| 1. |
- Dent, Elsa, et al.
(author)
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Recent developments in frailty identification, management, risk factors and prevention : A narrative review of leading journals in geriatrics and gerontology
- 2023
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In: Ageing Research Reviews. - 1568-1637 .- 1872-9649. ; 91
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Research review (peer-reviewed)abstract
- Frailty is an age-related clinical condition characterised by an increased susceptibility to stressors and an elevated risk of adverse outcomes such as mortality. In the light of global population ageing, the prevalence of frailty is expected to soar in coming decades. This narrative review provides critical insights into recent developments and emerging practices in frailty research regarding identification, management, risk factors, and prevention. We searched journals in the top two quartiles of geriatrics and gerontology (from Clarivate Journal Citation Reports) for articles published between 01 January 2018 and 20 December 2022. Several recent developments were identified, including new biomarkers and biomarker panels for frailty screening and diagnosis, using artificial intelligence to identify frailty, and investigating the altered response to medications by older adults with frailty. Other areas with novel developments included exercise (including technology-based exercise), multidimensional interventions, person-centred and integrated care, assistive technologies, analysis of frailty transitions, risk-factors, clinical guidelines, COVID-19, and potential future treatments. This review identified a strong need for the implementation and evaluation of cost-effective, community-based interventions to manage and prevent frailty. Our findings highlight the need to better identify and support older adults with frailty and involve those with frailty in shared decision-making regarding their care.
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| 2. |
- Wimmer, Barbara C., et al.
(author)
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Medication Regimen Complexity and Unplanned Hospital Readmissions in Older People
- 2014
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In: The Annals of Pharmacotherapy. - : SAGE Publications. - 1060-0280 .- 1542-6270. ; 48:9, s. 1120-1128
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Journal article (peer-reviewed)abstract
- Background: Medication-related problems and adverse drug events are leading causes of preventable hospitalizations. Few previous studies have investigated the possible association between medication regimen complexity and unplanned rehospitalization. Objective: To investigate the association between discharge medication regimen complexity and unplanned rehospitalization over a I 2-month period. Method: The prospective study comprised patients aged >= 70 years old consecutively admitted to a Geriatrics Evaluation and Management (GEM) unit between October 2010 and December 2011. Medication regimen complexity at discharge was calculated using the 65-item validated Medication Regimen Complexity Index (MRCI). Cox proportional-hazards regression was used to compute unadjusted and adjusted hazard ratios (HRs) with 95% CIs for factors associated with rehospitalization over a 12-month follow-up period. Result: Of 163 eligible patients, 99 patients had one or more unplanned hospital readmissions. When adjusting for age, sex, activities of daily living, depression, comorbidity, cognitive status, and discharge destination, MRCI (HR = 1.01; 95% CI = 0.81-1.2), number of discharge medications (HR = 1.01; 95% CI = 0.94-1.08), and polypharnnacy (>= 9 medications; HR = 1.12; 95% CI = 0.69-1.80) were not associated with rehospitalization. In patients discharged to nonhome settings, there was an association between rehospitalization and the number of discharge medications (HR = 1.12; 95% CI = 1.01-1.25) and polypharmacy (HR = 2.24; 95% CI = 1.02-4.94) but not between rehospitalization and MRCI (HR = 1.32; 95% CI = 0.98-1.78). Conclusion: Medication regimen complexity was not associated with unplanned hospital readmission in older people. However, in patients discharged to nonhonne settings, the number of discharge medications and polypharmacy predicted rehospitalization. A patient's discharge destination is an important factor in unplanned medication-related readmissions.
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| 3. |
- Wimmer, Barbara Caecilia, et al.
(author)
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Polypharmacy and Medication Regimen Complexity as Factors Associated with Hospital Discharge Destination Among Older People : A Prospective Cohort Study
- 2014
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In: Drugs & Aging. - : Springer Science and Business Media LLC. - 1170-229X .- 1179-1969. ; 31:8, s. 623-630
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Journal article (peer-reviewed)abstract
- Background Older people often take multiple medications. It is a policy priority to facilitate older people to stay at home longer. Three-quarters of nursing home placements in the US are preceded by a hospitalization. Objective To investigate the association between polypharmacy and medication regimen complexity with hospital discharge destination among older people. Methods This prospective cohort study comprised patients aged >= 70 years consecutively admitted to the Geriatric Evaluation and Management unit at a tertiary hospital in Adelaide, Australia, between October 2010 and December 2011. Medication regimen complexity at discharge was calculated using the 65-item validated Medication Regimen Complexity Index (MRCI). Unadjusted and adjusted relative risks (RRs) with 95 % confidence intervals (CIs) were calculated for medication-related factors associated with discharge directly to home versus non-community settings (rehabilitation, transition care, and residential aged care). Results From 163 eligible patients, 87 were discharged directly to home (mean age 84.6 years, standard deviation [SD] 6.9; mean MRCI 26.1, SD 9.7), while 76 were discharged to non-community settings (mean age 85.8 years, SD 5.8; mean MRCI 29.9, SD 13.2). After adjusting for age, sex, comorbidity, and activities of daily living, having a high medication regimen complexity (MRCI > 35) was inversely associated with discharge directly to home (RR 0.39; 95 % CI 0.20-0.73), whereas polypharmacy (>= 9 medications) was not significantly associated with discharge directly to home (RR 0.97; 95 % CI 0.53-1.58). Conclusion Having high medication regimen complexity was inversely associated with discharge directly to home, while polypharmacy was not associated with discharge destination.
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