scholarly journals Effects of Prescription Drug Reduction on Quality of Life in Community-Dwelling Patients with Dementia

2015 ◽  
Vol 18 (5) ◽  
pp. 705 ◽  
Author(s):  
Mikio Sakakibara ◽  
Ataru Igarashi ◽  
Yoshimasa Takase ◽  
Hiroyuki Kamei ◽  
Toshitaka Nabeshima
Keyword(s):  
Quality Of Life ◽  
Drug Use ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Intervention Group ◽  
Community Dwelling ◽  
Term Care ◽  
Benzodiazepine Use ◽  
Multiple Drugs

Purpose: Due to the use of multiple drugs and prevalence of diminished cognitive function, community-dwelling elderly individuals are more likely to have drug-related issues. We examined changes in quality of life (QOL) and activities of daily living (ADL) 3 months and 6 months after reducing drug use of dementia patients who had newly begun community-dwelling care.  Methods: Prescription drug use was reduced in the intervention group, whereas the non-intervention group continued their regimen or began using additional drugs. QOL and ADL were assessed with the Japanese version of the EQ-5D and the Barthel Index, respectively.  Results: Subjects were 32 individuals aged ≥65 years who had begun community-dwelling between March and July 2014 and had received approval for long-term care insurance. On average, the intervention group (n = 19) stopped using 2.6 prescription drugs. After 6 months, the differences in the QOL and ADL scores in the intervention group were -0.03 ± 0.29 and 6.32 ± 18.6, respectively, while the differences in the QOL and ADL scores in the non-intervention group (n = 13) were -0.13 ± 0.29 and -2.69 ± 23.7, respectively. In the intervention group, ADL scores were significantly increased by 14.0 ± 11.1 6 months after reduced benzodiazepine use.  Conclusions: QOL was maintained with reduced drug use, while ADL score was slightly increased. In addition, the reduction of benzodiazepine use significantly increased ADL. In order to reduce polypharmacy among community-dwelling elderly patients, it is necessary to create an opportunity for pharmacists to re-examine their prescriptions This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

Association Between Anticholinergic Drug Use and Health-Related Quality of Life in Community-Dwelling Older Adults

Drugs & Aging ◽  
2017 ◽  
Vol 34 (10) ◽  
pp. 785-792 ◽  
Author(s):  
Benoit Cossette ◽  
Maimouna Bagna ◽  
Modou Sene ◽  
Caroline Sirois ◽  
Gabrielle P. Lefebvre ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Drug Use ◽  
Anticholinergic Drug ◽  
Community Dwelling ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Community Dwelling Older Adults

AwareCare: a pilot randomized controlled trial of an awareness-based staff training intervention to improve quality of life for residents with severe dementia in long-term care settings

2012 ◽  
Vol 25 (1) ◽  
pp. 128-139 ◽  
Author(s):  
Linda Clare ◽  
Rhiannon Whitaker ◽  
Robert T Woods ◽  
Catherine Quinn ◽  
Hannah Jelley ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Care Home ◽  
Intervention Group ◽  
Well Being ◽  
Care Staff ◽  
Control Group ◽  
Severe Dementia ◽  
Term Care

ABSTRACTBackground: The extent to which care home residents with severe dementia show awareness is influenced by the extent to which the environment provides opportunities for engagement and by the way in which care staff interact with them. We aimed to establish whether training care staff to observe and identify signs of awareness in residents with severe dementia resulted in improved quality of life for residents.Methods: In this pilot cluster randomized trial, care staff in four homes (n = 32) received training and supervision and carried out structured observations of residents using the AwareCare measure (n = 32) over an eight-week period, while staff in four control homes (n = 33) had no training with regard to their residents (n = 33) and no contact with the research team. The primary outcome was resident quality of life. Secondary outcomes were resident well-being, behavior and cognition, staff attitudes and well-being, and care practices in the home.Results: Following intervention, residents in the intervention group had significantly better quality of life as rated by family members than those in the control group, but care staff ratings of quality of life did not differ. There were no other significant between-group differences. Staff participating in the intervention identified benefits in terms of their understanding of residents’ needs.Conclusions: Staff were able to use the observational measure effectively and relatives of residents in the intervention homes perceived an improvement in their quality of life.

scholarly journals INTEREST GROUP SESSION—RESEARCH IN QUALITY OF CARE: LIVING IN AND LEAVING NURSING HOMES: THE FACTORS THAT CONTRIBUTE TO QUALITY OF LIFE, HEALTH, AND SAFETY OUTCOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S359-S359
Author(s):  
Nancy Kusmaul ◽  
Mercedes Bern-Klug
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing homes house some of the most vulnerable older adults. They often have complex medical conditions and/or cognitive impairments that put them at risk for negative outcomes and poor quality of life. These outcomes can be altered through incorporating evidence-based practices aimed to improve care and residents’ life experiences. In this symposium we will explore factors that are shown to influence outcomes and quality of life for people that live in and are discharged from, long term care settings. Amy Roberts and colleagues will explore the influences of nursing home social service staff qualifications on residents’ discharge outcomes. Colleen Galambos and colleagues will present findings on advance directives and their impact on reducing potentially avoidable hospitalizations. Kelsey Simons and colleagues will discuss the potential for unmet needs for mental health services as part of nursing home care transitions, and will discuss a model of quality improvement that addresses this gap in care. Vivian Miller will present findings on the impact transportation access has on the ability of community-dwelling family members to visit and provide social support to their family member residents in long-term care. Finally, Nancy Kusmaul and Gretchen Tucker report the findings of their study comparing perceptions of nursing home residents, direct care staff, management, and families on the care practices that influence resident health and quality of life while they live in a long term care setting.

scholarly journals Pharmacare in Canada: The paediatric perspective

2020 ◽  
Vol 25 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Tom McLaughlin ◽  
Geert ‘t Jong ◽  
Andrea Gilpin ◽  
Charlotte Moore Hepburn
Keyword(s):  
Drug Use ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Cost Savings ◽  
Children And Youth ◽  
Paediatric Drug ◽  
Prescription Drug Use ◽  
Child Friendly ◽  
Health Canada

Abstract Canada’s drug insurance system is one of the most expensive in the world, yet millions of Canadians still struggle to access necessary medications. As a result, provincial, territorial, and federal governments are considering public pharmacare policy proposals to ensure that all Canadians can access the medications they need. Pharmacare policies offer an opportunity to prioritize children and youth, whose unique drug needs have long been neglected. Prescription drug use is common in this population, with approximately half of Canadian children and youth requiring at least one prescription in any given year. Drug use remains concentrated, however, among those with complex, chronic, and serious diseases. Children and youth rely heavily on compounded and off-label prescription drugs, which impacts safety, efficacy, palatability, and cost. Reimbursement decision-making bodies do not appropriately value the unique benefits of paediatric drugs, including child-friendly formulations, improved quality of life for children and families, and cost-savings outside the healthcare system. Regardless of the pharmacare model ultimately implemented, ensuring universal, comprehensive, and portable prescription drug coverage for all children and youth is essential. To accomplish this, paediatric drug experts should develop a national, evidence-informed formulary of paediatric drugs. Health Canada should also improve processes to make commercial paediatric drugs and child-friendly formulations more available and accessible. The federal government must also support paediatric drug research and development to this end.

scholarly journals Participation in community intervention programmes and quality of life: findings from a multicenter study in Portugal

2020 ◽  
Vol 23 (6) ◽  
Author(s):  
Maria Alice Martins da Silva Calçada Bastos ◽  
Joana Mafalda Miguelote de Pinho Monteiro ◽  
Carla Maria Gomes Marques de Faria ◽  
Maria Helena Pimentel ◽  
Sofia de Lurdes Rosas da Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Lifelong Learning ◽  
Family Income ◽  
Comparison Group ◽  
Community Intervention ◽  
Intervention Group ◽  
Community Dwelling ◽  
Satisfaction With Life Scale

Abstract Objective: The present study aimed to analyze quality of life (QoL) in participants of community intervention programs (CIP) focused on healthy aging. Method : A multicenter cross-sectional study was carried out with 304 community-dwelling participants, aged 55 years old or more and living in three locations in Portugal. Half of these individuals (n=152) were involved in a CIP (intervention group). The intervention group was paired according to sex and age group with an equivalent number of participants (n=152) that did not take part in a CIP (comparison group). Activities implemented in the CIP were grouped according to their nature: socio-recreational, educational/lifelong learning and physical activity. Data collection involved a Social Participation Questionnaire, the WHOQOL-Bref and the Satisfaction With Life Scale. Results: The CIP participants (n=152) had a mean age of 71.4 years (±5.4), were predominantly women (75.0%), married (65.4%), with fewer than five years of education (71.7%) and a monthly family income of up to 750 euros (47.4%). The intervention group had a significantly higher QoL in the physical domain than the comparison group (p<0.03). Physical activity was the most frequently attended session in the CIP (n=119, 78.3%), in comparison with educational/lifelong learning (n=46, 30.3%) and socio-recreational (n=25, 16.4%) activities. People practicing physical activity in the CIP had a significantly higher QoL in the psychological, social relationships and environment domains (p<0.05). Conclusion: Participation in the CIP was associated with QoL. Therefore, in line with the active aging framework, CIPs must be a part of public policy measures aimed at the QoL of the population.

scholarly journals Effects of a multi-component nutritional telemonitoring intervention on nutritional status, diet quality, physical functioning and quality of life of community-dwelling older adults

2018 ◽  
Vol 119 (10) ◽  
pp. 1185-1194 ◽  
Author(s):  
Marije N. van Doorn-van Atten ◽  
Annemien Haveman-Nies ◽  
Marit M. van Bakel ◽  
Monique Ferry ◽  
Maite Franco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Nutritional Status ◽  
Nutrition Education ◽  
Diet Quality ◽  
Physical Functioning ◽  
Intervention Group ◽  
Community Dwelling

AbstractThis study aimed to evaluate the effects of an intervention including nutritional telemonitoring, nutrition education, and follow-up by a nurse on nutritional status, diet quality, appetite, physical functioning and quality of life of Dutch community-dwelling elderly. We used a parallel arm pre-test post-test design with 214 older adults (average age 80 years) who were allocated to the intervention group (n97) or control group (n107), based on the municipality. The intervention group received a 6-month intervention including telemonitoring measurements, nutrition education and follow-up by a nurse. Effect measurements took place at baseline, after 4·5 months, and at the end of the study. The intervention improved nutritional status of participants at risk of undernutrition (β(T1)=2·55; 95 % CI 1·41, 3·68;β(T2)=1·77; 95 % CI 0·60, 2·94) and scores for compliance with Dutch guidelines for the intake of vegetables (β=1·27; 95 % CI 0·49, 2·05), fruit (β=1·24; 95 % CI 0·60, 1·88), dietary fibre (β=1·13; 95 % CI 0·70, 1·57), protein (β=1·20; 95 % CI 0·15, 2·24) and physical activity (β=2·13; 95 % CI 0·98, 3·29). The intervention did not have an effect on body weight, appetite, physical functioning and quality of life. In conclusion, this intervention leads to improved nutritional status in older adults at risk of undernutrition, and to improved diet quality and physical activity levels of community-dwelling elderly. Future studies with a longer duration should focus on older adults at higher risk of undernutrition than this study population to investigate whether the impact of the intervention on nutritional and functional outcomes can be improved.

scholarly journals The effect of individualized, theory-based counselling intervention on active aging and quality of life among older people (the AGNES intervention study)

2020 ◽  
Vol 32 (10) ◽  
pp. 2081-2090 ◽  
Author(s):  
Taina Rantanen ◽  
Mary Hassandra ◽  
Katja Pynnönen ◽  
Sini Siltanen ◽  
Katja Kokko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intervention Group ◽  
Autonomous Motivation ◽  
Community Dwelling ◽  
Control Group ◽  
Active Aging ◽  
Active Life ◽  
Post Trial ◽  
Counselling Intervention

Abstract Background We define active aging as a striving for activities as per one’s goals, capacities and opportunities. Aim To test the 1-year counselling intervention effects on active aging. Methods In this two-arm single-blinded randomized controlled trial, the intervention group received individually tailored counselling supporting autonomous motivation for active life (one face-to-face session, four phone calls and supportive written material, n = 101) and the control group written health information (n = 103). Participants were community-dwelling men and women aged 75 or 80 years with intermediate mobility function and without cognitive impairment. The primary outcome was active aging total score measured with the University of Jyväskylä Active Aging Scale (UJACAS, range 0–272, higher values indicate more activity) and secondary outcomes were its subscores for goals, ability, opportunity and activity (range 0–68) and a quality of life (QoL) score. Measures took place at pre-trial, mid-trial (6 months) and post-trial (12 months), except for QoL only pre and post-trial. Data were analyzed with intention-to-treat principles using GEE-models. Results The UJACAS total score increased in the intervention group slightly more than in the control group (group by time p-value = 0.050, effect size 0.011, net benefit 2%), but the group effect was not statistically significant. A small effect was observed for the activity subscore (p = 0.007). Discussion The individualized counselling supporting autonomous motivation for active life increased the UJACAS score slightly. Conclusions It may be possible to promote active aging with individualized counselling, but the effect is small and it is unclear whether the change is meaningful.

scholarly journals “Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study

2021 ◽  
Vol 18 (18) ◽  
pp. 9514
Author(s):  
Shefaly Shorey ◽  
Ee Heok Kua ◽  
Wilson Tam ◽  
Valerie Chan ◽  
Yong Shian Goh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Pilot Study ◽  
Intervention Group ◽  
Well Being ◽  
Small Sample ◽  
Community Dwelling ◽  
Control Group ◽  
Community Dwelling Older Adults

In Singapore, many older adults suffer from subsyndromal depression and/or subsyndromal anxiety, which can negatively impact their physical and mental well-being if left untreated. Due to the general public’s reluctance to seek psychological help and the low psychiatrist-to-population ratio in Singapore, this study aims to examine the preliminary efficacy, perceptions, and acceptability of a trained volunteer-led community-based intervention on community-dwelling older adults. Twenty-one participants (control: n = 11; intervention: n = 10) completed the randomized pilot study. A mixed-methods approach (questionnaires, semistructured interviews, examining blood samples, intervention fidelity) was adopted. No significant differences were found between the intervention and the control groups in depression, anxiety, life satisfaction, friendship, and quality of life. However, there was a positive change in quality-of-life scores from baseline to 6 months in the intervention group. The control group had significantly higher cortisol levels and lower annexin-A1 levels at 6 months, while the intervention group did not. Three themes emerged from the interviews: (1) impact of the intervention on older adults’ well-being, (2) attitudes toward intervention, and (3) a way forward. However, intervention efficacy could not be established due to small sample size caused by the coronavirus pandemic. Future randomized controlled trials should evaluate volunteer-led, technology-based psychosocial interventions to support these older adults.

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