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Community Services for the Elderly

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121. Developing Pharmacist-led Research to Educate and Sensitive Community Residents to the Inappropriate Prescription Burden in the Elderly

Behavioral: Pharmacist-led educational intervention Phase 4 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 600 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single (Outcomes Assessor) Primary Purpose: Health Services Research Official Title: Developing Pharmacist-led Research to Educate and Sensitive Community Residents to the Inappropriate Prescription Burden in the Elderly Study Start Date (...) Developing Pharmacist-led Research to Educate and Sensitive Community Residents to the Inappropriate Prescription Burden in the Elderly A Trial to De-prescribe Inappropriate Medications in the Community Dwelling Elderly - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies

2014 Clinical Trials

122. Realigning training with need: A case for mandatory family medicine resident experience in community-based care of the frail elderly (PubMed)

Realigning training with need: A case for mandatory family medicine resident experience in community-based care of the frail elderly 25122807 2015 09 04 2018 11 13 1715-5258 60 8 2014 Aug Canadian family physician Medecin de famille canadien Can Fam Physician Realigning training with need: A case for mandatory family medicine resident experience in community-based care of the frail elderly. 697-9, 704-7 McGregor Margaret J MJ Clinical Associate Professor and Director of Community Geriatrics (...) in the Department of Family Practice at the University of British Columbia in Vancouver. mrgret@mail.ubc.ca. Sloan John J Physician for the Home ViVE (Visits to Vancouver's Elders) program and Clinical Professor in the Department of Family Practice at the University of British Columbia. eng fre Journal Article Canada Can Fam Physician 0120300 0008-350X IM Aged Aged, 80 and over Curriculum Family Practice education Frail Elderly Health Services Needs and Demand House Calls Humans Nursing Homes Population

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2014 Canadian Family Physician

123. Efficacy of Integrated Care to Reduce Hospitalization and Nursing Home Placement in Community Dwelling Frail Elderly

and Institutionalization in Community Dwelling Frail Elderly, With Care Coordination Between Physicians, Home Nursing Services and a Community Geriatrics Unit. Study Start Date : July 2009 Actual Primary Completion Date : December 2012 Actual Study Completion Date : December 2012 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment No Intervention: Control arm= usual care Two clusters of patients over 60 years of age followed by a primary (...) Efficacy of Integrated Care to Reduce Hospitalization and Nursing Home Placement in Community Dwelling Frail Elderly Efficacy of Integrated Care to Reduce Hospitalization and Nursing Home Placement in Community Dwelling Frail Elderly - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2014 Clinical Trials

124. The effectiveness of assertive community treatment for elderly patients with severe mental illness: a randomized controlled trial. (PubMed)

The effectiveness of assertive community treatment for elderly patients with severe mental illness: a randomized controlled trial. Due to fragmented mental, somatic, and social healthcare services, it can be hard to engage into care older patients with severe mental illness (SMI). In adult mental health care, assertive community treatment (ACT) is an organizational model of care for treating patients with SMI who are difficult to engage. So far all outcome studies of assertive community (...) of dropouts (i.e. those discharged from care due to refusing care or those who unintentionally lost contact with the service over a period of at least 3 months); and patients' psychosocial functioning (HoNOS65+ scores) during 18 months follow-up. Secondary outcomes included the number of unmet needs and mental health care use. Analyses were based on intention-to-treat.Of the 62 patients who were randomized, 26 were lost to follow-up (10 patients in ACT for elderly patients and 16 in TAU). Relative

2014 BMC Psychiatry Controlled trial quality: uncertain

125. The effectiveness of assertive community treatment for elderly patients with severe mental illness: a randomized controlled trial. (PubMed)

The effectiveness of assertive community treatment for elderly patients with severe mental illness: a randomized controlled trial. Due to fragmented mental, somatic, and social healthcare services, it can be hard to engage into care older patients with severe mental illness (SMI). In adult mental health care, assertive community treatment (ACT) is an organizational model of care for treating patients with SMI who are difficult to engage. So far all outcome studies of assertive community (...) of dropouts (i.e. those discharged from care due to refusing care or those who unintentionally lost contact with the service over a period of at least 3 months); and patients' psychosocial functioning (HoNOS65+ scores) during 18 months follow-up. Secondary outcomes included the number of unmet needs and mental health care use. Analyses were based on intention-to-treat.Of the 62 patients who were randomized, 26 were lost to follow-up (10 patients in ACT for elderly patients and 16 in TAU). Relative

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2014 BMC psychiatry Controlled trial quality: uncertain

126. Twelve-week physical and leisure activity programme improved cognitive function in community-dwelling elderly subjects: a randomized controlled trial. (PubMed)

Twelve-week physical and leisure activity programme improved cognitive function in community-dwelling elderly subjects: a randomized controlled trial. Japan is one of the most rapidly ageing societies in the world. A number of municipalities have started services for the prevention of cognitive decline for community-dwelling elderly individuals, but the effectiveness of these services is currently insufficient. Our study explored the efficacy of a comprehensive intervention programme consisting (...) of physical and leisure activities to prevent cognitive decline in community-dwelling elderly subjects.We administered a 12-week intervention programme consisting of physical and leisure activities aimed at enhancing participants' motivation to participate and support one another by providing a pleasant atmosphere, empathetic communication, praise, and errorless support. This programme for the prevention of cognitive decline was conducted as a service by the city of Maebashi. All participants underwent

2014 Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society Controlled trial quality: uncertain

127. Screening for cognitive impairment in older adults: a systematic review for the US Preventive Services Task Force

Screening for cognitive impairment in older adults: a systematic review for the US Preventive Services Task Force Screening for cognitive impairment in older adults: a systematic review for the US Preventive Services Task Force Screening for cognitive impairment in older adults: a systematic review for the US Preventive Services Task Force Lin JS, O'Connor E, Rossom RC, Perdue LA, Eckstrom E CRD summary Brief screening instruments for cognitive impairment can adequately detect dementia. Whether (...) any study (except case-control studies) that assessed a brief screening instrument for cognitive impairment (taking no more than 20 minutes to perform) in community dwelling older adults who were not selected for cognitive impairment. For intervention studies, any pharmacological, non-pharmacological or decision-making intervention in older adults with mild cognitive impairment or moderate dementia (excluding Parkinson dementia) was eligible. For efficacy, only randomised trials were considered

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2013 DARE.

128. Royal Flying Doctor Service Western Operations Clinical manual part 1.Clinical guidelines

doctor by telephone or aircraft radio. However, in the event that communication is not possible, these clinical guidelines should be used. Flight Nurses must always practise within the scope of RFDSWO Flight Nurse Competency Standards and RFDSWO Nursing Practice Standards. Emergency actions in accordance with these clinical guidelines that are within the scope of the individual’s medical or nursing practice, will be endorsed by the Director of Medical Services and the Director of Nursing and Primary (...) Royal Flying Doctor Service Western Operations Clinical manual part 1.Clinical guidelines Clinical Manual Part 1 Clinical Guidelines Version 6.0 January 2013 RFDS Western Operations Version 6.0 Clinical Manual Issue Date: January 2013 Part 1 - Clinical Guidelines Royal Flying Doctor Service Western Operations 3 Eagle Drive, Jandakot Airport, Western Australia 6164 T 61-8-9417 6300 F 61-8-9417 6319 E medical@rfdswa.com.au Clinical Manual - Part 1 - Clinical Guidelines Version 6.0 January 2013

2014 Clinical Practice Guidelines Portal

129. Home-Based Versus Centre-Based Rehabilitation for Community-Dwelling Postacute Stroke Patients: An Economic Rapid Review

with the most cost-effective stroke rehabilitation for a community-dwelling stroke population will be explored. Economically, for centre- based stroke rehabilitation, the maintenance of a facility dedicated to outpatient rehabilitation is an ongoing cost, and individuals post-stroke may experience mobility issues that may increase the cost of transportation to and from appointments. Increased costs for home-based rehabilitation include additional service by allied health practitioners and other home care (...) services. Home-Based Versus Centre-Based Rehabilitation for Community-Dwelling Postacute Stroke Patients: An Economic Rapid Review. February 2015; pp. 1–23 7 Rapid Review Research Question What is the cost per quality-adjusted life-year of centre-based rehabilitation (outpatient clinic or rehabilitation centre) compared to home-based rehabilitation for community-dwelling stroke patients discharged from hospital inpatient facility? Research Methods Literature Search A literature search was performed

2015 Health Quality Ontario

130. Improving antibiotic use in the community setting

in the community or outpatient setting to minimise inappropriate antibiotic use. The Australian National Prescribing Service (NPS) has previously evaluated interventions to reduce the prescribing and requests for antibiotics for upper respiratory tract infections (3). This evaluation found consistent, modest behavioural changes. The current review was commissioned to evaluate any similar successful or otherwise interventions in urinary tract infections (UTI), skin infections (DI [dermatological infections (...) perceptions as a major factor. These could be the perception that AMR is not a serious problem 4 , reluctance to change a successful regimen 7 , or tailoring therapy to perceived patient needs/behaviours. 10,11 19 IMPROVING ANTIBIOTIC USE IN THE COMMUNITY SETTING | SAX INSTITUTE Table 6: Summary of results relating to urinary tract infections in elderly populations Source & Evidence type Study type/ method Population/ setting Intervention/outcome measure Brief findings Pettersson E, et al. 2011, Sweden

2015 Sax Institute Evidence Check

131. Evaluation of the implementation of a clinical pharmacy service on an acute internal medicine ward in Italy. (PubMed)

pharmacists and the rest of the healthcare team. The objective of this study was to evaluate the effect of a structured communication strategy on acceptance rate of interventions made by a clinical pharmacist implementing a ward-based clinical pharmacy service targeting elderly patients at high risk of drug-related problems. Characteristics of interventions made to improve appropriateness of prescribing, their clinical significance and intervention acceptance rate by doctors were recorded.A clinical (...) Evaluation of the implementation of a clinical pharmacy service on an acute internal medicine ward in Italy. Successful implementation of clinical pharmacy services is associated with improvement of appropriateness of prescribing. Both high clinical significance of pharmacist interventions and their high acceptance rate mean that potential harm to patients could be avoided. Evidence shows that low acceptance rate of pharmacist interventions can be associated with lack of communication between

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2018 BMC health services research

132. The effect of informal caregiver support on utilization of acute health services among home care clients: a prospective observational study. (PubMed)

, health service use by elderly patients, which may have implications for health care providers. (...) The effect of informal caregiver support on utilization of acute health services among home care clients: a prospective observational study. Emergency department visits and hospitalizations (EDVH) place a large burden on patients and the health care system. The presence of informal caregivers may be beneficial for reducing EDVH among patients with specific diagnoses. Our objective was to determine whether the presence of an informal caregiver was associated with the occurrence of an EDVH among

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2018 BMC health services research

133. Ambulatory Care Services for Patients with Chronic Heart Failure in Newfoundland and Labrador

to the effectiveness of health and community services in Newfoundland and Labrador and to the physical, social, and psychological wellbeing of its population. NLCAHR accomplishes this mandate by building capacity in applied health research, supporting high- quality research, and fostering the effective use of research evidence by decision makers and policy makers in the provincial healthcare system. Rapid Evidence Reports NLCAHR designed Rapid Evidence Reports to provide support for evidence-based decision making (...) in brief. Geography and Service Landscape Perhaps the most salient contextual issue confronting Newfoundland and Labrador is the dispersal of its healthcare facilities over a vast terrain. The Central Health Region, for instance, extends from Charlottetown in the east to the Baie Verte Peninsula in the west, and from Fogo Island in the north to Harbour Breton in the south. Urban areas such as Gander, Grand Falls-Windsor, and Lewisporte are readily accessible, but a number of the more remote communities

2013 Newfoundland and Labrador Centre for Health Information

134. What is the perfect fee-for-service system?

. The reality is that high-volume care can be good for patients. Some very challenging patients benefit from being seen frequently. While there are healthy patients for whom an annual physical would suffice, there are also elderly diabetics or patients with severe congestive heart failure that sometimes need to be seen every week. Fee-for-service payments encourage such high-volume care when it is appropriate. Similarly, patients benefit when their physicians make same-day appointments available for them (...) What is the perfect fee-for-service system? What is the perfect fee-for-service system? What is the perfect fee-for-service system? | | March 29, 2018 57 Shares It is wildly popular to say that the chief culprit in the U.S. health care system is the traditional fee-for-service payment system, which rewards physicians for volume but not quality, leading to high-cost, low-quality health care. It supposedly follows that the fix is a system of “value-based” payments. Despite the popularity

2018 KevinMD blog

135. Evaluating the impact of a home-based rehabilitation service on older people and their caregivers: a matched-control quasi-experimental study (PubMed)

Evaluating the impact of a home-based rehabilitation service on older people and their caregivers: a matched-control quasi-experimental study Previous studies evaluating home-based rehabilitation service (HBRS) merely focused on the period immediately after the patients' discharge from hospitals. The present study focuses on HBRS that covers clients who have not been recently hospitalized. HBRS aims to meet older clients' rehabilitation needs and support their caregivers in the community (...) . This study intended to evaluate the impact of HBRS on the older clients' health outcomes and hospital services utilization, and caregivers' strain in providing care for clients.This study used a matched-control quasi-experimental design with a 3-month follow-up to evaluate HBRS. The health outcome measures used for the older clients included Elderly Mobility Scale, Timed Up and Go test, Modified Barthel Index, Lawton's Instrumental Activities of Daily Living Scale, Mini-Mental State Examination

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2018 Clinical interventions in aging

136. 'Suicide rates in Crete, Greece during the economic crisis: the effect of age, gender, unemployment and mental health service provision'. (PubMed)

during the years of austerity. This may be related to the culturally different expectations for the two genders, as well as that younger individuals may find refuge to either strong family ties or by immigrating abroad. Finally, the relative increase of suicides in Eastern Crete may be explained by factors, such as the lack of community mental health services in that area. (...) 'Suicide rates in Crete, Greece during the economic crisis: the effect of age, gender, unemployment and mental health service provision'. Recently, suicides in Greece have drawn national and international interest due to the current economic crisis. According to published reports, suicides in Greece have increased up to 40% and Crete has been highlighted as an area with the sharpest increase.To investigate the suicide mortality rates in Crete between 1999 and 2013 and their association

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2018 BMC Psychiatry

137. Comparison of access to health services among urban-to-urban and rural-to-urban older migrants, and urban and rural older permanent residents in Zhejiang Province, China: a cross-sectional survey. (PubMed)

of these four groups to health services in Zhejiang Province, China and provide an evidence for the development of health services policies.A cross-sectional survey was conducted in community-dwelling older adults (aged 60 years or above) in 2013. Participants were recruited by random sampling. Demographic information and access to health services for the elderly populations were obtained via interviews using a self-designed structured questionnaire. Pearson's chi-square tests and Cochran-Mantel-Haenszel (...) Comparison of access to health services among urban-to-urban and rural-to-urban older migrants, and urban and rural older permanent residents in Zhejiang Province, China: a cross-sectional survey. While much literature reported the access of Chinese older migrants to health services, little was known about the differences among sub-groups of older adults, including urban-to-urban and rural-to-urban migrants, and urban and rural permanent residents. This study aimed to examine the access

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2018 BMC Geriatrics

138. Rehabilitation Services Use of Older Adults According to Fall-Risk Screening Guidelines. (PubMed)

Rehabilitation Services Use of Older Adults According to Fall-Risk Screening Guidelines. To characterize rehabilitation services use of older adults according to fall-risk classification based on screening guidelines.Cross-sectional analysis of 2015 National Health and Aging Trends Study.Study participants' homes.National sample of 7,440 community-dwelling Medicare beneficiaries.In-person interviews and functional assessments. Based on Centers for Disease Control and Prevention Stopping Elderly (...) Accidents, Deaths and Injuries criteria, participants were classified as low, moderate, or high fall risk.Twenty-three percent of older adults classified as moderate fall-risk (n = 2602) and 40.6% of those at high fall-risk (n = 940) reported rehabilitation services use in the past year. Among older adults who reported rehabilitation services in the past year (n = 1,505), treatment to address falls was reported by 2.8%, 12.6%, and 34.7% of those classified with low, moderate, and high fall-risk

2018 Journal of the American Geriatrics Society

139. Management of Hip Fractures in the Elderly

Management of Hip Fractures in the Elderly MANAGEMENT OF HIP FRACTURES IN THE ELDERLY EVIDENCE- BASED CLINICAL PRACTICE GUIDELINE Adopted by the American Academy of Orthopaedic Surgeons Board of Directors September 5, 2014 This Guideline has been endorsed by the following organizations: 2 Disclaimer This Clinical Practice Guideline was developed by an AAOS physician volunteer Work Group based on a systematic review of the current scientific and clinical information and accepted approaches (...) Fractures in the Elderly. All readers of this summary are strongly urged to consult the full guideline and evidence report for this information. We are confident that those who read the full guideline and evidence report will see that the recommendations were developed using systematic evidence-based processes designed to combat bias, enhance transparency, and promote reproducibility. This summary of recommendations is not intended to stand alone. Treatment decisions should be made in light of all

2014 American Academy of Orthopaedic Surgeons

140. Peri-operative Care of the Elderly

-operative care are to treat elderly patients in a timely, digni?ed manner, and to optimise reha- bilitation by avoiding postoperative complications. Effective peri-operative care improves the likelihood of very elderly surgical patients returning to their same pre-morbid place of residence, and maintains the continuity of their community care when in hospital. 6 Postoperative delirium is common, but underdiagnosed, in elderly surgical patients, and delays rehabilitation. Multimodal intervention (...) strategies are recommended for preventing postoperative delirium. 7 Peri-operative pain is common, but underappreciated, in elderly surgical patients, particularly if they are cogni- tively impaired. Anaesthetists should administer opioid-sparing analgesia where possible, and follow published guidance on the management of pain in older people. 8 Elderly patients should be assumed to have the mental capacity to make decisions about their treatment. Good communication is essential to this process

2014 Association of Anaesthetists of GB and Ireland

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