Maria Amorim, Jade Bennett, David McGarry, Brydie Moore, Paul Orrock, Lochlan Whitton, Stephen Dullard
Objectives
Residential aged care facilities (RACFs) are an emerging practice setting for osteopaths in Australia. This study explored the experiences of osteopaths working in Australian RACFs, reviewed current trends and challenges and considers future developments.
Methods
Purposive and snowball sampling were used to recruit osteopaths with experience working in RACFs. This was a qualitative descriptive study derived from verbatim interview transcripts. Data were analysed using a six-step thematic analysis.
Results
Eight interviews were conducted during January 2023. Thematic analysis identified common experiences between participants. These included positive aspects of aged care, perceived challenges of working in aged care, exposure to age-specific conditions, benefits of working in multidisciplinary teams and perceived gaps in university education curricula in relation to geriatric populations.
Conclusions
Employment in RACFs may offer a satisfying employment experience for osteopaths, albeit hindered by policy and funding inadequacy. The respondents suggested enhancing pre- and postgraduate education to better prepare and encourage the profession to engage in this health service.
{"title":"Osteopathic health care in aged care facilities: The experience of practitioners in an emerging practice setting","authors":"Maria Amorim, Jade Bennett, David McGarry, Brydie Moore, Paul Orrock, Lochlan Whitton, Stephen Dullard","doi":"10.1111/ajag.13362","DOIUrl":"10.1111/ajag.13362","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Residential aged care facilities (RACFs) are an emerging practice setting for osteopaths in Australia. This study explored the experiences of osteopaths working in Australian RACFs, reviewed current trends and challenges and considers future developments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Purposive and snowball sampling were used to recruit osteopaths with experience working in RACFs. This was a qualitative descriptive study derived from verbatim interview transcripts. Data were analysed using a six-step thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight interviews were conducted during January 2023. Thematic analysis identified common experiences between participants. These included positive aspects of aged care, perceived challenges of working in aged care, exposure to age-specific conditions, benefits of working in multidisciplinary teams and perceived gaps in university education curricula in relation to geriatric populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Employment in RACFs may offer a satisfying employment experience for osteopaths, albeit hindered by policy and funding inadequacy. The respondents suggested enhancing pre- and postgraduate education to better prepare and encourage the profession to engage in this health service.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"828-836"},"PeriodicalIF":1.4,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joanna Hikaka, Rebecca Abey-Nesbit, Zhenqiang Wu, Hamish A. Jamieson, Matthew Parsons, Ngaire Kerse, Rosemary Gibson
Objective
To investigate changes in well-being measures for older Māori after moving from community to long-term care (LTC).
Methods
We undertook a retrospective cohort study of older Māori in New Zealand (NZ) who had received assessments for their health needs whilst living at home (interRAI-HC assessment) as well as a subsequent assessment after moving into a care facility (interRAI-LTCF). All interRAI-HC assessments from 01 July 2013 to 21 December 2018 were identified and matched to LTCF assessments that were undertaken at least 6 months later. Odds ratios (OR) and 95% confidence interval (CI) were calculated to determine the difference in proportion of variables of interest (indicative of movement, socialising, sleep and nutrition, alongside general physical and mental health status) between participants' HC and subsequent LTCF assessments.
Results
Changes in well-being measures were investigated among 1531 Māori (mean age 76.2 years, 61% female). Odds of having a fall (OR: 0.40 [95% CI 0.34, 0.48]), being lonely (OR: 0.13 [95% CI 0.09, 0.18]), sleeping difficulty (OR: 0.74 [95% CI 0.60, 0.91]) and fatigue (OR: 0.18 [95% CI 0.14, 0.23]) reduced on moving to LTC. However, the presence of depression (OR 3.96 [95% CI 2.58, 6.09]) and dependence with locomotion (OR 1.56 [95% CI 1.23, 1.97]) significantly increased when moving from home to LTC.
Conclusion
Despite some indicators of functional and health-related decline, significant improvements are also apparent across multiple domains of well-being. Further investigation of resident and family perceptions of well-being in association with a move to LTC is warranted.
目的调查老年毛利人从社区转入长期护理（LTC）后在幸福指数方面的变化：我们对新西兰（NZ）的老年毛利人进行了一项回顾性队列研究，这些毛利人在家中生活时接受了健康需求评估（interRAI-HC评估），在搬入护理机构后又接受了后续评估（interRAI-LTCF）。对 2013 年 7 月 1 日至 2018 年 12 月 21 日期间的所有 interRAI-HC 评估进行了识别，并与至少 6 个月后进行的 LTCF 评估进行了比对。通过计算比值比（OR）和 95% 的置信区间（CI）来确定参与者的健康状况评估和随后的 LTCF 评估之间相关变量（运动、社交、睡眠和营养以及一般身心健康状况的指标）比例的差异：对 1531 名毛利人（平均年龄 76.2 岁，61% 为女性）的健康状况变化进行了调查。在搬到长期护理中心后，跌倒（OR：0.40 [95% CI 0.34, 0.48]）、孤独（OR：0.13 [95% CI 0.09, 0.18]）、睡眠困难（OR：0.74 [95% CI 0.60, 0.91]）和疲劳（OR：0.18 [95% CI 0.14, 0.23]）的几率降低。然而，从家中搬到长期护理中心后，抑郁（OR 3.96 [95% CI 2.58, 6.09]）和运动依赖（OR 1.56 [95% CI 1.23, 1.97]）明显增加：结论：尽管某些指标表明功能和健康相关性下降，但在多个福祉领域也有明显改善。有必要进一步调查居民和家人对迁往长期护理中心后的幸福感的看法。
{"title":"Changes in indicators of well-being on moving from home to long-term care for Māori in Aotearoa New Zealand: A retrospective cohort study","authors":"Joanna Hikaka, Rebecca Abey-Nesbit, Zhenqiang Wu, Hamish A. Jamieson, Matthew Parsons, Ngaire Kerse, Rosemary Gibson","doi":"10.1111/ajag.13361","DOIUrl":"10.1111/ajag.13361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate changes in well-being measures for older Māori after moving from community to long-term care (LTC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We undertook a retrospective cohort study of older Māori in New Zealand (NZ) who had received assessments for their health needs whilst living at home (interRAI-HC assessment) as well as a subsequent assessment after moving into a care facility (interRAI-LTCF). All interRAI-HC assessments from 01 July 2013 to 21 December 2018 were identified and matched to LTCF assessments that were undertaken at least 6 months later. Odds ratios (OR) and 95% confidence interval (CI) were calculated to determine the difference in proportion of variables of interest (indicative of movement, socialising, sleep and nutrition, alongside general physical and mental health status) between participants' HC and subsequent LTCF assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Changes in well-being measures were investigated among 1531 Māori (mean age 76.2 years, 61% female). Odds of having a fall (OR: 0.40 [95% CI 0.34, 0.48]), being lonely (OR: 0.13 [95% CI 0.09, 0.18]), sleeping difficulty (OR: 0.74 [95% CI 0.60, 0.91]) and fatigue (OR: 0.18 [95% CI 0.14, 0.23]) reduced on moving to LTC. However, the presence of depression (OR 3.96 [95% CI 2.58, 6.09]) and dependence with locomotion (OR 1.56 [95% CI 1.23, 1.97]) significantly increased when moving from home to LTC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite some indicators of functional and health-related decline, significant improvements are also apparent across multiple domains of well-being. Further investigation of resident and family perceptions of well-being in association with a move to LTC is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"818-827"},"PeriodicalIF":1.4,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient, surgical and hospital factors predicting actual first-day mobilisation after hip fracture surgery: An observational cohort study","authors":"Kalpana Kumari, Aashish Kumar, Syed Ali Arsal","doi":"10.1111/ajag.13360","DOIUrl":"10.1111/ajag.13360","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"867-868"},"PeriodicalIF":1.4,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tomomichi Sakai, Agathe Daria Jadczak, Ashna Khalid, Ronaldo D. Piovezan, Shalem Leemaqz, Renuka Visvanathan
Objectives
Depression is common amongst Australian residential aged care services (RACS) residents. This study aimed to estimate the risk of depression amongst residents and identify factors associated with this risk. In care settings such as RACS, time-efficient screening tools to identify depression risk may be a preferred tool.
Methods
The two-item Patient Health Questionnaire (PHQ-2), derived from the nine-item PHQ-9 used commonly in the United States (US), was employed in this study. A resident was identified as being at risk of depression where the score was ≥3. Multivariable logistic regression analysis was used to identify independent factors associated with being at risk of depression.
Results
Residents' mean age was 87.7 (standard deviation: 7.3) years and 73% were female. One-fifth of residents (n = 108 or 20%) were at risk of depression. Age (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93–0.99); Pain Assessment in Advanced Dementia (PAINAD) score (OR 1.55, 95% CI 1.11–2.16); Epworth Sleepiness Scale (ESS) score (OR 1.08, 95% CI 1.03–1.13); and 38-item Frailty Index (FI) score (OR 1.07, 95% CI 1.03–1.10) were significantly associated with being at risk of depression, whilst sex, urinary incontinence, polypharmacy, Dementia Severity Rating Scale (DSRS) and Nursing Home Life Space Diameter (NHLSD) score were not.
Conclusions
One in five residents were at risk of depression. Younger age, higher pain, higher daytime sleepiness and higher frailty status were associated with depressive risk. Future studies focusing on interventions targeting these factors may contribute to improved health outcomes.
{"title":"The prevalence of, and factors associated with, a risk of depression in residential aged care services residents: Findings from the FIRST study","authors":"Tomomichi Sakai, Agathe Daria Jadczak, Ashna Khalid, Ronaldo D. Piovezan, Shalem Leemaqz, Renuka Visvanathan","doi":"10.1111/ajag.13358","DOIUrl":"10.1111/ajag.13358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Depression is common amongst Australian residential aged care services (RACS) residents. This study aimed to estimate the risk of depression amongst residents and identify factors associated with this risk. In care settings such as RACS, time-efficient screening tools to identify depression risk may be a preferred tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The two-item Patient Health Questionnaire (PHQ-2), derived from the nine-item PHQ-9 used commonly in the United States (US), was employed in this study. A resident was identified as being at risk of depression where the score was ≥3. Multivariable logistic regression analysis was used to identify independent factors associated with being at risk of depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Residents' mean age was 87.7 (standard deviation: 7.3) years and 73% were female. One-fifth of residents (<i>n</i> = 108 or 20%) were at risk of depression. Age (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93–0.99); Pain Assessment in Advanced Dementia (PAINAD) score (OR 1.55, 95% CI 1.11–2.16); Epworth Sleepiness Scale (ESS) score (OR 1.08, 95% CI 1.03–1.13); and 38-item Frailty Index (FI) score (OR 1.07, 95% CI 1.03–1.10) were significantly associated with being at risk of depression, whilst sex, urinary incontinence, polypharmacy, Dementia Severity Rating Scale (DSRS) and Nursing Home Life Space Diameter (NHLSD) score were not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>One in five residents were at risk of depression. Younger age, higher pain, higher daytime sleepiness and higher frailty status were associated with depressive risk. Future studies focusing on interventions targeting these factors may contribute to improved health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"811-817"},"PeriodicalIF":1.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to explore how various factors affect older people's vehicle speed perception to enhance their road safety as pedestrians, focusing on the impact of their cognitive and perceptual abilities on road-crossing decisions.
Methods
The study evaluated the effects of brightness contrast (high, medium and low), road complexity (high and low) and vehicle travel direction (same and opposite) on speed perception errors in simulated traffic settings. It involved 38 older participants who estimated the speed of a comparison vehicle under two judgement conditions.
Results
Findings showed a consistent underestimation of speed in all conditions. A repeated-measure ANOVA revealed that speed perception errors were significantly higher with low brightness contrast, in simpler road environments, with vehicles travelling in the same direction, and when using absolute judgements.
Conclusions
These results have practical importance for public safety initiatives, traffic regulation and road design catering to older adults' perceptual needs. They also provide valuable insights for driver training programs for older adults, aimed at enhancing their understanding and management of perceptual biases.
{"title":"Impacts of brightness contrast, road environment complexity, travel direction and judgement type on speed perception errors among older adult pedestrians' road-crossing decision-making","authors":"Chia-Chen Wu","doi":"10.1111/ajag.13354","DOIUrl":"10.1111/ajag.13354","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to explore how various factors affect older people's vehicle speed perception to enhance their road safety as pedestrians, focusing on the impact of their cognitive and perceptual abilities on road-crossing decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study evaluated the effects of brightness contrast (high, medium and low), road complexity (high and low) and vehicle travel direction (same and opposite) on speed perception errors in simulated traffic settings. It involved 38 older participants who estimated the speed of a comparison vehicle under two judgement conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings showed a consistent underestimation of speed in all conditions. A repeated-measure ANOVA revealed that speed perception errors were significantly higher with low brightness contrast, in simpler road environments, with vehicles travelling in the same direction, and when using absolute judgements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results have practical importance for public safety initiatives, traffic regulation and road design catering to older adults' perceptual needs. They also provide valuable insights for driver training programs for older adults, aimed at enhancing their understanding and management of perceptual biases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"725-732"},"PeriodicalIF":1.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The COVID-19 pandemic has had a substantial impact on the utilisation of hospital and emergency department (ED) services. We examined the effect of a rapid response service on hospital re-presentations among people discharged from the ED and short-stay wards at a tertiary referral hospital.
Methods
This retrospective cohort study compared 112 patients who completed the Care in the Community program with 112 randomly selected controls. Both cases and controls were discharged from hospital between September 2020 and June 2021. Intervention patients were evaluated by a multidisciplinary team, who implemented a goal-directed program of up to 4-weeks duration. Logistic regression, negative binomial regression and Cox proportional hazards regression were used to evaluate outcomes at 28 days and at 6 months.
Results
The median time between referral and the first home visit was 3.9 days. In adjusted analyses, the intervention reduced hospital re-presentations at 28 days (odds ratio: .40, 95% confidence interval (CI): .17–.94) and lengthened the time to the first hospital re-presentation (hazard ratio: .59, 95% CI: .38–.92). Although the intervention did not reduce the total number of hospital re-presentations at 6 months (adjusted incidence rate ratio: .73, 95% CI: .49–1.08), it reduced total time spent in hospital by 303 days (582 vs. 885).
Conclusions
This study is among the first to investigate the effect of a community-based intervention on hospital re-presentations during the COVID-19 pandemic. It provides evidence that a sustainable 4-week intervention is associated with reduced hospital re-presentations and time spent in hospital.
{"title":"Care in the Community: A COVID-19 initiative to reduce hospital re-presentations among community-dwelling people","authors":"Tammy Ling, David Basic, Elise Tcharkhedian, Josephine Campisi, Bernadette Pringle, Angela Khoo","doi":"10.1111/ajag.13356","DOIUrl":"10.1111/ajag.13356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The COVID-19 pandemic has had a substantial impact on the utilisation of hospital and emergency department (ED) services. We examined the effect of a rapid response service on hospital re-presentations among people discharged from the ED and short-stay wards at a tertiary referral hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study compared 112 patients who completed the Care in the Community program with 112 randomly selected controls. Both cases and controls were discharged from hospital between September 2020 and June 2021. Intervention patients were evaluated by a multidisciplinary team, who implemented a goal-directed program of up to 4-weeks duration. Logistic regression, negative binomial regression and Cox proportional hazards regression were used to evaluate outcomes at 28 days and at 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median time between referral and the first home visit was 3.9 days. In adjusted analyses, the intervention reduced hospital re-presentations at 28 days (odds ratio: .40, 95% confidence interval (CI): .17–.94) and lengthened the time to the first hospital re-presentation (hazard ratio: .59, 95% CI: .38–.92). Although the intervention did not reduce the total number of hospital re-presentations at 6 months (adjusted incidence rate ratio: .73, 95% CI: .49–1.08), it reduced total time spent in hospital by 303 days (582 vs. 885).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is among the first to investigate the effect of a community-based intervention on hospital re-presentations during the COVID-19 pandemic. It provides evidence that a sustainable 4-week intervention is associated with reduced hospital re-presentations and time spent in hospital.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 3","pages":"474-481"},"PeriodicalIF":1.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hargun Bhalla, Guogui Huang, Karla Seaman, S. Sandun Malpriya Silva, Bosco Wu, Nasir Wabe, Johanna I. Westbrook, Amy D. Nguyen
Objective
Existing studies have highlighted suboptimal diabetes management in residential aged care facilities (RACFs). However, understanding of diabetes management in Australian metropolitan RACFs has been limited. This retrospective cohort study aimed to explore the pharmacological management of diabetes in 25 RACFs in Sydney Australia and assess concordance with clinical practice guidelines (CPGs).
Methods
Data from 231 permanent RACF residents aged ≥65 years and over with type 2 diabetes mellitus over the period from 1 July 2016 to 31 December 2019 were used. Concordance was measured by assessing the medications and medical history data for each individual resident for concordance with evidence-based CPGs. Multivariable logistic regression was used to estimate the effect of resident characteristics on concordance with CPGs.
Results
Of the 231 residents with diabetes, 87 (38%) were not taking any antidiabetic medication. Pharmacological management inconsistent with CPG recommendations was observed for 73 (32%) residents, with the most common reason for non-concordance being the use of medications with significant adverse effects in older adults (47, 2%). Residents with hypertension or other heart diseases in addition to their diabetes had greater odds of their diabetes management being non-concordant with CPGs (OR = 2.84 95% CI = 1.54, 5.3 and OR = 2.64, 95% CI = 1.07, 6.41, respectively).
Conclusions
Pharmacological diabetes management in metropolitan Australian RACFs is suboptimal, with a high prevalence of inconsistency with CPGs (32%) observed. Additionally, having hypertension or heart diseases significantly increased the possibility of non-concordance among diabetic RACF residents. Further investigation into the underlying relationships with comorbidities is required to develop better strategies.
{"title":"Diabetes in residential aged care: Pharmacological management and concordance with clinical guidelines","authors":"Hargun Bhalla, Guogui Huang, Karla Seaman, S. Sandun Malpriya Silva, Bosco Wu, Nasir Wabe, Johanna I. Westbrook, Amy D. Nguyen","doi":"10.1111/ajag.13351","DOIUrl":"10.1111/ajag.13351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Existing studies have highlighted suboptimal diabetes management in residential aged care facilities (RACFs). However, understanding of diabetes management in Australian metropolitan RACFs has been limited. This retrospective cohort study aimed to explore the pharmacological management of diabetes in 25 RACFs in Sydney Australia and assess concordance with clinical practice guidelines (CPGs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 231 permanent RACF residents aged ≥65 years and over with type 2 diabetes mellitus over the period from 1 July 2016 to 31 December 2019 were used. Concordance was measured by assessing the medications and medical history data for each individual resident for concordance with evidence-based CPGs. Multivariable logistic regression was used to estimate the effect of resident characteristics on concordance with CPGs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 231 residents with diabetes, 87 (38%) were not taking any antidiabetic medication. Pharmacological management inconsistent with CPG recommendations was observed for 73 (32%) residents, with the most common reason for non-concordance being the <i>use of medications with significant adverse effects in older adults</i> (47, 2%). Residents with hypertension or other heart diseases in addition to their diabetes had greater odds of their diabetes management being non-concordant with CPGs (OR = 2.84 95% CI = 1.54, 5.3 and OR = 2.64, 95% CI = 1.07, 6.41, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pharmacological diabetes management in metropolitan Australian RACFs is suboptimal, with a high prevalence of inconsistency with CPGs (32%) observed. Additionally, having hypertension or heart diseases significantly increased the possibility of non-concordance among diabetic RACF residents. Further investigation into the underlying relationships with comorbidities is required to develop better strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 4","pages":"792-801"},"PeriodicalIF":1.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Value co-creation to improve ageing-in-place programs in China","authors":"Shiufai Wong","doi":"10.1111/ajag.13343","DOIUrl":"10.1111/ajag.13343","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"236-238"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What is social frailty?","authors":"Jed Montayre","doi":"10.1111/ajag.13347","DOIUrl":"10.1111/ajag.13347","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"234-235"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Who is the frail consumer and how do we reach them? Engaging consumers in frailty research","authors":"Adrienne Young, Anja Christoffersen, Kenneth Rockwood","doi":"10.1111/ajag.13342","DOIUrl":"10.1111/ajag.13342","url":null,"abstract":"","PeriodicalId":55431,"journal":{"name":"Australasian Journal on Ageing","volume":"43 2","pages":"231-233"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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