scholarly journals Identification of potentially inappropriate medications with risk of major adverse cardiac and cerebrovascular events among elderly patients in ambulatory setting and long-term care facilities

2019 ◽  
Vol Volume 14 ◽  
pp. 535-547 ◽  
Author(s):  
João Pedro Aguiar ◽  
Luís Heitor Costa ◽  
Filipa Alves da Costa ◽  
Hubert GM Leufkens ◽  
Ana Paula Martins
Keyword(s):  
Elderly Patients ◽  
Long Term Care ◽  
Ambulatory Setting ◽  
Potentially Inappropriate Medications ◽  
Term Care ◽  
Cerebrovascular Events ◽  
Care Facilities ◽  
Inappropriate Medications

Polypharmacy and use of potentially inappropriate medications in long-term care facilities: does coordinated primary care make a difference?

2017 ◽  
Vol 26 (4) ◽  
pp. 318-324 ◽  
Author(s):  
Melissa K. Andrew ◽  
Chad A. Purcell ◽  
Emily G. Marshall ◽  
Nirupa Varatharasan ◽  
Barry Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Long Term Care ◽  
Potentially Inappropriate Medications ◽  
Term Care ◽  
Care Facilities ◽  
Inappropriate Medications

Opinions of Dentists on the Treatment of Elderly Patients in Long-term Care Facilities

1992 ◽  
Vol 52 (4) ◽  
pp. 239-244 ◽  
Author(s):  
Michael I. MacEntee ◽  
Rachel T. Weiss ◽  
Nancy E. Waxier-Morrison ◽  
Brenda J. Morrison
Keyword(s):  
Elderly Patients ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities

scholarly journals Vitamin D Supplementation for the Prevention of Falls and Fractures in Residents of Long-Term Care Facilities: A 2021 Update

2021 ◽  
Vol 1 (7) ◽  
Author(s):  
Srabani Banerjee ◽  
Holly Gunn ◽  
Carolyn Spry
Keyword(s):  
Vitamin D ◽  
Elderly Patients ◽  
Systematic Reviews ◽  
Long Term Care ◽  
Vitamin D Supplementation ◽  
Term Care ◽  
Care Facilities ◽  
Overview Of Systematic Reviews ◽  
Evidence Based Guidelines

The relevant publications identified comprised 1 overview of systematic reviews and 2 systematic reviews. There is a suggestion that for seniors living in long-term care facilities, compared to control, vitamin D supplementation, with or without calcium, may reduce the rate of falls and fractures; however, the reductions were not always statistically significant. There were no statistically significant differences in the number of seniors who fell with vitamin D supplementation, with or without calcium, compared with control groups. Findings need to be interpreted with caution, considering the limitations such as primary studies of variable quality (critically low to moderate) and lack of clarity with respect to the type of long-term care setting. No cost-effectiveness studies regarding vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities were identified. No evidence-based guidelines regarding vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities were identified.

Management of COVID-19 very elderly patients in Nursing Homes and Long-Term Care Facilities: Description of a new model and experience in a medicalized Nursing Home

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Ignacio Novo-Veleiro ◽  
Martín Vidal-Vazquez ◽  
Néstor Vázquez-Agra ◽  
Eduardo-David Otero Rodríguez ◽  
Paula Andújar-Plata ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Elderly Patients ◽  
Long Term Care ◽  
Descriptive Analysis ◽  
Very Elderly ◽  
Term Care ◽  
Duration Of Symptoms ◽  
Care Facilities ◽  
Pcr Test

Introduction: COVID-19 have been a challenge for healthcare, mainly in elderly patients in Nursing Homes (NHs) and Long-Term Care Facilities (LTCFs). We present a pioneering novel experience in addressing healthcare of very elderly patients with COVID-19 in these facilities by a reconversion of a NH in a medicalized NH. Methods: All patients admitted to the center were included, recording clinical and epidemiological variables. We conducted a descriptive analysis and a multivariate analysis to identify variables linked to mortality and persistence of positive PCR test. Results: we included 84 patients (40% men), women presented more symptomatology. We found a positive correlation between the duration of symptoms and the days required to obtain a negative PCR test (r=0.512, P<0.001). We also found an independent and significative association between asthenia (OR=2.58; IC95% 1.22–5.46) and mutism (OR=5.21; IC95% 1.58–17.15) and a longer time to achieve a negative PCR test. All patients, except contraindication, were treated with hydroxychloroquine and azithromycin, which was the recommended treatment during the period of the study. The early start of corticoid treatment (within the first 72 hours since the start of symptoms) was linked to a lower mortality in patients with moderate-severe symptoms. Mortality was lower than expected (which was higher than 20% in that period and group of age), reaching 14%, the main factors linked to mortality were the presence of mutism (OR=19; IC95% 3.4–108; P=0.001) and dyspnea (OR=12; IC95% 1.3–111; P=0.029). Conclusions: We present an alternative system for the care of these patients through the reconversion of a basic NH in a medicalized one, which showed a significant reduction in the expected mortality.

A New Care Model Reduces Polypharmacy and Potentially Inappropriate Medications in Long-Term Care

2021 ◽  
Vol 22 (1) ◽  
pp. 141-147 ◽  
Author(s):  
Carolina Tisnado Garland ◽  
Line Guénette ◽  
Edeltraut Kröger ◽  
Pierre-Hugues Carmichael ◽  
Rachel Rouleau ◽  
...  
Keyword(s):  
Long Term Care ◽  
Potentially Inappropriate Medications ◽  
Care Model ◽  
Term Care ◽  
Inappropriate Medications

Existing Warfarin Therapy in Long-Term Care Facilities Maybe Inadequate.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4160-4160
Author(s):  
Bahareh Motlagh ◽  
Madeleine M. Verhovsek ◽  
Alexandra Papaioannou ◽  
Crowther Mark ◽  
Lisa Dolovich ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Patients ◽  
Warfarin Therapy ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Increased Risk ◽  
Dosing Algorithm ◽  
Care Facilities

Abstract Despite evidence-based guidelines derived from large clinical trials supporting the use of warfarin for stroke prophylaxis, studies in elderly patients have shown that oral anticoagulants are not used optimally. The risk associated with inappropriate use is compounded by the observation that the elderly are at enhanced risk of thromboembolic complications compared with younger atrial fibrillation patients. All patients with atrial fibrillation who do not have a contraindication to warfarin, and who meet inclusion criteria, should be treated with warfarin to achieve a target International Normalized Range (INR) of 2.5 (range 2.0–3.0). INR levels of 2.0–3.0 have been shown to be relatively safe and more efficacious than lower target INR values in all age groups including the elderly. Patients with INR values below this range remain at increased risk of thrombosis, while those with INR values above the given range are at increased risk of bleeding. The primary objective of this study was to determine the achieved intensity of warfarin therapy in a cohort of patients living at long-term care facility. In such facilities optimal anticoagulation should be achievable, since laboratory monitoring, dose adjustment, and compliance can be achieved. In this study, data were collected on physicians’ warfarin prescribing practices as well as INR levels of 108 residents in five long-term care facilities in the Hamilton-Wentworth area over a period of 12 months. In total, 3146 INR values, extending over 28,256 patient-days of monitoring, were analyzed. Indications for warfarin were atrial fibrillation, transient ischemic attack, pulmonary embolus, cardiac valve replacement, myocardial infarction, and deep vein thrombosis. In general, the warfarin dosage was not determined using an established dosing algorithm. Our findings revealed that LTC residents spent approximately 40 percent of the time with INR values below 2.0. We therefore conclude, that the overall quality of anticoagulant therapy in long-term care patients may be inadequate. Our observations suggest that organized dosing algorithms may be of benefit in such settings, however this hypothesis needs to be confirmed in prospective studies. For this purpose we plan to implement a warfarin dosing algorithm in order to determine whether the percentage of time spent within the therapeutic INR range can be improved.

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