Background The rapid aging of the world’s population requires systems that support health facilities’ provision of integrated care at multiple levels of the health care system. The use of health information systems (HISs) at the point of care has shown positive effects on clinical processes and patient health in several settings of care. Objective We sought to describe HISs for older persons (OPs) in select government tertiary hospitals and health centers in the Philippines. Specifically, we aimed to review the existing policies and guidelines related to HISs for OPs in the country, determine the proportion of select government hospitals and health centers with existing health information specific for OPs, and describe the challenges related to HISs in select health facilities. Methods We utilized the data derived from the findings of the Focused Interventions for Frail Older Adults Research and Development Project (FITforFrail), a cross-sectional and ethics committee–approved study. A facility-based listing of services and human resources specific to geriatric patients was conducted in purposively sampled 27 tertiary government hospitals identified as geriatric centers and 16 health centers across all regions in the Philippines. We also reviewed the existing policies and guidelines related to HISs for OPs in the country. Results Based on the existing guidelines, multiple agencies were involved in the provision of services for OPs, with several records containing health information of OPs. However, there is no existing HIS specific for OPs in the country. Only 14 (52%) of the 27 hospitals and 4 (25%) of the 16 health centers conduct comprehensive geriatric assessment (CGA). All tertiary hospitals and health centers are able to maintain medical records of their patients, and almost all (26/27, 96%) hospitals and all (16/16, 100%) health centers have data on top causes of morbidity and mortality. Meanwhile, the presence of specific disease registries varied per hospitals and health centers. Challenges to HISs include the inability to update databases due to inadequately trained personnel, use of an offline facility–based HIS, an unstable internet connection, and technical issues and nonuniform reporting of categories for age group classification. Conclusions Current HISs for OPs are characterized by fragmentation, multiple sources, and inaccessibility. Barriers to achieving appropriate HISs for OPs include the inability to update HISs in hospitals and health centers and a lack of standardization by age group and disease classification. Thus, we recommend a 1-person, 1-record electronic medical record system for OPs and the disaggregation and analysis across demographic and socioeconomic parameters to inform policies and programs that address the complex needs of OPs. CGA as a required routine procedure for all OPs and its integration with the existing HISs in the country are also recommended.
Objectives A quantitative biomarker for identification of pre‐frail and frail persons is still lacking. This study aimed to identify biomarker predictors of frailty in HIV‐infected patients. Methods A cross‐sectional study of HIV‐infected patients who had been on antiretroviral therapy (ART) for at least 1 year and who presented an undetectable viral load (< 50 HIV‐1 RNA copies/mL) at baseline was carried out. For each frail patient, up to four pre‐frail and robust patients were randomly selected. The frailty status assessment was based on the five‐item criteria described by Fried et al. Sociodemographic, anthropometric, biochemical and HIV‐related characteristics were evaluated. Multiple potential biomarkers of frailty and a biological age biomarker were analysed. Results A total of 73 HIV‐infected patients on ART for at least 1 year were evaluated. The patients were categorized as robust (n = 33), pre‐frail (n = 32) and frail (n = 8) using the Fried criteria. All patients were on ART, with 100% undetectable viral load (< 50 copies/mL) at baseline. No significant differences in demographic, clinical or analytical characteristics were observed among patients in the different categories based on Fried criteria, with the exception of the veterans aging cohort study index (VACS). Similarly, no differences were observed in HIV‐related characteristics, although nucleoside reverse transcriptase inhibitor (NRTI) use was less common in frail persons. The distribution of biomarker values varied according to frailty status, with frail persons having higher levels of interleukin (IL)‐8, IL‐18, CXC chemokine ligand 10 (CXCL10) and retinol‐binding protein 4 (RBP4). In multivariable analysis, the assocation of frailty with RBP4 showed a tendency to statistical significance (odds ratio 1.0; 95% confidence interval 0.99–1.00; P < 0.05). Conclusions Differential biomarker expression was present according to Fried status. Longitudinal studies will clarify the utility of these biomarkers as targets for diagnostic or therapeutic intervention.
Objectives. 1) To describe the sociodemographic and clinical characteristics of working and retired employees aged 55 years and older; 2) To determine the proportion with visual and hearing impairments in participants with Type 2 diabetes mellitus (T2DM); and 3) To determine the association between quality of life in participants with T2DM and visual and hearing impairments.Methods. The study utilized a cross-sectional study design -data derived from the findings of the UP Wellness Initiative for Seniors and Elders (UPWISE) Program. The participants were working and retired university employees age 55 years and above residing in urban and rural-urban (rurban) communities. Stratified random sampling was utilized according to working status and sex. Visual and hearing impairments, and the presence of T2DM were assessed using a multidisciplinary diagnostic process, the comprehensive geriatric assessment (CGA). Results.A total of 301 participants agreed to participate and completed the CGA. The mean age of the participants was 64.8 (±6.3), and 51.2% belonged to the young-old subgroup. There was an almost equal proportion of males and females while there were more working (53.8%) than the retired (46.2%). There were 17.6% of participants with T2DM and of them, 47.2% with visual impairment (VI) alone, 7.5% hearing impairment (HI) alone, and 37.7% with dual sensory impairments (DSI). Good quality of life was reported by 100% of T2DM participants with HI, 80% with VI, and 72.3% with DSI. There was no significant association between quality of life and vision and hearing impairments. On the other hand, a significant association was identified between T2DM and DSI (p-value, 0.001). Conclusion.T2DM and vision and hearing impairments are prevalent among the two academic communities. Visual impairment was more common than hearing impairment. Participants diagnosed with T2DM and having a visual, hearing, or dual sensory impairments reported good quality of life.
Objectives. This study aims to describe the sociodemographic and clinical profile of working and retired staff and faculty age 55 years and older in an academic community living in Laguna, Philippines; to determine the proportion of participants with Type 2 Diabetes Mellitus (T2DM); and to describe the nutritional and frailty status of working and retired participants with T2DM. Methods. The study utilized a cross-sectional study design. The participants are current employees and retired faculty and staff of an academic community living in Bay and Los Baños, Laguna, Philippines. Stratified random sampling according to working status and gender was utilized. Participants with T2DM were determined and assessed based on their nutritional and frailty status using the comprehensive geriatric assessment (CGA), laboratory analysis, and mini nutritional assessment (MNA). Descriptive statistics were calculated for all continuous and categorical variables measured. Results. A total of 109 participants agreed to participate and completed the CGA, with 93.6% undergone blood extraction for laboratory analysis. The mean age of the participants was 63.7 (±5.8) and 57.8% belonged to the young-old subgroup. There were more working (60.6%) than the retired (39.4%) and more females (61.5%) than males (38.5%). There was a low level of malnutrition (0.9%) in this cohort. However, many had abdominal obesity and elevated low-density lipoprotein (LDL). Low vitamin D was prevalent. Type 2 Diabetes Mellitus was present among 14.7% of participants of which 93.8% were pre-frail and 6.3% were at risk for malnutrition. Conclusion. Although malnutrition and frailty were not prevalent among those with T2DM in this cohort, more participants were pre-frail and at risk for malnutrition. There are many opportunities to reduce the risk of malnutrition and frailty in the community. Early screening and interventions are recommended to improve the health and wellbeing of the working and retired participants.
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