Age and ageing最新文献

{"title":"3390 Establishing the prevalence of prescriptions for pharmacogenetic testable medications in a geriatric medicine inpatient cohort","authors":"M Patel, H Dillon, R Moore, C Barry","doi":"10.1093/ageing/afaf368.166","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.166","url":null,"abstract":"Introduction Genetic testing in medical practice is becoming increasingly commonplace. Particularly relevant to geriatric medicine and polypharmacy is the science of pharmacogenetics; the testing of an individual patient to check for drug-gene interactions, which can determine if a new or existing prescription is a good fit for them. We wanted to establish the prevalence of prescriptions for medicines that have a known pharmacogenetic target in a population of people admitted to a geriatric medicine department at a UK teaching hospital. Methods We conducted a retrospective cohort analysis, using a year’s worth of electronic prescribing records (1/6/23–31/05/24), for patients admitted under the care of any named geriatrician at a single site teaching hospital in the UK. We cross referenced those prescriptions against a reference list of pharmacogenetic medications (PGxMed) with a known applicable pharmacogenetic test. Results The department recorded 9115 admissions over this time period. Most patients received at least one PGxMed prescription, with nearly two thirds (61%, or 5528 out of 9115) of admissions in one year being associated with at least one PGx medication. 6 was the highest number of PGxMed prescriptions recorded against a single patient (3 instances). ‘Cholesterol lowering,’ ‘Analgesic’ and ‘Anticoagulant’ were the top three classes of medication by frequency respectively. Conclusions Prescriptions for PGxMeds are highly prevalent in geriatric medicine in-patients, and more research is required to determine what the most cost-effective PGx testing approach is. There could be a role for PGx to help identify ineffective or harmful medication in this patient group. Given that geriatricians possess an acknowledged expertise in medication review, whilst PGx is still a nascent field of testing from a UK perspective, it is one for them to be aware of since it is likely to become of more relevance in clinical practice over the next few years.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121875","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}

{"title":"3754 EAGLEcare: reducing healthcare utilisation for nursing home residents at the end of life","authors":"M H Tun, F L Ng, K Y Yee, Y-P Wong, S G Nathan, K-L Wong, L T Ang, T T Yang, CT-C Lien","doi":"10.1093/ageing/afaf368.052","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.052","url":null,"abstract":"Introduction Older people living in Nursing Homes (NH) are often admitted to Acute Hospitals (AH) towards their end-of-life (EOL) due to the limited capacity to manage exacerbations and symptoms within NHs. The EAGLEcare (Enhancing Advance care planning, Geriatric and End-of-Life care in NHs in the East) Programme was set up to improve in-NH care and to reduce avoidable AH admissions and their unintended consequences. Methods A system of proactive case-finding for residents with specific and general indicators of advanced life-limiting illnesses was developed in collaboration with NH partners, to enable early symptom recognition and timely response(s), supported by NH General Practitioners (GPs) and an interdisciplinary team from the AH, with out of hours coverage by a collaborating home palliative care service. We retrospectively studied a cohort of residents who passed away between January 2019 and December 2023 from five NHs during their final 6 months of life. Parameters including hospital admissions, emergency department (ED) visits, length of stay (LOS), and specialist outpatient clinic (SOC) visits were compared between EAGLEcare-enrolled and non-enrolled residents. Propensity score matching (1:5 ratio) was used to balance baseline characteristics, and negative binomial regression was employed to assess programme impact. Results After matching, 369 enrolled and 393 non-enrolled residents were analysed. Residents enrolled in the EAGLEcare Programme had significantly lower rates of hospital admissions (aIRR = 0.86, 95% CI: 0.77–0.97, p = 0.016), ED visits (aIRR = 0.82, 95% CI: 0.73–0.93, p = 0.001), and shorter LOS (aIRR = 0.82, 95% CI: 0.69–0.97, p = 0.024). However, SOC visit rates remained similar between groups. Conclusion(s) The EAGLEcare Programme effectively reduced hospitalizations and ED visits among NH residents at the EOL, supporting the need for integrated care models. Expanding such initiatives could improve EOL care, reduce healthcare burden, and enhance patient outcomes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"87 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121926","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}

{"title":"3689 Enhancing coordination of bone protection plans in ortho-geriatric patients: a quality improvement project","authors":"K Finch, Ð Alićehajić-Bečić","doi":"10.1093/ageing/afaf368.017","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.017","url":null,"abstract":"Introduction Bone health assessment forms a standard aspect of orthogeriatric care in line with NHFD* and NOGG**. Current recommendation is to administer first dose of bone protection medication during hospital stay due to high imminent fracture risk. We identified several cases where the first dose was delayed, including near misses and adverse events with potential for patient harm. Methods A process map of 20 patients was conducted to collect data on decision-making, documentation, and implementation of bone protection plans. A staff questionnaire identified key shortcomings and areas for improvement. A teaching session on the importance of bone protection was delivered to the ACM*** department. Trust guidelines were developed to support clinical decision making, and electronic system note redesigned for uniformity of documentation. This was included in the induction for incoming orthogeriatric team members. A re-audit was performed to assess whether patients received their first dose of bone protection prior to discharge. Result Of the sample initially collected 90% had a bone health plan made, however only 33% of these received their first dose before discharge. There were several barriers highlighted including lack of clarity/variation in documentation, inadequate replacement of vitamin D/Ca, not obtaining consent during the admission. This meant treatment was delayed in 56% and was not given in 10% of the cohort. Qualitative data collected from the questionnaire highlighted the causes in delays including requiring improvements in ‘clear communication and documentation,’ prioritising ‘early consent,’ and ‘clearer understanding of roles’ of members of the team. Following implementation of the interventions, 100% of the sample had a bone health plan made, of these 81.25% were given their first dose of iv bisphosphonate prior to discharge, thus showing a 48.25% improvement. Conclusion The improvements achieved reduction in imminent fracture risk and decreased delays in first dose of bone protective medication being administered. *National Hip Fracture Database. **National Osteoporosis Guideline Group. ***Ageing and Complex Medicine.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122020","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}

{"title":"3822 Hearing aid support for older adult patients","authors":"O C Cobb, H M Aung, L White","doi":"10.1093/ageing/afaf368.075","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.075","url":null,"abstract":"Introduction Hearing aids often appear broken and whether due to the battery or earwax simple fixes can allow patients to hear. This project aimed to improve hearing impaired patients’ experience and healthcare by providing support for hearing aids across Elderly Medicine wards in a large teaching hospital in Leeds. Method A survey evaluated the proportion of patients with non-functional hearing aids, with qualitative questions to evaluate the impact. The first intervention was a toolkit showing how to check if a hearing aid worked, how to fix common issues, to go alongside spare batteries with a QR code link for further information. As a second intervention, teaching sessions were arranged for ward staff to improve knowledge and encourage staff to fix issues. Results 101, 100 and 102 inpatients were surveyed for the baseline data collection, 1st re-audit and 2nd reaudit respectively. 1 in 4 patients had hearing aids with them and the primary outcome measure of ‘Are both hearing aids working’ improved from 56% to 70% to 87% after each intervention. The most common issue found was a flat battery and the prevalence reduced from 5 to 2 to 1. When asked what difference a working hearing aid makes: ‘It makes all the difference, I wouldn’t manage, I don’t want to miss anything,’ with one relative stating ‘I think it’s hugely important, people may just think she’s confused if she can’t hear what you’re saying, when she’s as sharp as a tack in there.’ Conclusion There was a clear improvement in the proportion of working hearing aids after each intervention and feedback from patients reinforced how impactful having a working hearing aid is. This has shown that providing hearing aid support is a practical and meaningful way of improving patient care that can be easily implemented elsewhere.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"48 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122200","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}

{"title":"3323 ‘I’m worried I won’t truly understand how to help them’: medical students’ perceptions of communicating with confused patients","authors":"S Wentzel, O Hodge","doi":"10.1093/ageing/afaf368.103","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.103","url":null,"abstract":"Introduction Hospital inpatients can present as confused for a multitude of reasons, thus learning how to effectively communicate with confused patients is a key skill for medical students. Fourth year is the first clinical year at our medical school. A verbal feedback session with fourth year medical student year representatives identified confidence in communicating with confused patients as a key concern of the cohort. Methods 40 fourth year medical students were surveyed using an online form. The students rated their confidence in communicating with confused patients on a Likert scale and were asked to explain this answer in under 100 words. These responses were collated into a Microsoft Excel Spreadsheet, and then thematic analysis using NVivo 12 software was applied to identify key themes. Results 20% (8/40) of students rated themselves as ‘very unconfident,’ 33% (13/40) as ‘somewhat unconfident,’ 38% (15/40) as ‘neither confident or unconfident,’ 7% (3/40) as ‘somewhat confident,’ and 2% (1/40) as ‘very confident.’ Key challenges identified by students included: unclear patient understanding or capacity (16 references), student communication style (15 references), patient distress or agitation (9 references), obtaining accurate information (7 references), and misunderstanding the patient (7 references). An e-learning resource including videoed simulated scenarios was created to attempt to address these challenges. 24 students who undertook the e-learning were surveyed at the end of the module. 4% (1/24) rated themselves as ‘neither confident or unconfident,’ 88% (21/24) as ‘somewhat confident,’ and 8% (2/24) as ‘very confident,’ with no students rating themselves as ‘very unconfident’ or ‘somewhat unconfident.’ Conclusion Medical students at the beginning of their clinical years lack confidence and identify several key challenges in communicating with confused patients. An understanding of these challenges is important for those working in Geriatric Medicine, particularly those involved in medical education. E-learning and utilising technology can be a helpful tool in developing students’ learning and confidence in this area.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"110 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122377","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}

{"title":"3694 Upholding equitable access to secondary fracture prevention for adults 80 years and older","authors":"A Singh, P Anthonypillai, A Williams, S Maggs, C Edwards, I Singh","doi":"10.1093/ageing/afaf368.093","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.093","url":null,"abstract":"Introduction Fragility fractures increase re-fracture and mortality risk, especially within two years. Fracture Liaison Services (FLS) aim to prevent secondary fractures by ensuring quality care for patients over 50. This study assesses equity of care in an existing FLS for patients above and below 80 years and evaluates re-fracture and mortality outcomes. Methods We retrospectively reviewed 2190 patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS) from January–December 2023 using national FLS Database (FLS-DB) data. After excluding 14 patients with missing data, 2176 were categorised as: below 80 and above 80 years. Data on previous fractures, re-fractures, and fracture type (hip/femur, spine, wrist, humerus, pelvis, others) were collected. Patients were followed until March 31, 2025, for re-fractures and mortality. Results The cohort’s mean age was 78.6 years (range: 50–103), with a significant female predominance (76.9%, p < 0.0001). Prior fractures were recorded in 50.7% (n = 1104), with a mean interval of 6 years (range: 0–36). Most (93.3%) lived in the community, 6.7% were in care homes. AB-FLS reviewed 1103 (50.7%) patients aged 50–80 and 1073 (49.3%) aged over 80, with no significant group differences. Female distribution was similar (78.8% vs. 75%). Bone treatment was initiated in 1207 (55.2%) patients. Over 27 months follow-up, 1801 (82.8%) had no re-fracture. Overall, 17.2% (n = 374) re-fractured (mean time: 253 days, range: 2–767 days). A significantly higher patients re-fractured in over 80 years (n = 209, 55.9%, mean 235 days) as compared to under 80 years (n = 165, 44.1%, mean 276 days, p = 0.023). At 12 months, 264 (12.1%) re-fractured: 154 (58.3%) over 80 (mean 137 days) and 110 (41.7%) under 80 (mean 151 days, p = 0.008). By 27 months, 503 patients had died. One-year mortality was 18.6% (n = 387), significantly higher in those over 80s (75.7%, n = 293) than under 80 (24.3%, n = 94, p < 0.0001). Conclusion The AB-FLS has demonstrated equitable care over the consecutive twelve-month period; however, further assessment over a longer timeframe is needed for confirmation. Given the significantly higher risk of re-fracture and mortality in older patients, secondary fracture services should be tailored to better address the needs of this population, ensuring true equity in healthcare.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"47 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122381","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}

{"title":"3749 Clinical determinants of 180-day hospital readmission and mortality in older adults with dementia: a UK-based cohort study","authors":"B Browne, E Ford, I Rogers, K Ali, N Tabet","doi":"10.1093/ageing/afaf368.092","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.092","url":null,"abstract":"Introduction Older adults with dementia occupy approximately one quarter of acute hospital beds in England. The risk of hospital readmission within six months of discharge increases with multiple long-term conditions, reduced mobility, and limited interdisciplinary collaboration between primary and secondary care. Subsequently, hospital readmission can increase the risk of mortality in this population. This study aimed to quantify the clinical determinants of readmission and subsequent mortality in older adults with dementia in England. Method A retrospective cohort study was conducted using anonymised data from adults in England aged 65 and over with a recorded diagnosis of dementia. Cases were identified through primary care electronic health records in the Clinical Practice Research Datalink (CPRD) GOLD, between April 1997 and November 2018. Readmissions within 180 days were identified using linked Hospital Episode Statistics. Adjusted logistic regression assessed factors associated with readmission, and Cox proportional hazards regression identified predictors of one-year mortality following readmission. Results The cohort included 24,956 patients from 253 general practices (mean age 81.93 years; 61.6% female). Chronic obstructive pulmonary disease (odds ratio [OR] = 1.26, 95% confidence interval [CI]: 1.15–1.39), diabetes mellitus (OR = 1.21, CI: 1.13–1.30), and chronic kidney disease (OR = 1.14, CI: 1.07–1.22) were strongly associated with readmission. Medication review in primary care within one year prior to admission (OR = 1.08, CI: 1.02–1.14), and primary care consultation within two weeks of discharge (OR = 1.21, CI: 1.15–1.28) were also associated with readmission. One-year mortality following readmission was associated with age (hazard ratio [HR] = 3.20, CI: 2.49–4.11 for ages 90+ versus 65–69), multiple long-term conditions (HR = 1.21, CI: 1.05–1.41 for 4–5 conditions versus none), prescriptions for antipsychotic medication (HR = 1.37, CI: 1.22–1.53), and care home residence (HR = 1.33, CI: 1.10–1.62). Conclusion Knowledge of clinical factors associated with readmission and mortality can inform advanced care planning between health and social care professionals, older adults with dementia and their families.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"301 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122204","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}

{"title":"3771 Improving clinical frailty score documentation in oncology wards","authors":"L Manokaran, P Biju","doi":"10.1093/ageing/afaf368.029","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.029","url":null,"abstract":"Introduction The Clinical Frailty Score (CFS) allows appropriate frailty assessment to guide management plans for oncology patients. CFS documentation is not standard at our trust. We aimed to introduce CFS documentation in the Acute Oncology Service (AOS) clerking proforma and evaluate its use in patients aged >65 to help guide management. Methods Data was obtained from inpatients on the oncology wards via NerveCentre. Three PDSA cycles were completed: Cycle 1: An evaluation to identify how many patients had a documented CFS. Based on this, a poster was created, emailed to oncology staff, and displayed around the ward. Cycle 2: A teaching presentation was delivered to junior doctors on the oncology ward. Cycle 3: Nursing staff were informed and encouraged to discuss CFS during morning board rounds. Data was collected after each cycle. Results There was a total increase of 20% in documentation after all three interventions. The initial documentation rate was 4.4%. This rose to 6.6% after posters were introduced, increased to 15.5% following junior doctor teaching, and reached 24.4% after involving nursing staff in PDSA Cycle 3. Conclusion Educating junior doctors and involving nurses in discussions around CFS helped improve documentation. It has been noted that identifying the CFS on admission increases the likelihood of it being recorded. Since the improvement is still modest, we now plan to incorporate the CFS into the AOS clerking proforma to increase compliance and make documentation part of routine practice.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"24 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121874","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}

{"title":"3724 An audit of inpatient falls—are we adequately addressing bone health?","authors":"A Ahmed","doi":"10.1093/ageing/afaf368.022","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.022","url":null,"abstract":"Background Falls in older adults frequently result in osteoporotic fractures, leading to longer stays, greater dependency, and long-term morbidity. Fragility fractures are estimated to cost the UK around £4.5 billion annually. Despite these serious implications, tools like FRAX, and routine assessments such as calcium and vitamin D levels, are still underused in the inpatient setting, especially following a fall. The National Osteoporosis Guideline Group (NOGG) recommends using the FRAX tool to estimate 10-year fracture risk and guide bone protection. Objective To evaluate: • Was a FRAX score calculated for patients who fell while in hospital? • Was bone protection initiated appropriately based on FRAX risk? • Was a vitamin D level checked within one year of the fall? Method A retrospective case review of 35 in-patients falls during April–May 2023 across the Trust was done. Patients identified via DATIX and then randomly selected. A custom-designed proforma was used to assess completion of post-fall assessment form, FRAX score, risk stratification and bone health management decisions. Results Most falls occurred in patients aged 70–90, consistent with NICE data indicating that 30% of people over 65 and 50% over 80 fall annually. Falls assessment sheet was completed in over 80% of cases. FRAX score was calculated in only 33.3% of cases. Among those, 60% of the patients were at intermediate risk, 20% at high risk and 10% at very high risk of future fractures. Among high-risk patients only 50% received oral bisphosphonates. Among patients without a FRAX assessment retrospective calculation showed 60% were very high risk and missed the opportunity for bone protection. Key Findings High compliance with Trust guidelines in completing post-fall assessments. Suboptimal FRAX score documentation, with more than half of fallers not being assessed for fracture risk. Retrospective FRAX scoring revealed many of these were at moderate or high risk and could have benefited from intervention. Calcium and vitamin D checks were performed more frequently than FRAX but still fell short of optimal levels. Concerns regarding bisphosphonate use in patients with renal impairment. Only 50% of intermediate-risk patients had safe creatinine clearance for bisphosphonates, and less than 10% of high-risk patients were eligible. Recommendations ‘Falls Alert Stickers’ were introduced in high-risk areas. These include checkboxes for Calcium, Vitamin D, FRAX, and Creatinine Clearance, and a QR code linking to guidance for easy access. Clinician education on bone health management should be enhanced through Grand Rounds and departmental meetings, especially given the high proportion of elderly admissions. Post falls proforma was updated with a separate bone health assessment section and a QR code linked to guidelines. Conclusion: Falls remain a major issue in older inpatients, often resulting in serious fractures and long-term disability. Improving adherence to NICE and NOGG guidel","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121973","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}

{"title":"3715 A qualitative evaluation exploring co-production in care homes","authors":"F Hallam-Bowles, A Kilby, A L Gordon, S Timmons, P A Logan, L Rees, W Lawry, , K Robinson","doi":"10.1093/ageing/afaf368.126","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.126","url":null,"abstract":"Introduction Co-production approaches are increasingly used in research. However, they are not often evaluated in care home settings. The study aimed to explore how co-production occurred in a series of workshops around falls management in care homes. Methods Sixteen stakeholders (care home residents and relatives, care home staff, health and social care professionals) participating in co-production workshops in a systematic action research study were invited to take part in a qualitative evaluation. The workshops were developing a model for delivering falls training in care homes across Nottinghamshire. Non-participant observations of workshops explored stakeholder interactions. Nine stakeholders participated in reflection meetings to share their experiences of the process. Framework analysis mapped key themes to the National Institute for Health and Care Research’s (NIHR) co-production principles. Results Nine themes were identified. Sharing power was influenced by opportunities to challenge dominant voices, resulting from the influence of the research team and separate stakeholder groups, and wider integration challenges across the health and social care system. Inclusion of all perspectives was affected by variable involvement of key stakeholders in the workshops and supported by a flexible approach. Respecting and valuing knowledge was influenced by self-confidence and supported by appreciating diverse stakeholder expertise and experiences. All stakeholders reported benefits of participating in co-production workshops, for example helping others and learning about falls management. However, reputational concerns and fatigue were potential harms of participation. Team dynamics changed as relationships developed. Conclusions Co-production was largely a positive experience for stakeholders and the NIHR’s key principles were partially achieved based on our qualitative findings. Co-production in care home settings is a complex process affected by multiple factors, including the individuals involved, stakeholder relationships, organisational priorities, and integration across the system. Future research should consider organisational power dynamics at all stages and create safe spaces for inclusive participation.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122144","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}