Age and ageing
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Randomized Controlled Trial
Educating nursing home staff on fracture prevention: a cluster randomised trial.
to assess whether specialist osteoporosis nurses delivering training to care home staff can reduce fractures and improve the prescription of treatments to reduce fractures versus usual care. ⋯ the intervention significantly increased the prescription of bisphosphonates and calcium/vitamin D, but was not associated with a significant effect on the rate of falls or fractures.
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Randomized Controlled Trial
Home-based medication review in a high risk elderly population in primary care--the POLYMED randomised controlled trial.
To assess whether home-based medication review by a pharmacist for at-risk older patients in a primary care setting can reduce hospital admissions. ⋯ No positive impact on clinical outcomes or quality of life was demonstrated, however, this intervention did appear to reduce prescribing. This is in line with other evidence and suggests that this form of intervention may not have a clear health gain, but may lead to modest savings in terms of reduced prescribing. Future research should focus on whether such a prescribing effect would make this type of intervention cost effective.
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Randomized Controlled Trial
Clinical medication review by a pharmacist of elderly people living in care homes--randomised controlled trial.
to measure the impact of pharmacist-conducted clinical medication review with elderly care home residents. ⋯ general practitioners do not review most care home patients' medication. A clinical pharmacist can review them and make recommendations that are usually accepted. This leads to substantial change in patients' medication regimens without change in drug costs. There is a reduction in the number of falls. There is no significant change in consultations, hospitalisation, mortality, SMMSE or Barthel scores.
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Randomized Controlled Trial Multicenter Study Comparative Study
The role of selective decontamination of the digestive tract in acute stroke.
following a stroke, morbidity and mortality is high, with aspiration pneumonia being a common complication. ⋯ high carriage of and colonisation by AGNB was found within this study, which was reduced by the addition of SDD. Although SDD reduced the presence of both organisms and documented episodes of pneumonia, mortality remained unchanged.
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Randomized Controlled Trial
Does home treatment affect delirium? A randomised controlled trial of rehabilitation of elderly and care at home or usual treatment (The REACH-OUT trial).
delirium is a frequent adverse consequence of hospitalisation for older patients, but there has been little research into its prevention. A recent study of Hospital in the Home (admission substitution) noted less delirium in the home-treated group. ⋯ home rehabilitation for frail elderly after acute hospitalisation is a viable option for selected patients and is associated with a lower risk of delirium, greater patient satisfaction, lower cost and more efficient hospital bed use.