Effect of Clinical Pharmacy Services in an Older Adult Emergency Medicine Unit on Unplanned Rehospitalization of Older Adults Admitted for Falls: MUPA-PHARM Study

Clementz, Alice; Jost, Jérémy; Lacour, Aurore; Bimou, Charlotte; Gayot, Caroline; Ratsimbazafy, V.; Tchalla, Achille

doi:10.1016/j.jamda.2019.02.029

Cited by 6 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although fall prevention interventions could be initiated in the observation unit, interventions that prolong ED LOS are unlikely to be adopted given the association of long ED wait times with increased mortality, hospital admission, and lower patient satisfaction . Another recent study of patients admitted to an older adult emergency medicine unit in France after a fall received a pharmacist‐led medication reconciliation intervention and demonstrated a significant reduction in 90‐day unplanned rehospitalization (odds ratio [OR] = .45; 95% confidence interval [CI] = 26‐.79) . The authors do not report on the LOS or recurrent fall events.…”

Section: Discussionmentioning

confidence: 99%

“…51,52 Another recent study of patients admitted to an older adult emergency medicine unit in France after a fall received a pharmacist-led medication reconciliation intervention and demonstrated a significant reduction in 90-day unplanned rehospitalization (odds ratio [OR] = .45; 95% confidence interval [CI] = 26-.79). 53 The authors do not report on the LOS or recurrent fall events.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

GAPcare: The Geriatric Acute and Post‐Acute Fall Prevention Intervention in the Emergency Department: Preliminary Data

Goldberg

Marks

Ilegbusi

et al. 2019

J American Geriatrics Society

View full text Add to dashboard Cite

OBJECTIVES We aimed to describe a new multidisciplinary team fall prevention intervention for older adults who seek care in the emergency department (ED) after having a fall, assess its feasibility and acceptability, and review lessons learned during its initiation. DESIGN Single‐blind randomized controlled pilot study. SETTING Two urban academic EDs PARTICIPANTS Adults 65 years old or older (n = 110) who presented to the ED within 7 days of a fall. INTERVENTION Participants were randomized to a usual care (UC) and an intervention (INT) arm. Participants in the INT arm received a brief medication therapy management session delivered by a pharmacist and a fall risk assessment and plan by a physical therapist (PT). INT participants received referrals to outpatient services (eg, home safety evaluation, outpatient PT). MEASUREMENTS We used participant, caregiver, and clinician surveys, as well as electronic health record review, to assess the feasibility and acceptability of the intervention. RESULTS Of the 110 participants, the median participant age was 81 years old, 67% were female, 94% were white, and 16.3% had cognitive impairment. Of the 55 in the INT arm, all but one participant received the pharmacy consult (98.2%); the PT consult was delivered to 83.6%. Median consult time was 20 minutes for pharmacy and 20 minutes for PT. ED length of stay was not increased in the INT arm: UC 5.25 hours vs INT 5.0 hours (P < .94). After receiving the Geriatric Acute and Post‐acute Fall Prevention Intervention (GAPcare), 100% of participants and 97.6% of clinicians recommended the pharmacy consult, and 95% of participants and 95.8% of clinicians recommended the PT consult. CONCLUSION These findings support the feasibility and acceptability of the GAPcare model in the ED. A future larger randomized controlled trial is planned to determine whether GAPcare can reduce recurrent falls and healthcare visits in older adults. J Am Geriatr Soc 68:198–206, 2019

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

GAPcare: The Geriatric Acute and Post‐Acute Fall Prevention Intervention in the Emergency Department: Preliminary Data

Goldberg

Marks

Ilegbusi

et al. 2019

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

“… 68 , 69 Further, early pharmacist‐led medication review in the ED has been shown to decrease odds of admission, hospital length of stay, and unplanned rehospitalizations. 58 , 59 , 62 However, medication reconciliation takes ∼30 min per patient, and even longer for comprehensive medication reviews. 70 Further, early assessment of geriatric patients in the ED by telemedical consultation with a geriatrician significantly reduced the number of PIMs.…”

Section: Ms Frameworkmentioning

confidence: 99%

Enhancing healthcare access for an older population: The age‐friendly emergency department

Lee,

Skains,

Magidson

et al. 2024

JACEP Open

View full text Add to dashboard Cite

Healthcare systems face significant challenges in meeting the unique needs of older adults, particularly in the acute setting. Age‐friendly healthcare is a comprehensive approach using the 4Ms framework—what matters, medications, mentation, and mobility—to ensure that healthcare settings are responsive to the needs of older patients. The Age‐Friendly Emergency Department (AFED) is a crucial component of a holistic age‐friendly health system. Our objective is to provide an overview of the AFED model, its core principles, and the benefits to older adults and healthcare clinicians. The AFED optimizes the delivery of emergency care by integrating age‐specific considerations into various aspects of (1) ED physical infrastructure, (2) clinical care policies, and (3) care transitions. Physical infrastructure incorporates environmental modifications to enhance patient safety, including adequate lighting, nonslip flooring, and devices for sensory and ambulatory impairment. Clinical care policies address the physiological, cognitive, and psychosocial needs of older adults while preserving focus on emergency issues. Care transitions include communication and involving community partners and case management services. The AFED prioritizes collaboration between interdisciplinary team members (ED clinicians, geriatric specialists, nurses, physical/occupational therapists, and social workers). By adopting an age‐friendly approach, EDs have the potential to improve patient‐centered outcomes, reduce adverse events and hospitalizations, and enhance functional recovery. Moreover, healthcare clinicians benefit from the AFED model through increased satisfaction, multidisciplinary support, and enhanced training in geriatric care. Policymakers, healthcare administrators, and clinicians must collaborate to standardize guidelines, address barriers to AFEDs, and promote the adoption of age‐friendly practices in the ED.

show abstract

“…The top-level institutional design of the older adult care service industry is crucial, as it involves various aspects of government, nation, business, and market for guarantee and regulation. To ensure the standardized operation and healthy development of the older adult care service industry, it is recommended to implement supervision and management at each stage, including pre-entry threshold regulation, ongoing market supervision and legal protection, as well as postperformance evaluation and risk prevention (Clementz, et al, 2019). The specific regulatory framework for industry development is depicted in Figure 4.…”

Section: Top-level Institutional Design Of the Senior Care Service In...mentioning

confidence: 99%

Research on the trend and optimization path of China’s older adult service industry

Sun

2024

J. Infras. Policy. Dev.

View full text Add to dashboard Cite

With the intensification of the aging population trend, China is facing an increasingly growing demand for older adult care services. As an important field that meets the needs of the older adult, the development of the older adult care service industry is of significant importance for social stability and the well-being of the older adult. This paper examines the trends and optimization paths of the older adult care service industry in China. It aims to analyze the current situation, problems, and causes of the industry, and propose corresponding policy adjustment recommendations. Through comparative analysis of scholars’ viewpoints, the paper redefines the connotation and scope of the older adult care service industry, emphasizing the characteristics of its compound industrial system. The analysis reveals that the current Chinese older adult care service industry is characterized by a small scale, single functionality, narrow coverage, short industrial chain, and a lack of policy support and rational resource allocation. Policy adjustment recommendations are proposed, including top-level institutional design, improvement of the social security system, and the formation of a comprehensive industrial system, in order to promote the development of the older adult care service industry. These recommendations not only promote the expansion of industry scale and the expansion of functionality, but also enhance the quality and effectiveness of older adult care services to meet the diverse needs of the older adult. The value of this paper lies in its in-depth analysis of the current situation of the older adult care service industry in China and the proposal of specific and feasible policy adjustment recommendations, providing important guidance for government departments and practitioners. The research findings can provide beneficial references for the sustainable development of the older adult care service industry, further promoting the progress of the social economy and the healthy development of an aging society.

show abstract

Effect of Clinical Pharmacy Services in an Older Adult Emergency Medicine Unit on Unplanned Rehospitalization of Older Adults Admitted for Falls: MUPA-PHARM Study

Cited by 6 publications

References 10 publications

GAPcare: The Geriatric Acute and Post‐Acute Fall Prevention Intervention in the Emergency Department: Preliminary Data

GAPcare: The Geriatric Acute and Post‐Acute Fall Prevention Intervention in the Emergency Department: Preliminary Data

Enhancing healthcare access for an older population: The age‐friendly emergency department

Research on the trend and optimization path of China’s older adult service industry

Contact Info

Product

Resources

About