Untitled

Galé, Catharine R.; Deary, Ian J.; Batty, G. David

doi:10.1111/jgs.2008.56.issue-4

Cited by 13 publications

(6 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The research was performed in 12 different countries. Three (5.0%) of the eligible articles were published between 1994 and 1999, [31][32][33] 19 (31.7%) between 2000 and 2009, [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] and 38 (63.3%) between 2010 and 2017 ( Table 2). The respective sample size ranged from 13 to 2637 participants.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Thirty-nine studies met our age-related eligibility criteria by exclusively including adults aged 65 years and older, 32,35,[37][38][39]41,42,[44][45][46][49][50][51][52][53][54][55][56][57][58][59][60][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] 16 by reporting a mean or median age ≥ 75 years, 31,36,40,43,47,48,61,[79][80][81][82]…”

Section: Study Populationsmentioning

confidence: 99%

“…42,47,49,51,52,54,56,57,71,74,79 Thirty-seven studies reported data regarding the cognitive status of their participants. 31,32,35,36,[41][42][43][44]47,49,[51][52][53][55][56][57][58][59][60][61][63][64][65][66][67][68][69][70][71][72]74,75,78,80,83,84,90 In 83.8 % of these studies Variety of pharmacological aspects represented by the method ▼ Low: Method elicits preferences for < 5 different pharmacological aspects (health outcomes, treatment options or procedural characteristics) ▬ Intermediate: Method elicits preferences for 5-10 different pharmacological aspects (health outcomes, treatment options or procedural characteristics) ▲ Hi...…”

Section: Study Populationsmentioning

confidence: 99%

“…Seventeen studies detailed the results of a standardized cognitive evaluation of their study population. 32,36,43,51,52,55,66,[68][69][70][71][72]74,78,80,83,84 The participants' affective status was considered by 30 studies ( Table 2).…”

Section: Study Populationsmentioning

confidence: 99%

“…Four tools concentrated on a specific sub-context of multimorbidity, such as the tradeoffs between present and future health (2 tools) 58,59 or the trade-offs between a specific subset of competing health outcomes in multimorbidity (2 tools). 51,52,63 One instrument evaluated a set of general health outcomes for the medical care of older adults. 62…”

Section: Study Contextmentioning

confidence: 99%

See 4 more Smart Citations

<p>Methods to Assess Patient Preferences in Old Age Pharmacotherapy – A Systematic Review</p>

Eidam¹,

Roth²,

Lacroix³

et al. 2020

PPA

View full text Add to dashboard Cite

Purpose: The aim of this systematic review was to identify methods used to assess medication preferences in older adults and evaluate their advantages and disadvantages with respect to their applicability to the context of multimorbidity and polypharmacy. Material and Methods: Three electronic databases (PubMed, Web of Science, PsycINFO) were searched. Eligible studies elicited individual treatment or outcome preferences in a context that involved long-term pharmacological treatment options. We included studies with a study population aged ≥ 65 years and/or with a mean or median age of ≥ 75 years. Qualitative studies, studies assessing preferences for only two different treatments, and studies targeting preferences for life-sustaining treatments were excluded. The identified preference measurement methods were evaluated based on four criteria (time budget, cognitive demand, variety of pharmacological aspects, and link with treatment strategies) judged to be relevant for the elicitation of patient preferences in polypharmacy. Results: Sixty articles met the eligibility criteria and were included in the narrative synthesis. Fifty-five different instruments to assess patient preferences, based on 24 different elicitation methods, were identified. The most commonly applied preference measurement techniques were "medication willingness" (description of a specific medication with inquiry of the participant's willingness to take it), discrete choice experiments, Likert scale-based questionnaires, and rank prioritization. The majority of the instruments were created for disease-specific or context-specific settings. Only three instruments (Outcome Prioritization Tool, a complex intervention, "MediMol" questionnaire) dealt with the broader issue of geriatric multimorbidity. Only seven of the identified tools showed somewhat favorable characteristics for a potential use of the respective method in the context of polypharmacy. Conclusion: Up to now, few instruments have been specifically designed for the assessment of medication preferences in older patients with multimorbidity. To facilitate valid preference elicitation in the context of geriatric polypharmacy, future research should focus on suitable characteristics of existing techniques to develop new measurement approaches for this increasingly relevant population.

show abstract

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Populationsmentioning

confidence: 99%

Section: Study Populationsmentioning

confidence: 99%

Section: Study Populationsmentioning

confidence: 99%

Section: Study Contextmentioning

confidence: 99%

See 3 more Smart Citations

<p>Methods to Assess Patient Preferences in Old Age Pharmacotherapy – A Systematic Review</p>

Eidam¹,

Roth²,

Lacroix³

et al. 2020

PPA

View full text Add to dashboard Cite

show abstract

Default Palliative Care Consultation for Seriously Ill Hospitalized Patients

Courtright,

Madden,

Bayes

et al. 2024

JAMA

View full text Add to dashboard Cite

ImportanceIncreasing inpatient palliative care delivery is prioritized, but large-scale, experimental evidence of its effectiveness is lacking.ObjectiveTo determine whether ordering palliative care consultation by default for seriously ill hospitalized patients without requiring greater palliative care staffing increased consultations and improved outcomes.Design, Setting, and ParticipantsA pragmatic, stepped-wedge, cluster randomized trial was conducted among patients 65 years or older with advanced chronic obstructive pulmonary disease, dementia, or kidney failure admitted from March 21, 2016, through November 14, 2018, to 11 US hospitals. Outcome data collection ended on January 31, 2019.InterventionOrdering palliative care consultation by default for eligible patients, while allowing clinicians to opt-out, was compared with usual care, in which clinicians could choose to order palliative care.Main Outcomes and MeasuresThe primary outcome was hospital length of stay, with deaths coded as the longest length of stay, and secondary end points included palliative care consult rate, discharge to hospice, do-not-resuscitate orders, and in-hospital mortality.ResultsOf 34 239 patients enrolled, 24 065 had lengths of stay of at least 72 hours and were included in the primary analytic sample (10 313 in the default order group and 13 752 in the usual care group; 13 338 [55.4%] women; mean age, 77.9 years). A higher percentage of patients in the default order group received palliative care consultation than in the standard care group (43.9% vs 16.6%; adjusted odds ratio [aOR], 5.17 [95% CI, 4.59-5.81]) and received consultation earlier (mean [SD] of 3.4 [2.6] days after admission vs 4.6 [4.8] days; P &lt; .001). Length of stay did not differ between the default order and usual care groups (percent difference in median length of stay, −0.53% [95% CI, −3.51% to 2.53%]). Patients in the default order group had higher rates of do-not-resuscitate orders at discharge (aOR, 1.40 [95% CI, 1.21-1.63]) and discharge to hospice (aOR, 1.30 [95% CI, 1.07-1.57]) than the usual care group, and similar in-hospital mortality (4.7% vs 4.2%; aOR, 0.86 [95% CI, 0.68-1.08]).Conclusions and RelevanceDefault palliative care consult orders did not reduce length of stay for older, hospitalized patients with advanced chronic illnesses, but did improve the rate and timing of consultation and some end-of-life care processes.Trial RegistrationClinicalTrials.gov Identifier: NCT02505035

show abstract

Association Between the Patient Driven Payment Model and Therapy Utilization and Patient Outcomes in US Skilled Nursing Facilities

et al. 2022

View full text Add to dashboard Cite

IMPORTANCEIn October 2019, Medicare changed its skilled nursing facility (SNF) reimbursement model to the Patient Driven Payment Model (PDPM), which has modified financial incentives for SNFs that may relate to therapy use and health outcomes. OBJECTIVE To assess whether implementation of the PDPM was associated with changes in therapy utilization or health outcomes. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used a regression discontinuity (RD) approach among Medicare fee-for-service postacute-care patients admitted to a Medicarecertified SNF following hip fracture between January 2018 and March 2020. EXPOSURES Skilled nursing facility admission after PDPM implementation. MAIN OUTCOMES AND MEASURES Main outcomes were individual and nonindividual (concurrent and group) therapy minutes per day, hospitalization within 40 days of SNF admission, SNF length of stay longer than 40 days, and discharge activities of daily living score. RESULTS The study cohort included 201 084 postacute-care patients (mean [SD] age, 83.8 [8.3] years; 143 830 women [71.5%]; 185 854 White patients [92.4%]); 147 711 were admitted pre-PDPM, and 53 373 were admitted post-PDPM. A decrease in individual therapy (RD estimate: −15.9 minutes per day; 95% CI, −16.9 to −14.6) and an increase in nonindividual therapy (RD estimate: 3.6 minutes per day; 95% CI, 3.4 to 3.8) were observed. Total therapy use in the first week following admission was about 12 minutes per day (95% CI, −13.3 to −11.3) (approximately 13%) lower for residents admitted post-PDPM vs pre-PDPM. No consistent and statistically significant discontinuity in hospital readmission (0.31 percentage point increase; 95% CI, −1.46 to 2.09), SNF length of stay (2.7 percentage point decrease in likelihood of staying longer than 40 days; 95% CI, −4.83 to −0.54), or functional score at discharge (0.04 point increase in activities of daily living score; 95% CI, −0.19 to 0.26) was observed. Nonindividual therapy minutes were reduced to nearly zero in late March 2020, likely owing to COVID-19-related restrictions on communal activities in SNFs. CONCLUSIONS AND RELEVANCEIn this cross-sectional study of SNF admission after PDPM implementation, a reduction of total therapy minutes was observed following the implementation of PDPM, even though PDPM was designed to be budget neutral. No significant changes in postacute outcomes were observed. Further study is needed to understand whether the PDPM is associated with successful discharge outcomes.

show abstract

Untitled

Cited by 13 publications

References 1 publication

<p>Methods to Assess Patient Preferences in Old Age Pharmacotherapy – A Systematic Review</p>

<p>Methods to Assess Patient Preferences in Old Age Pharmacotherapy – A Systematic Review</p>

Default Palliative Care Consultation for Seriously Ill Hospitalized Patients

Association Between the Patient Driven Payment Model and Therapy Utilization and Patient Outcomes in US Skilled Nursing Facilities

Contact Info

Product

Resources

About