Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.126
F Hallam-Bowles, A Kilby, A L Gordon, S Timmons, P A Logan, L Rees, W Lawry, , K Robinson
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.
{"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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.150
S Hassane, A Hassane, R Ashworth, E Law, M Drummond, S D Shenkin
Introduction Care home residents and staff have limited, though increasing, opportunities to participate in research. This project aimed to describe motivating and limiting factors for research participation and priorities in Scottish care homes. Methods In a cross-sectional study, a 21-item questionnaire was distributed to Scottish care homes for older people by ENRICH (Enabling Research in Care Homes) Scotland. It included questions on demographics and previous research involvement, with multiple choice and free-text response options. Mixed methods analysis was used including non-parametric descriptive statistics and thematic analysis. Ethical approval from University of Edinburgh SREG (ref: 2425 SREG 008). Results There were responses from 121 care homes, (28% ‘small’ <30 beds, 42.9% ‘medium’ 30–60 beds, 28.9% ‘large/very large’ > 60 beds) with ~70% residents with dementia or other neuro-progressive conditions. 40.5% (of 131 responses, multiple responses allowed) had previously been involved in research (19.1% ageing-related, 19.1% dementia-related), 29.8% had chosen not to be involved, 16% reported not being offered opportunities to be involved. Key themes about research participation were that it allows staff/resident perspectives to be heard and can improve care practices. Respondents reported that research participation was decided by family (24.6%), resident (21.9%), manager (20.3%) or others. Important research motivators were altruism: benefits for residents (94 of 631 responses, 14.9%), to help others (13.8%), future generations (12.2%), to find a cure (11.1%) or new treatment (10.1%). Important barriers included workload pressures (82 of 243 responses, 33.7%), time constraints (32.1%), potential for harm (16%) or confidentiality concerns (10.7%). Future research priorities were dementia/neuro-progressive diseases (31 of 124 responses, 25%), staff-related issues (14.5%), activities/quality of life improvements (10.5%), residents’ mental well-being (8.1%) and medications/interventions (6.5%). Conclusion Many care home staff shows that many are keen to be involved in research, but require appropriate support, and the involvement and consideration of multiple stakeholders: staff, researchers, families, residents.
养老院的居民和工作人员参与研究的机会虽然有限，但在不断增加。该项目旨在描述苏格兰护理院研究参与和优先事项的激励和限制因素。方法在横断面研究中，由苏格兰养老院使能研究（Enabling Research In care homes）向苏格兰老年人养老院分发了一份21项问卷。它包括人口统计和以前的研究参与的问题，有多项选择和自由文本回答选项。采用混合分析方法，包括非参数描述性统计和专题分析。爱丁堡大学SREG伦理批准（参考：2425 SREG 008）。结果来自121家养老院的回复（28%为“小型”和30张床位，42.9%为“中型”30 - 60张床位，28.9%为“大型/超大型”和60张床位），其中约70%的居民患有痴呆症或其他神经进展性疾病。40.5%（在131份回复中，允许多次回复）以前曾参与研究（19.1%与衰老有关，19.1%与痴呆症有关），29.8%选择不参与，16%表示没有机会参与。关于研究参与的关键主题是，它可以让工作人员/住院医生的观点得到倾听，并可以改善护理实践。受访者报告说，参与研究是由家人（24.6%）、居民（21.9%）、经理（20.3%）或其他人决定的。重要的研究动机是利他主义：居民利益（631份回应中有94份，14.9%），帮助他人（13.8%），后代（12.2%），找到治愈方法（11.1%）或新的治疗方法（10.1%）。重要的障碍包括工作量压力（243份回复中有82份，占33.7%）、时间限制（32.1%）、潜在危害（16%）或保密问题（10.7%）。未来的研究重点是痴呆/神经进步性疾病（124份回复中有31份，占25%）、工作人员相关问题（14.5%）、活动/生活质量改善（10.5%）、居民精神健康（8.1%）和药物/干预（6.5%）。结论：许多养老院工作人员热衷于参与研究，但需要适当的支持，以及多个利益相关者的参与和考虑：工作人员，研究人员，家属，居民。
{"title":"3878 Scottish care homes’ research involvement and priorities","authors":"S Hassane, A Hassane, R Ashworth, E Law, M Drummond, S D Shenkin","doi":"10.1093/ageing/afaf368.150","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.150","url":null,"abstract":"Introduction Care home residents and staff have limited, though increasing, opportunities to participate in research. This project aimed to describe motivating and limiting factors for research participation and priorities in Scottish care homes. Methods In a cross-sectional study, a 21-item questionnaire was distributed to Scottish care homes for older people by ENRICH (Enabling Research in Care Homes) Scotland. It included questions on demographics and previous research involvement, with multiple choice and free-text response options. Mixed methods analysis was used including non-parametric descriptive statistics and thematic analysis. Ethical approval from University of Edinburgh SREG (ref: 2425 SREG 008). Results There were responses from 121 care homes, (28% ‘small’ &lt;30 beds, 42.9% ‘medium’ 30–60 beds, 28.9% ‘large/very large’ &gt; 60 beds) with ~70% residents with dementia or other neuro-progressive conditions. 40.5% (of 131 responses, multiple responses allowed) had previously been involved in research (19.1% ageing-related, 19.1% dementia-related), 29.8% had chosen not to be involved, 16% reported not being offered opportunities to be involved. Key themes about research participation were that it allows staff/resident perspectives to be heard and can improve care practices. Respondents reported that research participation was decided by family (24.6%), resident (21.9%), manager (20.3%) or others. Important research motivators were altruism: benefits for residents (94 of 631 responses, 14.9%), to help others (13.8%), future generations (12.2%), to find a cure (11.1%) or new treatment (10.1%). Important barriers included workload pressures (82 of 243 responses, 33.7%), time constraints (32.1%), potential for harm (16%) or confidentiality concerns (10.7%). Future research priorities were dementia/neuro-progressive diseases (31 of 124 responses, 25%), staff-related issues (14.5%), activities/quality of life improvements (10.5%), residents’ mental well-being (8.1%) and medications/interventions (6.5%). Conclusion Many care home staff shows that many are keen to be involved in research, but require appropriate support, and the involvement and consideration of multiple stakeholders: staff, researchers, families, residents.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"177 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122197","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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.101
W Berthon, S J McGurnaghan, L A K Blackbourne, A de Assuncao Santiago Fernandes, L Walker, H Colhoun, D A McAllister, P Hanlon
Introduction This study assessed national trends in polypharmacy and potentially inappropriate prescribing among people with type 2 diabetes in Scotland, 2012 to 2022. Methods We analysed nationwide data from the Scottish Care Information–Diabetes database. Individuals aged ≥40 years with type 2 diabetes between 2012 and 2022 were included. Medication counts were based on unique medications dispensed per year excluding those for short-term indications (e.g. antibiotics). Potentially inappropriate medications were based on 2023 Beers criteria applied to people over 65 years. A Poisson mixed-effects model with individual-level random intercepts assessed the relationship between polypharmacy and gender, age group, and socioeconomic status, Elixhauser comorbidity index and the hospital frailty risk score. Results 387,338 people with type 2 diabetes were included. Median number of medications dispensed was 9 (IQR 5–13). People over 65 were dispensed a median of 2 (IQR 1–3) potentially inappropriate medications. Adjusted medication counts were modestly higher in older people (rate ratio [RR] 1.06, 95% confidence interval [CI] 1.06–1.06 at age 80+ compared to 40–59), females (1.14, 1.13–1.14), in more deprived areas (1.24, 1.23–1.24 in most deprived vs most affluent quintile) and with higher comorbidity (1.12, 1.12–1.13 in 4+ vs 0 comorbidities) but not with high frailty risk (1.00, 1.00–1.00). Potentially inappropriate medication showed a similar pattern except a stronger association with comorbidity (1.24, 1.23–1.25) and a positive association with high frailty risk (1.24, 1.23–1.25). Rates of polypharmacy and potentially inappropriate prescribing showed minimal changes across calendar time. Conclusions Polypharmacy is the norm among people with type 2 diabetes, and most people aged over 65 are prescribed two or more potentially risky medications each year. Understanding how this impacts diabetes management, risk of adverse outcomes, and quality of life is a priority in order to optimise care for people with type 2 diabetes.
{"title":"3819 Polypharmacy and potentially inappropriate prescribing in type 2 diabetes: a nationally comprehensive analysis of Scottish data","authors":"W Berthon, S J McGurnaghan, L A K Blackbourne, A de Assuncao Santiago Fernandes, L Walker, H Colhoun, D A McAllister, P Hanlon","doi":"10.1093/ageing/afaf368.101","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.101","url":null,"abstract":"Introduction This study assessed national trends in polypharmacy and potentially inappropriate prescribing among people with type 2 diabetes in Scotland, 2012 to 2022. Methods We analysed nationwide data from the Scottish Care Information–Diabetes database. Individuals aged ≥40 years with type 2 diabetes between 2012 and 2022 were included. Medication counts were based on unique medications dispensed per year excluding those for short-term indications (e.g. antibiotics). Potentially inappropriate medications were based on 2023 Beers criteria applied to people over 65 years. A Poisson mixed-effects model with individual-level random intercepts assessed the relationship between polypharmacy and gender, age group, and socioeconomic status, Elixhauser comorbidity index and the hospital frailty risk score. Results 387,338 people with type 2 diabetes were included. Median number of medications dispensed was 9 (IQR 5–13). People over 65 were dispensed a median of 2 (IQR 1–3) potentially inappropriate medications. Adjusted medication counts were modestly higher in older people (rate ratio [RR] 1.06, 95% confidence interval [CI] 1.06–1.06 at age 80+ compared to 40–59), females (1.14, 1.13–1.14), in more deprived areas (1.24, 1.23–1.24 in most deprived vs most affluent quintile) and with higher comorbidity (1.12, 1.12–1.13 in 4+ vs 0 comorbidities) but not with high frailty risk (1.00, 1.00–1.00). Potentially inappropriate medication showed a similar pattern except a stronger association with comorbidity (1.24, 1.23–1.25) and a positive association with high frailty risk (1.24, 1.23–1.25). Rates of polypharmacy and potentially inappropriate prescribing showed minimal changes across calendar time. Conclusions Polypharmacy is the norm among people with type 2 diabetes, and most people aged over 65 are prescribed two or more potentially risky medications each year. Understanding how this impacts diabetes management, risk of adverse outcomes, and quality of life is a priority in order to optimise care for people with type 2 diabetes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"41 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121868","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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.031
J Hughes, H Parker, S Birchenough, E Cattell, U Barthakur, S Woodhill, M Foster
Introduction Increasing numbers of patients live with both frailty and cancer, highlights highlighting the need for onco-geriatric services. Comprehensive Geriatric Assessment (CGA) of older oncology patients increases QoL and treatment tolerance. Recent guidance from British Geriatrics Society stresses the importance of frailty assessment to identify and optimise frailty related issues, alongside collaborative decision-making with patients. Methods OACOS was created at a District General Hospital in Somerset to identify and medically optimise frail patients in whom the treating oncologist had concerns about their ability to tolerate radical cancer treatment. Patients were referred to the service for a therapy assessment and geriatrician-led CGA to further investigate and manage concerns relating to co-morbidity, social isolation, cognitive impairment and falls. Results Between September 2022 and March 2024, 68 patients were discussed in Oncogeriatrics MDT. 49 patients were seen in the accompanying Oncogeriatrics clinic. Reasons for not being reviewed included not meeting referral criteria, redirection to alternative specialist clinic, sole OT input required and patients declining. Patients seen in clinic had an average CFS of 4 and an average G8 score of 12.5. All patients seen in clinic saw a geriatrician consultant or registrar, with 84% of patients seeing a physiotherapist for a personalised assessment. 92% of patients had a treatment escalation plan completed. All patients had a medication review with 93% of those seen having at least one medication discontinued. Other key interventions included optimisation of blood pressure, cognition and anaemia. Conclusions Patient feedback has been positive, appreciating the opportunity to review their health, optimise medical issues and reduce medication burden. Oncologists have appreciated rapid access to holistic geriatrician review alongside therapy input to improve health outcomes. Further exploration into patient’s reasons for declining review by OACOS may help identify barriers to access for some patients and the future clinic model.
{"title":"3785 Eighteen months of OACOS: evaluating the OACOS (older adults cancer optimisation service) at a district general hospital in Somerset","authors":"J Hughes, H Parker, S Birchenough, E Cattell, U Barthakur, S Woodhill, M Foster","doi":"10.1093/ageing/afaf368.031","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.031","url":null,"abstract":"Introduction Increasing numbers of patients live with both frailty and cancer, highlights highlighting the need for onco-geriatric services. Comprehensive Geriatric Assessment (CGA) of older oncology patients increases QoL and treatment tolerance. Recent guidance from British Geriatrics Society stresses the importance of frailty assessment to identify and optimise frailty related issues, alongside collaborative decision-making with patients. Methods OACOS was created at a District General Hospital in Somerset to identify and medically optimise frail patients in whom the treating oncologist had concerns about their ability to tolerate radical cancer treatment. Patients were referred to the service for a therapy assessment and geriatrician-led CGA to further investigate and manage concerns relating to co-morbidity, social isolation, cognitive impairment and falls. Results Between September 2022 and March 2024, 68 patients were discussed in Oncogeriatrics MDT. 49 patients were seen in the accompanying Oncogeriatrics clinic. Reasons for not being reviewed included not meeting referral criteria, redirection to alternative specialist clinic, sole OT input required and patients declining. Patients seen in clinic had an average CFS of 4 and an average G8 score of 12.5. All patients seen in clinic saw a geriatrician consultant or registrar, with 84% of patients seeing a physiotherapist for a personalised assessment. 92% of patients had a treatment escalation plan completed. All patients had a medication review with 93% of those seen having at least one medication discontinued. Other key interventions included optimisation of blood pressure, cognition and anaemia. Conclusions Patient feedback has been positive, appreciating the opportunity to review their health, optimise medical issues and reduce medication burden. Oncologists have appreciated rapid access to holistic geriatrician review alongside therapy input to improve health outcomes. Further exploration into patient’s reasons for declining review by OACOS may help identify barriers to access for some patients and the future clinic model.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"30 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122199","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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.114
E Williamson, M Sanchez-Santos, P Nicolson, J Bruce, C Mallen, F Griffith, A Morris, S Lamb
Introduction Being able to walk is a priority for older people and is key to maintaining independence. Declining mobility is an early predictor of loss of independence, reduced quality of life, increased health care use and death. The aim of this study was to develop and validate a prediction model to identify when an older person was at risk of self-reported mobility decline over a 2-year period. Method We used self-reported data from a prospective cohort study of 5409 people aged 65 years and over in England (The Oxford Pain, Activity and Lifestyle (OPAL) Cohort Study). Mobility status was assessed using the EQ-5D-5L mobility question. The outcome was any mobility decline at two years. Thirty-one candite variables were entered into the model including demographic factors, pain, walking, falls, comorbidities, general health and physical activity. LASSO logistic regression was used to select predictors. Models were internally validated using bootstrapping. Scores were assigned to identified predictors to calculate an individual’s risk of mobility decline. Results Over 18% of participants who could walk at baseline reported mobility decline at year two. The following variables were identified as predictors: Age Adequacy of income; Body Mass Index; Usual walking pace; Difficulties maintaining balance; Confidence to walk; Use of walking aid; Change in walking ability over 12 months; Lower limb pain; Current pain/discomfort severity; Number of health conditions; Physical tiredness; Self-reported general health; Current mobility level. Conclusions A prediction model for mobility decline were developed and internally validated. These questions could be used as an assessment tool within primary care or by older people themselves. External validation is required. We are working with stakeholders to understand how this model could be used to help older people maintain mobility.
{"title":"3725 Developing a model to predict mobility decline in community dwelling older people","authors":"E Williamson, M Sanchez-Santos, P Nicolson, J Bruce, C Mallen, F Griffith, A Morris, S Lamb","doi":"10.1093/ageing/afaf368.114","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.114","url":null,"abstract":"Introduction Being able to walk is a priority for older people and is key to maintaining independence. Declining mobility is an early predictor of loss of independence, reduced quality of life, increased health care use and death. The aim of this study was to develop and validate a prediction model to identify when an older person was at risk of self-reported mobility decline over a 2-year period. Method We used self-reported data from a prospective cohort study of 5409 people aged 65 years and over in England (The Oxford Pain, Activity and Lifestyle (OPAL) Cohort Study). Mobility status was assessed using the EQ-5D-5L mobility question. The outcome was any mobility decline at two years. Thirty-one candite variables were entered into the model including demographic factors, pain, walking, falls, comorbidities, general health and physical activity. LASSO logistic regression was used to select predictors. Models were internally validated using bootstrapping. Scores were assigned to identified predictors to calculate an individual’s risk of mobility decline. Results Over 18% of participants who could walk at baseline reported mobility decline at year two. The following variables were identified as predictors: Age Adequacy of income; Body Mass Index; Usual walking pace; Difficulties maintaining balance; Confidence to walk; Use of walking aid; Change in walking ability over 12 months; Lower limb pain; Current pain/discomfort severity; Number of health conditions; Physical tiredness; Self-reported general health; Current mobility level. Conclusions A prediction model for mobility decline were developed and internally validated. These questions could be used as an assessment tool within primary care or by older people themselves. External validation is required. We are working with stakeholders to understand how this model could be used to help older people maintain mobility.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"4 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121867","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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.143
C Whitear, S Wai, J Jegard, M Kaneshamoorthy
Introduction Involvement of Geriatricians in peri-operative assessment acknowledges the altered physiology of frail patients and helps to evaluate realistic outcomes as part of patient-centred shared decision making. This is with the aim of addressing modifiable risk factors, preventing complications, preparing for a realistic recovery and ensuring that treatment options are aligned to what is important to the patient. There is data suggesting improved survival following geriatric peri-operative assessment but little analysis from the patient’s perspective; their thoughts about the shared decision-making process, regrets about having surgery and the impact it has had on their quality of life. This study aims to identify success of our peri-operative clinic based on patient-centred parameters. Methods We identified 69 patients seen in our joint Anaesthestic and Geriatrician peri-operative assessment clinic before elective colorectal surgery. These patients were over the age of 65, had multiple co-morbidities and had their surgery between 2022–2024. Participants answered a standardised ‘Shared Decision-Making Questionnaire’ (SDM-Q-9) and ‘Decision Regret Scale’ over the phone. Results 45 patients were able to answer our questionnaires. 9 patients had died, 14 did not answer or declined and 1 was incorrectly identified. Ages ranged from 69 to 91, with the majority undergoing laparoscopic hemicolectomies. 100% of respondents felt the team helped them understand information regarding the operation, and 93% felt they made the decision jointly with the doctor. Though 6% felt that the operation did them harm, 100% agreed that it was the right decision and would go for the same choice if they chose again. Conclusion Our study suggests that patients are very satisfied after having undergone surgery and had realistic expectations and goals from combined pre-operative assessment. The shared decision-making analysis is positive and demonstrates the importance of stressing ‘not having surgery’ as an option to patients. The subjective and retrospective nature of the study may limit results.
{"title":"3513 Satisfaction with shared decision making, and decision regret in older adults undergoing elective colorectal cancer surgery","authors":"C Whitear, S Wai, J Jegard, M Kaneshamoorthy","doi":"10.1093/ageing/afaf368.143","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.143","url":null,"abstract":"Introduction Involvement of Geriatricians in peri-operative assessment acknowledges the altered physiology of frail patients and helps to evaluate realistic outcomes as part of patient-centred shared decision making. This is with the aim of addressing modifiable risk factors, preventing complications, preparing for a realistic recovery and ensuring that treatment options are aligned to what is important to the patient. There is data suggesting improved survival following geriatric peri-operative assessment but little analysis from the patient’s perspective; their thoughts about the shared decision-making process, regrets about having surgery and the impact it has had on their quality of life. This study aims to identify success of our peri-operative clinic based on patient-centred parameters. Methods We identified 69 patients seen in our joint Anaesthestic and Geriatrician peri-operative assessment clinic before elective colorectal surgery. These patients were over the age of 65, had multiple co-morbidities and had their surgery between 2022–2024. Participants answered a standardised ‘Shared Decision-Making Questionnaire’ (SDM-Q-9) and ‘Decision Regret Scale’ over the phone. Results 45 patients were able to answer our questionnaires. 9 patients had died, 14 did not answer or declined and 1 was incorrectly identified. Ages ranged from 69 to 91, with the majority undergoing laparoscopic hemicolectomies. 100% of respondents felt the team helped them understand information regarding the operation, and 93% felt they made the decision jointly with the doctor. Though 6% felt that the operation did them harm, 100% agreed that it was the right decision and would go for the same choice if they chose again. Conclusion Our study suggests that patients are very satisfied after having undergone surgery and had realistic expectations and goals from combined pre-operative assessment. The shared decision-making analysis is positive and demonstrates the importance of stressing ‘not having surgery’ as an option to patients. The subjective and retrospective nature of the study may limit results.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"89 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121873","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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.010
A M Attolico, A Homayooni, A Nathaniel, J Jegard
Background Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use. Older adults are at higher risk of antibiotic associated complications, especially C. diff infection. Methods Baseline data were collected from the hospital’s electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance, documentation of therapy end dates, and PPI co-prescription. An educational intervention (intervention 1: poster highlighting prescriber responsibilities, intervention 2: educational talk on the topic) was implemented, followed by repeat audits to measure impact. Data were analysed quantitatively using percentage adherence to metrics and qualitatively via prescriber feedback. Results After the first intervention, adherence to prescribing guidelines improved by 3%(65% to 68%), therapy end-date documentation increased by 9%(75% to 84%), and unjustified PPI co-prescriptions decreased by 7%(50% to 43%). Following the second intervention, adherence improved by an additional 4% (68% to 72%), therapy end-date documentation increased by 1% (84% to 85%), and unjustified PPI co-prescriptions decreased by 10% (43% to 33%). Conclusion Targeted educational interventions effectively improved antibiotic prescribing practices. Further cycles will focus on sustaining and building upon these improvements to optimise antimicrobial stewardship. Implications This QIP demonstrates the impact of simple, structured interventions in promoting responsible antibiotic use and reducing risks of resistance.
{"title":"3663 Improving antibiotic prescribing practices: a quality improvement project","authors":"A M Attolico, A Homayooni, A Nathaniel, J Jegard","doi":"10.1093/ageing/afaf368.010","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.010","url":null,"abstract":"Background Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use. Older adults are at higher risk of antibiotic associated complications, especially C. diff infection. Methods Baseline data were collected from the hospital’s electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance, documentation of therapy end dates, and PPI co-prescription. An educational intervention (intervention 1: poster highlighting prescriber responsibilities, intervention 2: educational talk on the topic) was implemented, followed by repeat audits to measure impact. Data were analysed quantitatively using percentage adherence to metrics and qualitatively via prescriber feedback. Results After the first intervention, adherence to prescribing guidelines improved by 3%(65% to 68%), therapy end-date documentation increased by 9%(75% to 84%), and unjustified PPI co-prescriptions decreased by 7%(50% to 43%). Following the second intervention, adherence improved by an additional 4% (68% to 72%), therapy end-date documentation increased by 1% (84% to 85%), and unjustified PPI co-prescriptions decreased by 10% (43% to 33%). Conclusion Targeted educational interventions effectively improved antibiotic prescribing practices. Further cycles will focus on sustaining and building upon these improvements to optimise antimicrobial stewardship. Implications This QIP demonstrates the impact of simple, structured interventions in promoting responsible antibiotic use and reducing risks of resistance.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"91 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121924","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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.099
A Seeley, A Wang, J Sheppard
Introduction In older patients, and in those living with frailty, the evidence for continued statin description is uncertain. Current guidelines advocate for an individualised approach, including consideration of deprescribing where the benefits are unclear. Aim Determine safety and efficacy of statin discontinuation in older people, stratified by frailty status. Methods This was a retrospective cohort study using data from Clinical practice research Datalink (CPRD) between 1998–2021. Inclusion criteria were age ≥ 65 years, with a 12-month statin medication possession ratio of ≥80%. Statin discontinuation was defined as no prescription for ≥180 days. Exposed participants were matched within practice 1:2 to those unexposed. The primary outcome measure was all-cause hospitalisation; secondary outcomes included major adverse cardiovascular events (MACE), muscle disorders, liver injury, new diabetes mellitus or cataracts. The effect of discontinuation was examined using Fine-Grey models accounting for competing risk of death, with inverse probability of treatment weighting to adjust for confounding. Results were stratified by electronic Frailty Index (eFI) category, dementia, care home residency, or housebound status in preceding year. Results The cohort included 65,727 participants who stopped a statin, and 131,453 who continued. The 1-year sub Hazard Ratios (sHR) for hospitalisation and MACE, with statin discontinuation, were 1.22 (95% CI 1.20–1.25) and 1.3 (95%CI 1.24–1.35) respectively. However, for those living with severe frailty (eFI ≥ 0.36), dementia, housebound or in a care home, risks of all-cause hospitalisation, stroke, myocardial infarction and heart failure, at 1 and 5 years, were either non-significant, or lower. Discontinuation was linked to lower risks of some statin-related adverse events (e.g. 5-Year sHR for new diabetes 0.79 [95%CI 0.74–0.84]). Conclusions Statin discontinuation is associated with an increased risk of hospitalisation and cardiovascular disease, but in those living with frailty, the relative risks of hospitalisation were lower. This may be important informing patient-centred decisions for this population.
{"title":"3690 Efficacy and safety of statin discontinuation in older people living with frailty: a UK population-wide study","authors":"A Seeley, A Wang, J Sheppard","doi":"10.1093/ageing/afaf368.099","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.099","url":null,"abstract":"Introduction In older patients, and in those living with frailty, the evidence for continued statin description is uncertain. Current guidelines advocate for an individualised approach, including consideration of deprescribing where the benefits are unclear. Aim Determine safety and efficacy of statin discontinuation in older people, stratified by frailty status. Methods This was a retrospective cohort study using data from Clinical practice research Datalink (CPRD) between 1998–2021. Inclusion criteria were age ≥ 65 years, with a 12-month statin medication possession ratio of ≥80%. Statin discontinuation was defined as no prescription for ≥180 days. Exposed participants were matched within practice 1:2 to those unexposed. The primary outcome measure was all-cause hospitalisation; secondary outcomes included major adverse cardiovascular events (MACE), muscle disorders, liver injury, new diabetes mellitus or cataracts. The effect of discontinuation was examined using Fine-Grey models accounting for competing risk of death, with inverse probability of treatment weighting to adjust for confounding. Results were stratified by electronic Frailty Index (eFI) category, dementia, care home residency, or housebound status in preceding year. Results The cohort included 65,727 participants who stopped a statin, and 131,453 who continued. The 1-year sub Hazard Ratios (sHR) for hospitalisation and MACE, with statin discontinuation, were 1.22 (95% CI 1.20–1.25) and 1.3 (95%CI 1.24–1.35) respectively. However, for those living with severe frailty (eFI ≥ 0.36), dementia, housebound or in a care home, risks of all-cause hospitalisation, stroke, myocardial infarction and heart failure, at 1 and 5 years, were either non-significant, or lower. Discontinuation was linked to lower risks of some statin-related adverse events (e.g. 5-Year sHR for new diabetes 0.79 [95%CI 0.74–0.84]). Conclusions Statin discontinuation is associated with an increased risk of hospitalisation and cardiovascular disease, but in those living with frailty, the relative risks of hospitalisation were lower. This may be important informing patient-centred decisions for this population.","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":"146121970","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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.132
T Tay, F Chen, L Shepherd, M Fertleman, A Darzi, K Grailey
Introduction Literature reviews indicate older adults are less engaged in using digital technologies due to reasons such as fear of falling and perceived lack of time. However, there is limited literature on the facilitators and barriers to engagement in digitally enabled interventions, like remote exercise programmes with sensors, among older adults with frailty. This study aimed to explore the facilitators and barriers to engagement in digital interventions among community-dwelling older adults with and without frailty. Method Community-dwelling older adults at or above 65 years old across the United Kingdoms were invited to participate in this study. Qualitative data were collected using 1:1 semi-structured interviews to understand their experiences (SETREC 6875521). Frailty was measured using PRISMA-7 where a score of greater than two was considered Frail. Purposive sampling was conducted to ensure a representative cohort was included. Interviews were audio recorded, transcribed and analysed using Braun and Clarke thematic analysis. Results Overall, 26 participants were interviewed and 13 (50%) were females. The mean age was 74.7(SD 7.67) years old, and mean duration of the interviews was 64 (SD 21.2) minutes. Six (23%) were frail on PRISMA-7. Eight themes emerged: cost, usability and functions, personal motivation, influence of immediate network, external influences, device design, perceived health benefits, and concerns about privacy and data protection. Twenty-five subthemes which emerged were categorised into facilitators and barriers to engagement. Examples of subthemes are: clear provision of health benefits was a facilitator; concerns over privacy and data protection were barriers to engagement. Participants felt there was room to do more among stakeholders like government and technology companies. Conclusions The findings highlighted various facilitators and barriers which influenced engagement with digitally enabled interventions among community-dwelling older adults with and without frailty. Wider applications of digitally enabled interventions can be informed by recommendations to overcome barriers to engagement.
{"title":"3736 Exploring facilitators and brriers to engagement with technology among older adults with and without frailty","authors":"T Tay, F Chen, L Shepherd, M Fertleman, A Darzi, K Grailey","doi":"10.1093/ageing/afaf368.132","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.132","url":null,"abstract":"Introduction Literature reviews indicate older adults are less engaged in using digital technologies due to reasons such as fear of falling and perceived lack of time. However, there is limited literature on the facilitators and barriers to engagement in digitally enabled interventions, like remote exercise programmes with sensors, among older adults with frailty. This study aimed to explore the facilitators and barriers to engagement in digital interventions among community-dwelling older adults with and without frailty. Method Community-dwelling older adults at or above 65 years old across the United Kingdoms were invited to participate in this study. Qualitative data were collected using 1:1 semi-structured interviews to understand their experiences (SETREC 6875521). Frailty was measured using PRISMA-7 where a score of greater than two was considered Frail. Purposive sampling was conducted to ensure a representative cohort was included. Interviews were audio recorded, transcribed and analysed using Braun and Clarke thematic analysis. Results Overall, 26 participants were interviewed and 13 (50%) were females. The mean age was 74.7(SD 7.67) years old, and mean duration of the interviews was 64 (SD 21.2) minutes. Six (23%) were frail on PRISMA-7. Eight themes emerged: cost, usability and functions, personal motivation, influence of immediate network, external influences, device design, perceived health benefits, and concerns about privacy and data protection. Twenty-five subthemes which emerged were categorised into facilitators and barriers to engagement. Examples of subthemes are: clear provision of health benefits was a facilitator; concerns over privacy and data protection were barriers to engagement. Participants felt there was room to do more among stakeholders like government and technology companies. Conclusions The findings highlighted various facilitators and barriers which influenced engagement with digitally enabled interventions among community-dwelling older adults with and without frailty. Wider applications of digitally enabled interventions can be informed by recommendations to overcome barriers to engagement.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"21 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121976","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}
Pub Date : 2026-02-05DOI: 10.1093/ageing/afaf368.104
B Logan, A Young, K Ludlow, D Ward, L S Hanjani, N Reid, R E Hubbard
Background There has been success in implementing frailty education for healthcare professionals, but there remains a need to improve the knowledge and skills of researchers and healthcare professionals to develop, implement and evaluate frailty-focused research. This paper describes how the Australian Frailty Network developed and evaluated a virtual community of practice (VCOP), a proven model for fostering knowledge mobilisation, to support researchers and healthcare professionals in advancing frailty research and practice in Australia. Methods A survey of prospective members sought to define the VCOP’s purpose, membership and structure. An evaluation was undertaken 18 months post-commencement, guided by the RE-AIM framework to assess reach, effectiveness, adoption, implementation and maintenance. Results Fifty-five prospective members completed the initial survey. There was wide agreement from respondents to be inclusive in defining membership. The preferred purposes of the group included networking, opportunities to gain feedback, review frailty research, and knowledge and skill acquisition. In response, Frailty Nexus was launched, with three core components (‘Learning Link-Up,’ online learning events; ‘Nexus News,’ newsletter sharing learning and research opportunities; ‘Nexus Nook,’ a library of shared resources). Membership totalled 618 from 81 organisations. Ninety-six percent of surveyed members expressed satisfaction with Frailty Nexus. Conclusions Frailty Nexus is contributing to capacity building in multidisciplinary and translational frailty research. This VCOP could serve as a model that can be adapted by others to improve research outcomes and policy implementation.
{"title":"3342 Frailty nexus: community of practice for frailty researchers and healthcare professionals","authors":"B Logan, A Young, K Ludlow, D Ward, L S Hanjani, N Reid, R E Hubbard","doi":"10.1093/ageing/afaf368.104","DOIUrl":"https://doi.org/10.1093/ageing/afaf368.104","url":null,"abstract":"Background There has been success in implementing frailty education for healthcare professionals, but there remains a need to improve the knowledge and skills of researchers and healthcare professionals to develop, implement and evaluate frailty-focused research. This paper describes how the Australian Frailty Network developed and evaluated a virtual community of practice (VCOP), a proven model for fostering knowledge mobilisation, to support researchers and healthcare professionals in advancing frailty research and practice in Australia. Methods A survey of prospective members sought to define the VCOP’s purpose, membership and structure. An evaluation was undertaken 18 months post-commencement, guided by the RE-AIM framework to assess reach, effectiveness, adoption, implementation and maintenance. Results Fifty-five prospective members completed the initial survey. There was wide agreement from respondents to be inclusive in defining membership. The preferred purposes of the group included networking, opportunities to gain feedback, review frailty research, and knowledge and skill acquisition. In response, Frailty Nexus was launched, with three core components (‘Learning Link-Up,’ online learning events; ‘Nexus News,’ newsletter sharing learning and research opportunities; ‘Nexus Nook,’ a library of shared resources). Membership totalled 618 from 81 organisations. Ninety-six percent of surveyed members expressed satisfaction with Frailty Nexus. Conclusions Frailty Nexus is contributing to capacity building in multidisciplinary and translational frailty research. This VCOP could serve as a model that can be adapted by others to improve research outcomes and policy implementation.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"9 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122022","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：