首页 > 最新文献

Journal of the American Geriatrics Society最新文献

英文 中文
Cover 封面
IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-08 DOI: 10.1111/jgs.17875
Kay Khaing MMed, Xenia Dolja-Gore PhD, Balakrishnan R. Nair MD, Julie Byles PhD, John Attia PhD

Cover caption: Anxiety and increased risk of dementia. See the related article by Khaing et al., pages 3327–3334.

封面标题:焦虑与痴呆症风险增加。请参阅 Khaing 等人的相关文章,第 3327-3334 页。
{"title":"Cover","authors":"Kay Khaing MMed,&nbsp;Xenia Dolja-Gore PhD,&nbsp;Balakrishnan R. Nair MD,&nbsp;Julie Byles PhD,&nbsp;John Attia PhD","doi":"10.1111/jgs.17875","DOIUrl":"https://doi.org/10.1111/jgs.17875","url":null,"abstract":"<p><b>Cover caption</b>: Anxiety and increased risk of dementia. See the related article by Khaing et al., pages 3327–3334.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 11","pages":"C1"},"PeriodicalIF":4.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17875","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142664650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction for the 2024 Chinese Congress on Gerontology and Health Industry (CCGI) Abstracts 2024 年中国老年学与健康产业大会摘要 2024 年 11 月 1 日至 3 日,中华人民共和国海南省海口市。
IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-30 DOI: 10.1111/jgs.19221
Sean X. Leng MD, PhD, Xiao-Ying Li MD
<p>It is once again with great pleasure that we introduce the research work to be presented at the 2024 Chinese Congress on Gerontology and Health Industry (CCGI), which is published in abstract form in this issue of the Journal of the American Geriatrics Society (JAGS). The 2024 CCGI conference is the continuation of the annual national geriatrics and gerontology conference co-organized and co-sponsored by a number of major Chinese professional healthcare organizations including the Chinese Medical Association (CMA) Geriatrics Branch and China Health Promotion Foundation. This year's CCGI conference will be held on November 1–3. 2024 in the city of Haikou, China's island province Hainan. We have 115 quality abstracts to be included in this issue.</p><p>While COVID-19 pandemic is largely behind us, its impact on world economy and scientific conferences continues to be palpable. The current economic downturn and overseas regional conflicts create additional challenges. Despite these difficulties, the 2024 CCGI conference will be held in person and the research work to be presented at the conference is as robust as that presented at previous years' CCGI conferences. Similar to the previous 11 years, the work to be presented at this year's CCGI conference encompasses many important areas of geriatrics and gerontology, from basic aging research to geriatric syndromes; from clinical observation and large epidemiological studies to clinical trials; and from biological investigations to social and behavioral research. Unique to this year, it emphasizes palliative care, cardiovascular aging and diseases, systems approach for senior health, as well as socioeconomic determinants of aging care. It also includes a broad range of studies of basic and translational aging research, such as investigation into chronic cytomegalovirus (CMV) infection as a potential contributing factor to immunosenescence and age-related chronic inflammation, longitudinal cohort studies, mechanistic studies in animal models, and other types of studies including clinical trials for the prevention and treatment of common geriatric syndromes and age-related diseases. Moreover, almost 20% of the abstracts are submitted by researchers from other countries and regions including the United States, European countries (Germany, UK), South Korea, Macao, etc., demonstrating a robust international representation. The work described here will be presented in the form of oral presentation or poster at the conference. The conference will have similar number of symposia with individual symposium on translational aging research, common geriatric syndromes, prevention, rehabilitation, nutrition, geriatric nursing, traditional Chinese medicine, community geriatrics care, and long-term care, and so on. Publication of such exemplary work in geriatrics and gerontology in this supplement issue of JAGS will further enhance scientific and scholarly exchanges between colleagues in China and geriatrics and g
本期《美国老年医学会杂志》(JAGS)以摘要形式刊登了将在2024年中国老年学与健康产业大会(CCGI)上发表的研究成果。2024 年中国老年医学与健康产业大会(CCGI)是由中华医学会老年医学分会、中国健康促进基金会等多家中国主要专业医疗机构共同主办和协办的全国性老年医学与老年产业年会的延续。今年的 CCGI 会议将于 11 月 1 日至 3 日举行。今年的 CCGI 大会将于 2024 年 11 月 1 日至 3 日在中国海南省海口市举行。虽然COVID-19大流行病已基本过去,但其对世界经济和科学会议的影响依然明显。当前的经济衰退和海外地区冲突带来了更多的挑战。尽管存在这些困难,2024年CCGI会议仍将亲自举行,会上展示的研究工作与往年CCGI会议上展示的研究工作一样强劲。与前11年类似,今年CCGI会议上将要展示的工作涵盖了老年医学和老年学的许多重要领域,从基础老龄化研究到老年综合症;从临床观察和大型流行病学研究到临床试验;从生物调查到社会和行为研究。今年的独特之处在于,它强调姑息治疗、心血管衰老和疾病、老年健康的系统方法以及老年护理的社会经济决定因素。此外,还包括广泛的基础和转化性老龄化研究,如慢性巨细胞病毒(CMV)感染作为免疫衰老和老年慢性炎症潜在诱因的调查、纵向队列研究、动物模型的机理研究,以及其他类型的研究,包括预防和治疗常见老年综合症和老年相关疾病的临床试验。此外,近 20% 的摘要是由其他国家和地区的研究人员提交的,包括美国、欧洲国家(德国、英国)、韩国、澳门等,显示了强大的国际代表性。这里介绍的工作将以口头报告或海报的形式在大会上展示。会议还将举办数量相近的专题讨论会,分别就老龄化转化研究、常见老年综合症、预防、康复、营养、老年护理、中医、社区老年护理和长期护理等内容展开讨论。在《老年医学杂志》增刊上发表这些老年病学和老年医学领域的典范之作,将进一步加强中国同行与美国及世界各地老年病学和老年医学界的科学和学术交流。为此,我们要再次感谢JAGS的领导层,特别是现任主编Joseph Ouslander博士、美国老年医学会首席执行官Nancy Lundebjerg女士以及Wiley公司的Kurt Polesky先生,感谢他们为本刊的成功发行所给予的支持和付出的努力。正如前几期 JAGS CCGI 会议增刊所指出的,1-8 中国是世界上老龄人口最多的国家,发展高质量的老年医学护理和老龄化研究是中国的国家优先事项。虽然国家医疗政策已经规定所有综合医院都必须提供老年医学护理服务,但对老年医学人才培养的迫切需求仍然是前所未有的。为了解决这一难以克服的需求,在2015年和2016年完成国家高级培训班的中国医师协会老年医学分会成员通过继续医学教育(CME)和其他机制,继续在中国各地开展老年医学培训工作。自2011年起每年举办的北京协和医院-约翰霍普金斯老年医学研讨会,也已经并将继续作为一个重要的老年医学培训平台。然而,中国老年医学发展的道路曲折而漫长,任重而道远。目前,我们正致力于发展高质量的老年医学临床和教育项目,以及推进老年医学临床和转化研究。国际学术交流与合作作为中国老年医学发展的催化剂至关重要,但也充满挑战,尤其是在当前的政治环境下。 美国医学慈善机构,如伊尔玛和保罗-米尔斯坦老年健康项目下的米尔斯坦亚美医学合作基金会(MMAAP),已经并将继续提供私人资金支持中国的临床和研究项目。同样,《老年医学杂志》多年来通过发表同类特别文章9-11,向美国和世界各地的同行介绍中国的人口老龄化情况和老年医学的最新发展,起到了带头作用。考虑到除医疗保健外,老年人对其他支持服务和产品的需求,CCGI大会还组织了国内外医疗保健行业的合格养老服务项目、设备、辅助器具和其他相关产品的大型展览。因此,今年的 CCGI 会议仍将是一个重要的平台和有益的网络,不仅可以进行科学和学术交流,还可以在老年保健和医疗保健行业发展潜在的伙伴关系和合作。今年早些时候,中国刚刚宣布了允许其他国家的实体在中国开发、管理和拥有医疗保健业务的政策,这一点显得尤为重要和及时。为了鼓励和欢迎美国老年医学学会和美国老年学学会的会员以及除美国以外的其他国家的研究人员参加会议,会议设立了一个国际研讨会。CCGI 组委会将继续执行免收会议注册费的政策,并承担与会议相关的中国差旅费用(即会议期间的酒店住宿和餐饮)。正如我们在前几期 JAGS CCGI 会议增刊中所做的那样,我们承认继续开展此类国际性工作所面临的挑战。我们再次对中国医师协会老年医学分会和CCGI组委会的领导表示敬意,感谢他们为这个在中国相对较新但正在崛起的学科争取到了资金、征集到了高质量的论文摘要,并进行了严格的科学同行评审。尽管我们从以往的 CCGI 会议中积累了经验,并尽了最大努力进行审阅和编辑,但有些摘要在翻译成英文时仍不可避免地存在语言错误。因此,我们希望读者能够理解我们的疏忽。我们也希望读者能提出反馈意见,以便我们今后进一步改进。为此,我们要感谢中美两国参与这项重要工作的所有人。我们再次预祝2024年CCGI会议取得圆满成功!
{"title":"Introduction for the 2024 Chinese Congress on Gerontology and Health Industry (CCGI) Abstracts","authors":"Sean X. Leng MD, PhD,&nbsp;Xiao-Ying Li MD","doi":"10.1111/jgs.19221","DOIUrl":"10.1111/jgs.19221","url":null,"abstract":"&lt;p&gt;It is once again with great pleasure that we introduce the research work to be presented at the 2024 Chinese Congress on Gerontology and Health Industry (CCGI), which is published in abstract form in this issue of the Journal of the American Geriatrics Society (JAGS). The 2024 CCGI conference is the continuation of the annual national geriatrics and gerontology conference co-organized and co-sponsored by a number of major Chinese professional healthcare organizations including the Chinese Medical Association (CMA) Geriatrics Branch and China Health Promotion Foundation. This year's CCGI conference will be held on November 1–3. 2024 in the city of Haikou, China's island province Hainan. We have 115 quality abstracts to be included in this issue.&lt;/p&gt;&lt;p&gt;While COVID-19 pandemic is largely behind us, its impact on world economy and scientific conferences continues to be palpable. The current economic downturn and overseas regional conflicts create additional challenges. Despite these difficulties, the 2024 CCGI conference will be held in person and the research work to be presented at the conference is as robust as that presented at previous years' CCGI conferences. Similar to the previous 11 years, the work to be presented at this year's CCGI conference encompasses many important areas of geriatrics and gerontology, from basic aging research to geriatric syndromes; from clinical observation and large epidemiological studies to clinical trials; and from biological investigations to social and behavioral research. Unique to this year, it emphasizes palliative care, cardiovascular aging and diseases, systems approach for senior health, as well as socioeconomic determinants of aging care. It also includes a broad range of studies of basic and translational aging research, such as investigation into chronic cytomegalovirus (CMV) infection as a potential contributing factor to immunosenescence and age-related chronic inflammation, longitudinal cohort studies, mechanistic studies in animal models, and other types of studies including clinical trials for the prevention and treatment of common geriatric syndromes and age-related diseases. Moreover, almost 20% of the abstracts are submitted by researchers from other countries and regions including the United States, European countries (Germany, UK), South Korea, Macao, etc., demonstrating a robust international representation. The work described here will be presented in the form of oral presentation or poster at the conference. The conference will have similar number of symposia with individual symposium on translational aging research, common geriatric syndromes, prevention, rehabilitation, nutrition, geriatric nursing, traditional Chinese medicine, community geriatrics care, and long-term care, and so on. Publication of such exemplary work in geriatrics and gerontology in this supplement issue of JAGS will further enhance scientific and scholarly exchanges between colleagues in China and geriatrics and g","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 S4","pages":"S3-S5"},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abstracts for JGS Chinese Supplement 2024 年中国老年学与健康产业大会摘要 2024 年 11 月 1 日至 3 日,中华人民共和国海南省海口市。
IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-30 DOI: 10.1111/jgs.19222
{"title":"Abstracts for JGS Chinese Supplement","authors":"","doi":"10.1111/jgs.19222","DOIUrl":"10.1111/jgs.19222","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 S4","pages":"S6-S68"},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cover 封面
IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-08 DOI: 10.1111/jgs.17872
Rachel O'Conor PhD, MPH, Andrea M. Russell PhD, Allison Pack PhD, MPH, Dianne Oladejo BA, Sarah Filec MPH, Emily Rogalski PhD, Darby Morhardt PhD, Lee A. Lindquist MD, MPH, MBA, Michael S. Wolf PhD, MPH

Cover caption: Summary of Medication Management Responsibilities by Severity of Cognitive Impairment. For full details, see “Managing medications among individuals with mild cognitive impairment and dementia: Patient-caregiver perspectives” on page 3011.

封面标题:按认知障碍严重程度划分的药物管理责任摘要。详情请参阅第 3011 页 "轻度认知障碍和痴呆症患者的药物管理:患者-护理人员的观点"(第 3011 页)。
{"title":"Cover","authors":"Rachel O'Conor PhD, MPH,&nbsp;Andrea M. Russell PhD,&nbsp;Allison Pack PhD, MPH,&nbsp;Dianne Oladejo BA,&nbsp;Sarah Filec MPH,&nbsp;Emily Rogalski PhD,&nbsp;Darby Morhardt PhD,&nbsp;Lee A. Lindquist MD, MPH, MBA,&nbsp;Michael S. Wolf PhD, MPH","doi":"10.1111/jgs.17872","DOIUrl":"https://doi.org/10.1111/jgs.17872","url":null,"abstract":"<p><b>Cover caption</b>: Summary of Medication Management Responsibilities by Severity of Cognitive Impairment. For full details, see “Managing medications among individuals with mild cognitive impairment and dementia: Patient-caregiver perspectives” on page 3011.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 10","pages":"C1"},"PeriodicalIF":4.3,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142429507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Barriers to accessing home and community-based services among family caregivers of Veterans 退伍军人家庭照顾者获得家庭和社区服务的障碍。
IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-25 DOI: 10.1111/jgs.19051
Ranak Trivedi PhD, Victoria Ngo PhD, Trevor Lee BS, Marika Blair Humber PhD, Rashmi Risbud MA, Josephine C. Jacobs PhD, Karl Lorenz MD, MSHS, Steven M. Asch MD, MPH, Dolores Gallagher-Thompson PhD, Luci K. Leykum MD, MBA, MSc, the Elizabeth Dole Center of Excellence for Veteran and Caregiver Research

Background

The Department of Veterans Affairs (VA) has long recognized the importance of having a rich complement of home and community-based resources for the Veteran population. For Veterans experiencing disability-related impairments, home- and community-based services (HCBS) facilitate aging in place and alleviate family caregivers' burden. However, even in the enriched VA context, HCBS are underutilized. Our objective was to understand unmet needs and barriers to accessing HCBS from the perspectives of Veterans' family caregivers.

Methods

This multi-method study recruited family caregivers of Veterans seen within a major VA Health Care System. Eligible caregivers provided care for at least 8 h/week in the prior 6 months, to a Veteran with 1+ impairments in instrumental activities of daily living. Recruitment was conducted via flyers, physician referrals, registries, and chart reviews. Participants completed 1-h semi-structured interviews to assess unmet psychosocial needs and barriers to accessing VA and non-VA HCBS. Interviews were analyzed using a thematic analysis approach.

Results

A total of 23 caregivers (62.9 + 13.5 years; 74% women; 52.2% White; 26.1% Black; 95.2% pre-9/11) provided 8.4 ± 6.3 h of daily care. Most had provided care for more than 1 year; nine had cared for their Veteran for 5+ years. The following themes were identified: (1) need for clear, accurate, timely information about HCBS; (2) lack of time, amplified by COVID-19 restrictions; (3) need for respite to manage their own health and other caregiving responsibilities; and (4) perceived difference in care needs that can strain caregivers' relationship with the care recipient.

Conclusions

In addition to known barriers including lack of timely knowledge, service delays, and caregiver stress, Veteran–caregiver disagreements emerged as a novel barrier to using HCBS. A multi-pronged approach that addresses these barriers may increase timely access to HCBS.

背景:退伍军人事务部(VA)早已认识到为退伍军人提供丰富的家庭和社区资源的重要性。对于有残疾相关损伤的退伍军人来说,家庭和社区服务(HCBS)有助于居家养老,减轻家庭照顾者的负担。然而,即使在退伍军人事务部的丰富环境中,家庭和社区服务也未得到充分利用。我们的目标是从退伍军人家庭照护者的角度来了解未得到满足的需求和获得 HCBS 的障碍:这项多方法研究招募了在退伍军人医疗保健系统内就诊的退伍军人的家庭护理人员。符合条件的照顾者在过去 6 个月中每周至少为一名在日常生活工具性活动方面有 1+ 缺陷的退伍军人提供 8 小时的照顾。招募通过传单、医生转介、登记和病历审查等方式进行。参与者完成了 1 小时的半结构式访谈,以评估未满足的社会心理需求以及获得退伍军人和非退伍军人 HCBS 的障碍。访谈采用主题分析法进行分析:共有 23 名护理人员(62.9 + 13.5 岁;74% 为女性;52.2% 为白人;26.1% 为黑人;95.2% 在 9/11 事件之前)提供了 8.4 ± 6.3 小时的日常护理。大多数人提供护理的时间超过 1 年;9 人护理退伍军人的时间超过 5 年。确定了以下主题:(1) 需要清晰、准确、及时的 HCBS 信息;(2) 缺乏时间,COVID-19 的限制更加剧了这一点;(3) 需要喘息的时间来管理自己的健康和其他护理责任;(4) 认为护理需求的差异会使护理者与接受护理者的关系紧张:除了已知的障碍(包括缺乏及时了解、服务延迟和护理者压力)外,退伍军人与护理者之间的分歧也成为使用 HCBS 的新障碍。采取多管齐下的方法来解决这些障碍可能会增加及时使用 HCBS 的机会。
{"title":"Barriers to accessing home and community-based services among family caregivers of Veterans","authors":"Ranak Trivedi PhD,&nbsp;Victoria Ngo PhD,&nbsp;Trevor Lee BS,&nbsp;Marika Blair Humber PhD,&nbsp;Rashmi Risbud MA,&nbsp;Josephine C. Jacobs PhD,&nbsp;Karl Lorenz MD, MSHS,&nbsp;Steven M. Asch MD, MPH,&nbsp;Dolores Gallagher-Thompson PhD,&nbsp;Luci K. Leykum MD, MBA, MSc,&nbsp;the Elizabeth Dole Center of Excellence for Veteran and Caregiver Research","doi":"10.1111/jgs.19051","DOIUrl":"10.1111/jgs.19051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Department of Veterans Affairs (VA) has long recognized the importance of having a rich complement of home and community-based resources for the Veteran population. For Veterans experiencing disability-related impairments, home- and community-based services (HCBS) facilitate aging in place and alleviate family caregivers' burden. However, even in the enriched VA context, HCBS are underutilized. Our objective was to understand unmet needs and barriers to accessing HCBS from the perspectives of Veterans' family caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multi-method study recruited family caregivers of Veterans seen within a major VA Health Care System. Eligible caregivers provided care for at least 8 h/week in the prior 6 months, to a Veteran with 1+ impairments in instrumental activities of daily living. Recruitment was conducted via flyers, physician referrals, registries, and chart reviews. Participants completed 1-h semi-structured interviews to assess unmet psychosocial needs and barriers to accessing VA and non-VA HCBS. Interviews were analyzed using a thematic analysis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 23 caregivers (62.9 + 13.5 years; 74% women; 52.2% White; 26.1% Black; 95.2% pre-9/11) provided 8.4 ± 6.3 h of daily care. Most had provided care for more than 1 year; nine had cared for their Veteran for 5+ years. The following themes were identified: (1) need for clear, accurate, timely information about HCBS; (2) lack of time, amplified by COVID-19 restrictions; (3) need for respite to manage their own health and other caregiving responsibilities; and (4) perceived difference in care needs that can strain caregivers' relationship with the care recipient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In addition to known barriers including lack of timely knowledge, service delays, and caregiver stress, Veteran–caregiver disagreements emerged as a novel barrier to using HCBS. A multi-pronged approach that addresses these barriers may increase timely access to HCBS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 11","pages":"3541-3550"},"PeriodicalIF":4.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Family caregiver lived experience matters in home- and community-based services 家庭照护者的生活经验对家庭和社区服务至关重要。
IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-25 DOI: 10.1111/jgs.19120
Nathan A. Boucher DrPH, PA, MS, MPA, CPHQ
<p>In this issue of the Journal, Trivedi et al. (<i>not sure about final citation</i>) use in-depth interviews with family caregivers of Veterans to identify novel intervention targets to help the field improve awareness, access, and use of home- and community-based services (HCBS) among family caregivers. The authors now help me make a clarion call for the importance of engaging family caregivers—those family (sometimes friends/neighbors) bearing the joys and burdens of community-based care and support. Optimal support for aging adults and those living with disabilities in our community pivots on the awareness, willingness, skills, and time of family caregivers.</p><p>Inquiries such as this from Trivedi et al. are both timely and important. Their work reflects adherence to tenets of person-centeredness and community engagement trumpeted by recent reports such as the U.S. Department of Health and Human Services' Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities in May 2024, which explicitly calls out the role of family caregivers in community-based care.<span><sup>1</sup></span> The voices of family caregivers in the provision of HCBS need to be amplified as US health care and payment for that care are rebalanced toward community-based solutions and away from facility-based care.<span><sup>2</sup></span></p><p>The authors studied a critical context: family caregivers supporting Veterans served by the largest comprehensive healthcare system in the United States, the Veterans Administration (VA). Importantly, the VA pushes innovations in health systems research attuned to aging, disability, and caregiver inclusion,<span><sup>3-6</sup></span> but, as Trivedi et al. note, HCBS continue to be underutilized by Veterans and others. Complicating this, HCBS are under-resourced in many areas including direct care workers<span><sup>7</sup></span> who often work in tandem with family caregivers cobbling together ongoing services for the aging and those living with disabilities.<span><sup>1</sup></span> Well-supported family caregivers are crucial to the intended expansion in HCBS across populations.<span><sup>8, 9</sup></span></p><p>The authors bring to the readers of the Journal insights on barriers to optimal use of HCBS. They accomplish this by focusing not just on logistical issues—challenges known and persistent—but, more uniquely, psychosocial and interpersonal barriers to accessing VA and non-VA HCBS alike using two complementary research methods.</p><p>First, the authors conducted semi-structured interviews with caregivers. This was elegantly guided by Andersen's Behavioral Model of Health Services Use.<span><sup>10</sup></span> The first three resulting themes are not necessarily new but help bolster findings in the Veteran caregiver population where fewer studies reside. The authors found that caregivers experience gaps in accurate and timely information from the VA and community organizations; they lack time and expe
在本期期刊中,Trivedi 等人(不确定最终引文)通过对退伍军人家庭照护者的深入访谈,确定了新的干预目标,以帮助该领域提高家庭照护者对家庭和社区服务 (HCBS) 的认识、获取和使用。作者现在帮我大声呼吁,让家庭照顾者--那些承担着社区照顾和支持的快乐和负担的家人(有时是朋友/邻居)--参与进来非常重要。为社区中的老年人和残障人士提供最佳支持的关键在于家庭照顾者的意识、意愿、技能和时间。他们的工作体现了以人为本和社区参与的原则,这些原则在最近的报告中得到了大力弘扬,例如美国卫生与公众服务部的健康老龄化和老龄友好社区机构间协调委员会在 2024 年 5 月的报告中明确提出了家庭照护者在社区照护中的作用。2 作者研究了一个重要的背景:由美国最大的综合医疗系统退伍军人管理局(VA)提供服务的退伍军人家庭照护者。重要的是,退伍军人管理局推动了医疗系统研究的创新,以适应老龄化、残疾和照顾者的融入,3-6 但正如 Trivedi 等人所指出的,退伍军人和其他人对 HCBS 的利用仍然不足。1 得到良好支持的家庭照顾者对于在不同人群中推广 HCBS 至关重要。8, 9 作者为本刊读者带来了有关最佳使用 HCBS 的障碍的见解。为了实现这一目标,他们不仅关注了后勤问题--众所周知且长期存在的挑战--更独特的是,他们采用了两种互补的研究方法,同时关注了使用退伍军人和非退伍军人家庭护理服务的社会心理和人际障碍。首先,作者对护理人员进行了半结构式访谈,访谈以安德森的健康服务使用行为模型为指导。10 访谈得出的前三个主题并不一定是新的,但有助于支持退伍军人护理人员群体的研究结果,因为该群体的研究较少。作者发现,护理人员在退伍军人事务部和社区组织提供的准确及时的信息方面存在差距;他们缺乏时间并付出了机会成本;他们渴望得到喘息的机会,这使他们能够从护理工作中抽身出来,并为自己留出时间。第四个主题--人际关系的压力进一步阻碍了对 HCBS 的使用--是一个新颖的发现,在与退伍军人及其家人合作多年之后,我对此深有感触。个人自尊和自立在退伍军人的生活中扮演着重要角色,11 当然在退伍军人社区中与我有联系的人的生活中也是如此。当自尊心表现为拒绝寻求帮助,并且在作者的研究结果中,在接受护理者和护理者共同做出决定的方式上产生裂痕时,会发生什么呢?这种障碍并不小,可能会减少对所需服务和支持的参与。根据我的经验,始终以肯定他们迄今为止所取得的成就为引导,似乎是吸引这类人群参与的更好方法。此外,发掘军队文化中根深蒂固的团队合作理念也是另一个有用的策略--承认我们在广阔的人生道路上都需要帮助。其次,在访谈中,作者团队让参与者填写了一份通常属于 HCBS 的服务和支持清单。重要的是,参与者可以表示不知道该服务或支持,知道但没有使用,或者现在或过去使用过。虽然没有经过验证,但在我看来,这种测量方法是明确和有用的,并且与定性访谈很好地结合在一起。在这个样本中,对退伍军人护理者支持服务和其他社区服务缺乏了解是显而易见的,这与我们自己在重病护理者和退伍军人样本中的发现如出一辙12 。
{"title":"Family caregiver lived experience matters in home- and community-based services","authors":"Nathan A. Boucher DrPH, PA, MS, MPA, CPHQ","doi":"10.1111/jgs.19120","DOIUrl":"10.1111/jgs.19120","url":null,"abstract":"&lt;p&gt;In this issue of the Journal, Trivedi et al. (&lt;i&gt;not sure about final citation&lt;/i&gt;) use in-depth interviews with family caregivers of Veterans to identify novel intervention targets to help the field improve awareness, access, and use of home- and community-based services (HCBS) among family caregivers. The authors now help me make a clarion call for the importance of engaging family caregivers—those family (sometimes friends/neighbors) bearing the joys and burdens of community-based care and support. Optimal support for aging adults and those living with disabilities in our community pivots on the awareness, willingness, skills, and time of family caregivers.&lt;/p&gt;&lt;p&gt;Inquiries such as this from Trivedi et al. are both timely and important. Their work reflects adherence to tenets of person-centeredness and community engagement trumpeted by recent reports such as the U.S. Department of Health and Human Services' Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities in May 2024, which explicitly calls out the role of family caregivers in community-based care.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The voices of family caregivers in the provision of HCBS need to be amplified as US health care and payment for that care are rebalanced toward community-based solutions and away from facility-based care.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The authors studied a critical context: family caregivers supporting Veterans served by the largest comprehensive healthcare system in the United States, the Veterans Administration (VA). Importantly, the VA pushes innovations in health systems research attuned to aging, disability, and caregiver inclusion,&lt;span&gt;&lt;sup&gt;3-6&lt;/sup&gt;&lt;/span&gt; but, as Trivedi et al. note, HCBS continue to be underutilized by Veterans and others. Complicating this, HCBS are under-resourced in many areas including direct care workers&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; who often work in tandem with family caregivers cobbling together ongoing services for the aging and those living with disabilities.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Well-supported family caregivers are crucial to the intended expansion in HCBS across populations.&lt;span&gt;&lt;sup&gt;8, 9&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The authors bring to the readers of the Journal insights on barriers to optimal use of HCBS. They accomplish this by focusing not just on logistical issues—challenges known and persistent—but, more uniquely, psychosocial and interpersonal barriers to accessing VA and non-VA HCBS alike using two complementary research methods.&lt;/p&gt;&lt;p&gt;First, the authors conducted semi-structured interviews with caregivers. This was elegantly guided by Andersen's Behavioral Model of Health Services Use.&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt; The first three resulting themes are not necessarily new but help bolster findings in the Veteran caregiver population where fewer studies reside. The authors found that caregivers experience gaps in accurate and timely information from the VA and community organizations; they lack time and expe","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 11","pages":"3296-3298"},"PeriodicalIF":4.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dexmedetomidine for agitation in dementia: Current data and future direction. 右美托咪定治疗痴呆症患者的躁动:当前数据和未来方向。
IF 6.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-19 DOI: 10.1111/jgs.19196
Kayla S Murphy,Julia C Golden,Rajesh R Tampi
BACKGROUNDThe incidence and prevalence of dementia, and thus dementia-related behavioral and psychological symptoms, are increasing significantly. Currently, there are limited safe and efficacious options for treating these symptoms. Dexmedetomidine has been used for agitation related to delirium and showed significant benefit in prior studies. This raises the question whether dexmedetomidine could also provide a safe and effective treatment for BPSD, including agitation related to dementia.METHODSOur team searched PubMed, Cochrane Database, and Ovid with the terms dexmedetomidine and dementia. Only studies published in English language journals, or with official English language translations, and human studies were included. All reports of dexmedetomidine for dementia were included regardless of study type.RESULTSNo completed studies on dexmedetomidine for agitation in dementia were identified. The TRANQUILITY study is in progress, although results are yet to be published.CONCLUSIONDexmedetomidine has shown benefit for hospital delirium and for agitation in schizophrenia and bipolar disorder. However, there are no completed studies published on dexmedetomidine for agitation in dementia. Controlled studies with larger sample sizes are needed to assess the efficacy, safety, and the best route of administration for this drug in managing BPSD including agitation.
背景痴呆症的发病率和流行率以及与痴呆症相关的行为和心理症状正在显著增加。目前,治疗这些症状的安全而有效的方法十分有限。右美托咪定已被用于治疗与谵妄相关的躁动,并在之前的研究中显示出明显的疗效。这就提出了一个问题:右美托咪定是否也能安全有效地治疗BPSD,包括与痴呆症相关的躁动?方法我们的研究小组以右美托咪定和痴呆症为关键词检索了PubMed、Cochrane数据库和Ovid。只有发表在英文期刊上的研究或有官方英文翻译的研究以及人类研究才被纳入。结果未发现有关右美托咪定治疗痴呆症躁动的完整研究。结论右美托咪定对住院谵妄以及精神分裂症和双相情感障碍中的躁动有一定疗效。然而,目前还没有关于右美托咪定治疗痴呆症躁动的完整研究报告。需要进行样本量更大的对照研究,以评估这种药物在治疗包括躁动在内的 BPSD 方面的疗效、安全性和最佳给药途径。
{"title":"Dexmedetomidine for agitation in dementia: Current data and future direction.","authors":"Kayla S Murphy,Julia C Golden,Rajesh R Tampi","doi":"10.1111/jgs.19196","DOIUrl":"https://doi.org/10.1111/jgs.19196","url":null,"abstract":"BACKGROUNDThe incidence and prevalence of dementia, and thus dementia-related behavioral and psychological symptoms, are increasing significantly. Currently, there are limited safe and efficacious options for treating these symptoms. Dexmedetomidine has been used for agitation related to delirium and showed significant benefit in prior studies. This raises the question whether dexmedetomidine could also provide a safe and effective treatment for BPSD, including agitation related to dementia.METHODSOur team searched PubMed, Cochrane Database, and Ovid with the terms dexmedetomidine and dementia. Only studies published in English language journals, or with official English language translations, and human studies were included. All reports of dexmedetomidine for dementia were included regardless of study type.RESULTSNo completed studies on dexmedetomidine for agitation in dementia were identified. The TRANQUILITY study is in progress, although results are yet to be published.CONCLUSIONDexmedetomidine has shown benefit for hospital delirium and for agitation in schizophrenia and bipolar disorder. However, there are no completed studies published on dexmedetomidine for agitation in dementia. Controlled studies with larger sample sizes are needed to assess the efficacy, safety, and the best route of administration for this drug in managing BPSD including agitation.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"191 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiovascular health, measured using Life's Essential 8, is associated with reduced dementia risk among older men and women 使用 "生命必备 8 项指标 "衡量心血管健康状况,可降低老年男性和女性患痴呆症的风险
IF 6.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-18 DOI: 10.1111/jgs.19194
Xin Li, Yichen Jin, Stefania Bandinelli, Luigi Ferrucci, Toshiko Tanaka, Sameera A. Talegawkar
BackgroundDementia poses considerable challenges to healthy aging. Prevention and management of dementia are essential given the lack of effective treatments for this condition.MethodsA secondary data analysis was conducted using data from 928 InCHIANTI study participants (55% female) aged 65 years and older without dementia at baseline. Cardiovascular health (CVH) was assessed by the “Life's Essential 8” (LE8) metric that included health behaviors (diet, physical activity, smoking status, sleep duration) and health factors (body mass index, blood lipid, blood glucose, blood pressure). This new LE8 metric scores from 0 to 100, with categorization including “low LE8” (0–49), indicating low CVH, “moderate LE8 (50‐79)”, indicating moderate CVH, and “high LE8 (80‐100)”, indicating high CVH. Dementia was ascertained by a combination of neuropsychological testing and clinical assessment at each follow‐up visit. Cox proportional hazards models were used to examine associations between CVH at baseline and risk of incident dementia after a median follow‐up of 14 years.ResultsBetter CVH (moderate/high LE8 vs. low LE8) was inversely associated with the risk of incident dementia (hazard ratio [HR]: 0.61, 95% confidence interval [CI]: 0.46–0.83, p = 0.001). Compared with health factors, higher scores of the health behaviors (per 1 standard deviation [SD]), specifically weekly moderate‐to‐vigorous physical activity time (per 1 SD), were significantly associated with a lower risk of incident dementia (health behaviors: HR:0.84, CI:0.73–0.96, p = 0.01; physical activity: HR: 0.62, CI: 0.53–0.72, p < 0.001).ConclusionWhile longitudinal studies with repeated measures of CVH are needed to confirm these findings, improving CVH, measured by the LE8 metric, may be a promising dementia prevention strategy.
背景痴呆症给健康老龄化带来了巨大挑战。方法利用 928 名 InCHIANTI 研究参与者(55% 为女性)的数据进行了二次数据分析,这些参与者年龄在 65 岁及以上,基线时未患有痴呆症。心血管健康(CVH)通过 "生命必需 8"(LE8)指标进行评估,该指标包括健康行为(饮食、体力活动、吸烟状况、睡眠时间)和健康因素(体重指数、血脂、血糖、血压)。这一新的 LE8 指标从 0 到 100 分,分类包括 "低 LE8"(0-49 分),表示低 CVH;"中 LE8(50-79 分)",表示中度 CVH;"高 LE8(80-100 分)",表示高度 CVH。在每次随访时,通过神经心理学测试和临床评估相结合的方法确定痴呆程度。结果较好的CVH(中度/高度LE8与低度LE8)与痴呆症发病风险成反比(危险比[HR]:0.61,95%置信区间[CI]:0.46-0.83,P = 0.001)。与健康因素相比,较高的健康行为得分(每 1 个标准差 [SD]),特别是每周中强度体育活动时间(每 1 个标准差),与较低的痴呆症发病风险显著相关(健康行为:HR:0.84,CI:0.73-0.96,P = 0.01;体育活动:结论虽然还需要对 CVH 进行重复测量的纵向研究来证实这些发现,但通过 LE8 指标来改善 CVH 可能是一种很有前景的痴呆症预防策略。
{"title":"Cardiovascular health, measured using Life's Essential 8, is associated with reduced dementia risk among older men and women","authors":"Xin Li, Yichen Jin, Stefania Bandinelli, Luigi Ferrucci, Toshiko Tanaka, Sameera A. Talegawkar","doi":"10.1111/jgs.19194","DOIUrl":"https://doi.org/10.1111/jgs.19194","url":null,"abstract":"BackgroundDementia poses considerable challenges to healthy aging. Prevention and management of dementia are essential given the lack of effective treatments for this condition.MethodsA secondary data analysis was conducted using data from 928 InCHIANTI study participants (55% female) aged 65 years and older without dementia at baseline. Cardiovascular health (CVH) was assessed by the “Life's Essential 8” (LE8) metric that included health behaviors (diet, physical activity, smoking status, sleep duration) and health factors (body mass index, blood lipid, blood glucose, blood pressure). This new LE8 metric scores from 0 to 100, with categorization including “low LE8” (0–49), indicating low CVH, “moderate LE8 (50‐79)”, indicating moderate CVH, and “high LE8 (80‐100)”, indicating high CVH. Dementia was ascertained by a combination of neuropsychological testing and clinical assessment at each follow‐up visit. Cox proportional hazards models were used to examine associations between CVH at baseline and risk of incident dementia after a median follow‐up of 14 years.ResultsBetter CVH (moderate/high LE8 vs. low LE8) was inversely associated with the risk of incident dementia (hazard ratio [HR]: 0.61, 95% confidence interval [CI]: 0.46–0.83, <jats:italic>p</jats:italic> = 0.001). Compared with health factors, higher scores of the health behaviors (per 1 standard deviation [SD]), specifically weekly moderate‐to‐vigorous physical activity time (per 1 SD), were significantly associated with a lower risk of incident dementia (health behaviors: HR:0.84, CI:0.73–0.96, <jats:italic>p</jats:italic> = 0.01; physical activity: HR: 0.62, CI: 0.53–0.72, <jats:italic>p</jats:italic> &lt; 0.001).ConclusionWhile longitudinal studies with repeated measures of CVH are needed to confirm these findings, improving CVH, measured by the LE8 metric, may be a promising dementia prevention strategy.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"65 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The quality of home‐based primary care delivered by nurse practitioners: A national Medicare claims analysis 执业护士提供的居家初级保健的质量:全国医疗保险报销分析
IF 6.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-18 DOI: 10.1111/jgs.19182
Jennifer Perloff, Alex Hoyt, Meera Srinivasan, Michelle Alvarez, Sam Sobul, Monica O'Reilly‐Jacob
BackgroundAs the US population ages, there is an increasing demand for home‐based primary care (HBPC) by those with Alzheimer's/dementia, multiple chronic conditions, severe physical limitations, or those facing end‐of life. Nurse practitioners (NPs) are increasingly providing HBPC, yet little is known about their quality of care in this unique setting.MethodsThis observational study uses Medicare claims data from 2018 to assess the quality of care for high‐intensity HBPC users (5 or more visits/year) based on provider type (NP‐only, physician (MD)‐only, or both NP and MDs). We employ 12 quality measures from 3 care domains: access and prevention, acute care utilization, and end‐of‐life. Analysis includes bivariate comparisons and logistic regression models that adjust for demographic, clinical, and geographic characteristics.ResultsAmong the 574,567 beneficiaries with 5 or more HBPC visits, 37% saw an NP, 37% saw a MD, and 27% saw both NPs and MDs. In multivariate models, those receiving HBPC from an NP or both NP‐MD are significantly more likely to receive a flu shot than the MD‐only group, but less likely to access preventive care. NP‐only care is associated with more acute care hospitalizations, avoidable ED visits, and fall‐related injuries, but significantly fewer avoidable admissions. For end‐of‐life care, those with NP‐only or both NP‐MD care are significantly more likely to have an advanced directive, be in hospice in the last 3 days of life, and more likely to die in hospice. The NP group is also more likely to die in the next year.ConclusionsHBPC patients are complex, with both palliative and curative needs. NPs provide almost half of HBPC in the Medicare program, to patients who are possibly sicker than those treated by physicians, with similar quality to MDs.
背景随着美国人口的老龄化,患有阿尔茨海默氏症/痴呆症、多种慢性疾病、严重身体限制或面临生命终结的人对居家初级保健(HBPC)的需求日益增加。本观察性研究使用 2018 年的医疗保险索赔数据,根据提供者类型(仅有护士、仅有医生或既有护士又有医生)评估高强度 HBPC 用户(每年就诊 5 次或以上)的护理质量。我们采用了来自 3 个护理领域的 12 项质量测量指标:就诊和预防、急性病护理利用和临终关怀。结果在 574,567 名接受过 5 次或 5 次以上 HBPC 就诊的受益人中,37% 的人接受过 NP 就诊,37% 的人接受过 MD 就诊,27% 的人同时接受过 NP 和 MD 就诊。在多变量模型中,接受 NP 或 NP-MD HBPC 治疗的受益人接受流感疫苗注射的几率明显高于仅接受 MD 治疗的受益人,但接受预防性护理的几率较低。仅接受全科医生护理的患者接受急诊住院治疗、可避免的急诊室就诊和跌倒相关伤害的几率更高,但可避免的入院治疗的几率明显更低。在临终关怀方面,只接受全科医生护理或同时接受全科医生和医生护理的患者更有可能拥有预先指示,在生命的最后 3 天接受临终关怀,也更有可能在临终关怀中去世。结论HBPC 患者病情复杂,既需要姑息治疗,也需要治疗。在医疗保险计划中,近一半的 HBPC 是由 NP 提供的,这些病人的病情可能比医生治疗的病人更严重,但其质量与医学博士类似。
{"title":"The quality of home‐based primary care delivered by nurse practitioners: A national Medicare claims analysis","authors":"Jennifer Perloff, Alex Hoyt, Meera Srinivasan, Michelle Alvarez, Sam Sobul, Monica O'Reilly‐Jacob","doi":"10.1111/jgs.19182","DOIUrl":"https://doi.org/10.1111/jgs.19182","url":null,"abstract":"BackgroundAs the US population ages, there is an increasing demand for home‐based primary care (HBPC) by those with Alzheimer's/dementia, multiple chronic conditions, severe physical limitations, or those facing end‐of life. Nurse practitioners (NPs) are increasingly providing HBPC, yet little is known about their quality of care in this unique setting.MethodsThis observational study uses Medicare claims data from 2018 to assess the quality of care for high‐intensity HBPC users (5 or more visits/year) based on provider type (NP‐only, physician (MD)‐only, or both NP and MDs). We employ 12 quality measures from 3 care domains: access and prevention, acute care utilization, and end‐of‐life. Analysis includes bivariate comparisons and logistic regression models that adjust for demographic, clinical, and geographic characteristics.ResultsAmong the 574,567 beneficiaries with 5 or more HBPC visits, 37% saw an NP, 37% saw a MD, and 27% saw both NPs and MDs. In multivariate models, those receiving HBPC from an NP or both NP‐MD are significantly more likely to receive a flu shot than the MD‐only group, but less likely to access preventive care. NP‐only care is associated with more acute care hospitalizations, avoidable ED visits, and fall‐related injuries, but significantly fewer avoidable admissions. For end‐of‐life care, those with NP‐only or both NP‐MD care are significantly more likely to have an advanced directive, be in hospice in the last 3 days of life, and more likely to die in hospice. The NP group is also more likely to die in the next year.ConclusionsHBPC patients are complex, with both palliative and curative needs. NPs provide almost half of HBPC in the Medicare program, to patients who are possibly sicker than those treated by physicians, with similar quality to MDs.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"15 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Home alone and high risk: Supporting medication management in older adults living alone with cognitive impairment 独自在家,风险高:支持有认知障碍的独居老年人的药物管理
IF 6.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-17 DOI: 10.1111/jgs.19186
Peter M. Hoang, Nathan M. Stall, Paula A. Rochon
See related article by Growdon et al.
参见 Growdon 等人的相关文章。
{"title":"Home alone and high risk: Supporting medication management in older adults living alone with cognitive impairment","authors":"Peter M. Hoang, Nathan M. Stall, Paula A. Rochon","doi":"10.1111/jgs.19186","DOIUrl":"https://doi.org/10.1111/jgs.19186","url":null,"abstract":"See related article by <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://doi.org/10.1111/jgs.19108\">Growdon et al</jats:ext-link>.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"3 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of the American Geriatrics Society
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1