHODS A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older) living in the urban area of the city of Bagé, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (≥ 2 and ≥ 3). The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. RESULTS The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8–19.6) and 10.6% (95%CI 9.1–12.1), respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition’ form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09–2.69) times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. CONCLUSIONS The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases.

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