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Preventing Adverse Events in Hospitalized Elderly

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1. Tiotropium (Spiriva Respimat) add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma

in the tiotropium and placebo arms (26 patients [5.7%] versus 21 patients [4.6%]) 1,15 . Serious adverse events were reported for 37 patients (8.1%) in the tiotropium arm and 40 patients (8.8%) in the placebo arm. Three events in the tiotropium arm were considered to be life-threatening: two patients had asthma exacerbations and fully recovered, and one patient was admitted to hospital for cerebral infarction 1,15 . The most frequent serious adverse events by system organ class in either arm were respiratory (...) as a score = 1.0 to < 1.5, and uncontrolled asthma as a score = 1.5. Exacerbations are defined in the phase III studies, and are categorised as non-severe, severe (requiring initiation or doubling of the existing dose of systemic corticosteroids for at least three days) without hospitalisation, and severe with hospitalisation 1 . Adverse events are excluded on the basis they did not differ significantly between tiotropium and placebo, and as no deaths were recorded in the phase III studies, the base case

2018 All Wales Medicines Strategy Group

2. Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal Full Text available with Trip Pro

data linked to hospital discharge data) assessing older inpatient safety related to anticoagulation in both Switzerland and France, and enabling comparisons across time and among hospitals, health territories, and countries. Geriatric patient safety indicators (GPSIs) will assess anticoagulant-related adverse events. Geriatric quality indicators (GQIs) will evaluate the management of anticoagulants for the prevention and treatment of arterial or venous thromboembolism in older inpatients.GPSIs (...) Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing

2017 JMIR Research Protocols

3. Causality and preventability assessment of adverse drug reactions and adverse drug events of antibiotics among hospitalized patients: A multicenter, cross-sectional study in Lahore, Pakistan. Full Text available with Trip Pro

Causality and preventability assessment of adverse drug reactions and adverse drug events of antibiotics among hospitalized patients: A multicenter, cross-sectional study in Lahore, Pakistan. Adverse drug events (ADEs) are the fifth leading cause of death and thus responsible for a large number of hospital admissions in all over the globe. This study was aimed to assess the antibiotics associated preventability of ADEs and causality of adverse drug reactions (ADRs) among hospitalized patients.A (...) prospective, cross-sectional, observational study was conducted in four tertiary care public sector hospitals of Lahore, Pakistan. Study population consisted of hospitalized patients who were prescribed with one or more antibiotics. Data were collected between 1st January, 2017 and 31st June, 2017 from 1,249 patients (384 patients aged ≤ 18 years and 865 patients aged >18 years). Schumock and Thornton scale was used to assess the preventability of the ADEs. Medication errors (MEs) that caused preventable

2018 PLoS ONE

4. Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline from the American College of Physicians and the American Academy of Family Physicians Full Text available with Trip Pro

( , ). A subgroup analysis of SPRINT showed a nonstatistically significant increase in the rate of serious adverse events, hypotension, syncope, electrolyte abnormalities, or acute kidney injury in patients aged 75 years or older who were treated to SBP targets less than 120 mm Hg versus SBP targets less than 140 mm Hg ( ). Although electrolyte disturbances are a common adverse effect of hypertension treatment in clinical practice, data were not presented on these abnormalities in the evidence review. Drugs (...) to treat hypertension have well-known adverse effects, including hypokalemia, hyperkalemia, hyponatremia, hypotension, dizziness, headache, edema, erectile dysfunction, and cough. Effect of Age Low-quality evidence showed no difference in adverse events, including unsteadiness, dizziness, and renal failure, in patients younger or older than 75 years ( , , ). Effect of Multiple Chronic Conditions No trials assessed the effect of comorbid conditions on harms. Recommendations The summarizes

2017 American College of Physicians

5. Use of multiple micronutrient powders for point-of-use fortification of foods consumed by infants and young children aged 6?23 months and children aged 2?12 years

and then have timely introduction of adequate and safe complementary foods, while continuing breastfeeding up to 2 years of age (23). Several countries are implementing or planning to implement point-of-use fortification programmes that provide multiple micronutrient powders to infants older than 6 months of age and children up to 12 years of age (24). Countries should have a national strategy for control and prevention of micronutrient deficiency. For the specific case of prevention and control of iron (...) with the reader. In no event shall WHO be liable for damages arising from its use. Design and layout: Alberto March (Barcelona, Spain). Cover photo by Nicole Rodriguez Neufeld and Alberto March. Baby’s model: Jason Kamperis. SUGGESTED CITATION: WHO guideline: Use of multiple micronutrient powders for point-of-use fortification of foods consumed by infants and young children aged 6–23 months and children aged 2–12 years. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO.v WHO guideline: Use

2017 World Health Organisation Guidelines

6. Age-related macular degeneration

people are diagnosed and treated to prevent loss of sight. Who is it for? Healthcare professionals in primary and secondary care Social care professionals Commissioners and providers of ophthalmic and optometric services People with age-related macular degeneration, their families and carers Age-related macular degeneration (NG82) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 24Recommendations Recommendations (...) priorities when making management decisions. 1.2.5 Promote peer support for people with AMD, particularly for people who are beginning intravitreal injections, who may be reassured by discussion with someone who has previously had the same treatment. 1.3 Risk factors 1.3.1 If you suspect AMD, recognise that the following risk factors make it more likely that the person has AMD: older age presence of AMD in the other eye family history of AMD smoking hypertension BMI of 30 kg/m 2 or higher diet low

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

7. Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions. (Abstract)

Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions. A systematic review found that 3% of working adults who had received influenza vaccine and 5% of those who were unvaccinated had laboratory-proven influenza per season; in healthcare workers (HCWs) these percentages were 5% and 8% respectively. Healthcare workers may transmit influenza to patients.To identify all randomised controlled trials (RCTs) and non-RCTs assessing (...) the effects of vaccinating healthcare workers on the incidence of laboratory-proven influenza, pneumonia, death from pneumonia and admission to hospital for respiratory illness in those aged 60 years or older resident in long-term care institutions (LTCIs).We searched CENTRAL (2015, Issue 9), MEDLINE (1966 to October week 3, 2015), EMBASE (1974 to October 2015) and Web of Science (2006 to October 2015), but Biological Abstracts only from 1969 to March 2013 and Science Citation Index-Expanded from 1974

2016 Cochrane

8. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

, American Academy of Physician Assistants (AAPA), Association of Black Cardiologists (ABC), American College of Preventive Medicine (ACPM), American Geriatrics Society (AGS), American Pharmacists Association (APhA), American Society of Hypertension (ASH), American Society for Preventive Cardiology (ASPC), National Medical Association (NMA), and Preventive Cardiovascular Nurses Association (PCNA). 1.3. Document Review and Approval This document was reviewed by 2 official reviewers nominated by the ACC (...) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines | Hypertension Search Hello Guest! Login to your account Email Password

2017 American Heart Association

9. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary Full Text available with Trip Pro

, a nephrologist, a neurologist, a nurse, a pharmacist, a physician assistant, and 2 lay/patient representatives. It included representatives from the ACC, AHA, American Academy of Physician Assistants (AAPA), Association of Black Cardiologists (ABC), American College of Preventive Medicine (ACPM), American Geriatrics Society (AGS), American Pharmacists Association (APhA), American Society of Hypertension (ASH), American Society for Preventive Cardiology (ASPC), National Medical Association (NMA (...) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines | Hypertension Search Hello Guest

2017 American Heart Association

10. Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia

studies used multidomain interventions, and potentially none have explored the possibility of cumulative or synergistic effects. Timing and measurement choices affect cognitive decline prevention studies. Researchers can recruit participants at any point along the cognitive continuum. Various proposed strategies target young and middle-aged adults with no evidence of cognitive decline, older adults worried about age-related changes, people with documented MCI, and those with major neurocognitive (...) , physical exercise, cardiovascular and other medications, diets, and ES-2 nutraceuticals (products derived from food sources that are purported to provide extra health benefits). Preventive efforts can target people with any level of cognitive function, from normal, to age-related cognitive decline, to MCI, and finally, to dementia. Research participants seeking to slow or prevent age-related cognitive decline, MCI, and CATD may have more than one risk factor. CATD may result from cumulative

2017 Effective Health Care Program (AHRQ)

11. Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia

studies used multidomain interventions, and potentially none have explored the possibility of cumulative or synergistic effects. Timing and measurement choices affect cognitive decline prevention studies. Researchers can recruit participants at any point along the cognitive continuum. Various proposed strategies target young and middle-aged adults with no evidence of cognitive decline, older adults worried about age-related changes, people with documented MCI, and those with major neurocognitive (...) , physical exercise, cardiovascular and other medications, diets, and ES-2 nutraceuticals (products derived from food sources that are purported to provide extra health benefits). Preventive efforts can target people with any level of cognitive function, from normal, to age-related cognitive decline, to MCI, and finally, to dementia. Research participants seeking to slow or prevent age-related cognitive decline, MCI, and CATD may have more than one risk factor. CATD may result from cumulative

2017 Effective Health Care Program (AHRQ)

12. Interventions for preventing falls in older people in care facilities and hospitals. Full Text available with Trip Pro

Interventions for preventing falls in older people in care facilities and hospitals. Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012.To assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals.We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (...) (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017.Randomised controlled trials of interventions for preventing falls in older people in residential or nursing care facilities, or hospitals.One review author screened abstracts; two review authors screened full-text articles for inclusion. Two review authors independently performed study selection, 'Risk of bias' assessment and data extraction. We calculated rate

2018 Cochrane

13. Productive healthy ageing: interventions for quality of life

. In around 5% of cases a fall leads to a fracture and hospitalisation, which is costly to the health service, as well as distressing for the patient. 2 There are around 255,000 falls-related emergency hospital admissions per year for older people in England and the annual cost of hip fractures to the United Kingdom (UK) is estimated at being around £2 billion. 2 Pharmacy teams are in a good position to provide consistent and effective advice to reduce falls and fracture risk factors in the ageing (...) ageing. For example, supporting older people and their carers to prevent or reduce falls, increasing levels of physical activity, maintaining a healthy weight, reducing the risk of social isolation and loneliness, reducing the risk of dementia, supporting people diagnosed with dementia, delaying the progress of dementia and reducing the need for medicines. This is a menu of interventions that could be undertaken by pharmacy teams in the different sectors. It is recognised that not all pharmacy teams

2019 Public Health England

14. Antibiotics for preventing lower respiratory tract infections in high-risk children aged 12 years and under. (Abstract)

infections in high-risk children aged 12 years and under. We used a combination of the Centers for Disease Control and Prevention (CDC), National Health Service (NHS), American Academy of Paediatrics (AAP) and National Institute for Health and Care Excellence (NICE) guidelines to define conditions at higher risk of complications. Our primary outcome was the incidence of bacterial lower respiratory infections. Secondary outcomes included clinical function, hospital admission, mortality, growth, use (...) ). There was no significant effect on mortality with co-trimoxazole or isoniazid prophylaxis (RR 0.82, 0.46 to 1.46, I(2) statistic = 76%, P value = 0.58); however, analysis of one study that used co-trimoxazole showed a significant reduction in mortality (RR 0.67, 95% CI 0.53 to 0.85, P value = 0.001). There was a significant decrease in the rates of hospital admission per child-year of follow-up with co-trimoxazole prophylaxis in one study (P value = 0.01). There was no evidence of increased adverse events due

2015 Cochrane

15. An update to the Greig Health Record: Preventive health care visits for children and adolescents aged 6 to 17 years ? Technical report

An update to the Greig Health Record: Preventive health care visits for children and adolescents aged 6 to 17 years ? Technical report An update to the Greig Health Record: Preventive health care visits for children and adolescents aged 6 to 17 years – Technical report | Canadian Paediatric Society CPS In this section Protecting and promoting the health and well-being of children and youth CPS Policy & Advocacy Clinical Practice Education & Events News & Publications Programs Membership About (...) for sexual activity In Canada, the criminal code defines the age of consent for sexual activity as 16 years for non-exploitative activity and as 18 years for situations involving prostitution, pornography or in relationships where there is a difference in authority or dependence. There are close-in-age exceptions. For 14- or 15- year-olds, the relationship must be non-exploitative and the partner must be < 5 years older. For 12- and 13-year-olds, the partner must be < 2 years older. For details, see

2016 Canadian Paediatric Society

16. Preventing Adverse Events in Hospitalized Elderly

Administration 4 Preventing Adverse Events in Hospitalized Elderly Preventing Adverse Events in Hospitalized Elderly Aka: Preventing Adverse Events in Hospitalized Elderly , Geriatric Emergency Care , Acute Care in Older Adults From Related Chapters II. Epidemiology Adverse events occur in 6% of hospitalized patients over age 65 Twice the rate of all patients Adverse events in the hospitalized elderly Drug event (15%) (13-23%) Functional loss (33%) (9-56%) (75%) Hospital Infections ( , s) III. Precautions (...) Pharmacy medication reconciliation and review adverse medication risks ( , , ) Social workers and case managers Physical therapists IX. References AA Borrud (Fall, 2005) Mayo Geriatric Update Lecture Cimino-Fiallos and Khoujas (2018) Crit Dec Emerg Med 12(9): 3-11 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Preventing Adverse Events in Hospitalized Elderly." Click on the image (or right click) to open the source website in a new

2018 FP Notebook

17. Practice Advisory: Management of Pregnant and Reproductive-Aged Women during a Measles Outbreak

persons are at increased risk of severe illness and complications of measles 2 . The two-dose series of the measles-mumps-rubella (MMR) vaccine is safe and is 97% effective at preventing measles infection 2 . Measles Infection during Pregnancy Measles infection in pregnant women is associated with several adverse events including increased risk of hospitalization and pneumonia 3 . Measles infection during pregnancy is also associated with significant risks to the fetus 4-6 , including: Miscarriage (...) are currently experiencing. Measles is highly contagious. An estimated 92-95% of individuals in a community must be immune to prevent ongoing transmission. Measles can cause serious illness and infects approximately nine out of every ten susceptible individuals exposed in close-contact settings 2 . Anyone who is unvaccinated or is undervaccinated is at risk. Certain individuals, including unvaccinated and undervaccinated pregnant women, infants 12 months of age or younger, and severely immunocompromised

2019 American College of Obstetricians and Gynecologists

18. Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

First Street, NE, Washington, DC 20002-4242. E-mail: cpg@apa.org. APA GUIDELINE FOR THE TREATMENT OF DEPRESSION ii Abstract The American Psychological Association (APA) developed this clinical practice guideline to provide recommendations for the treatment of depressive disorders (including major depression, subsyndromal depression, and persistent depressive disorder). It addresses three developmental cohorts: children and adolescents; general adults; and older adults (ages 60 and over). Ten (...) Across Three Age Cohorts 1 Scope of the Problem 1 Children and Adolescents 2 General Adult Population 11 Older Adult Population 14 The Need for a Clinical Practice Guideline and Decisions about Scope and Goals of the Clinical Practice Guideline 18 The APA Clinical Practice Guideline for the Treatment of the Problem 19 Guideline Purpose and Scope: What the Guideline Does and Does Not Address 23 APA GUIDELINE FOR THE TREATMENT OF DEPRESSION iv Process and Method 26 Vetting and Appointment of Members

2019 American Psychological Association

19. Causality and preventability assessment of adverse drug events of antibiotics among inpatients having different lengths of hospital stay: a multicenter, cross-sectional study in Lahore, Pakistan Full Text available with Trip Pro

Causality and preventability assessment of adverse drug events of antibiotics among inpatients having different lengths of hospital stay: a multicenter, cross-sectional study in Lahore, Pakistan A large number of hospital admissions are attributed to adverse drug reactions (ADRs) and they are the fifth leading cause of death worldwide. The present study aimed to assess the causality and preventability of adverse drug events (ADEs) of antibiotics among inpatients having different lengths (...) (38.4%) and lack of information about antibiotics (32%). Most of the non-preventable ADEs or ADRs among patients having long and short LOS in hospital were "probable" (35.5%) and "possible" (35.8%), respectively. Logistic regression analysis revealed that ADEs were significantly less among females (OR = 0.047, 95% CI = 0.018─0.121, p-value = < 0.001), patients aged 18─52 years (OR = 0.041, 95% CI = 0.013─0.130, p-value = < 0.001), patients with ARTIs (OR = 0.004, 95% CI = 0.01-0.019, p-value

2018 BMC pharmacology & toxicology

20. Unplanned readmission prevention by a geriatric emergency network for transitional care (URGENT): a prospective before-after study. Full Text available with Trip Pro

ED patients aged 70 years or older were eligible for enrolment. Patients in the control cohort received usual care. Patient in the intervention cohort received the URGENT care model. A geriatric emergency nurse conducted CGA and interdisciplinary care planning among older patients identified as at risk for adverse events (e.g. unplanned ED readmission, functional decline) with the interRAI ED Screener© and clinical judgement of ED staff. Case manager follow-up was offered to at risk patients (...) Unplanned readmission prevention by a geriatric emergency network for transitional care (URGENT): a prospective before-after study. URGENT is a comprehensive geriatric assessment (CGA) based nurse-led care model in the emergency department (ED) with geriatric follow-up after ED discharge aiming to prevent unplanned ED readmissions.A quasi-experimental study (sequential design with two cohorts) was conducted in the ED of University Hospitals Leuven (Belgium). Dutch-speaking, community-dwelling

2019 BMC Geriatrics

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