Journal of the American Medical Directors Association
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Randomized Controlled Trial
Education to reduce potentially harmful medication use among residents of assisted living facilities: a randomized controlled trial.
The objectives of this study were (1) to investigate the effect of nurse training on the use of potentially harmful medications; and (2) to explore the effect of nurse training on residents' health-related quality of life (HRQoL), health service utilization, and mortality. ⋯ Activating learning methods directed at nurses in charge of comprehensive care can reduce the use of harmful medications, maintain HRQoL, and reduce hospitalization in residents of assisted living facilities.
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Randomized Controlled Trial Multicenter Study
An educational intervention on drug use in nursing homes improves health outcomes resource utilization and reduces inappropriate drug prescription.
Inappropriate drug prescription is a common problem in people living in nursing homes and is linked to adverse health outcomes. This study assessed the effect of an educational intervention directed to nursing home physicians in reducing inappropriate prescription and improving health outcomes and resource utilization. ⋯ An educational intervention on drug use is feasible in nursing home physicians and improves the use of inappropriate drugs, use of antipsychotics, and drug duplications in their residents. It may also improve the risk of delirium and falls, and reduce the use of health care resources.
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Use of hospice has been associated with improved outcomes for nursing home residents and attitudes of nursing home staff toward hospice influences hospice referral. The objective of this study is to describe attitudes of certified nursing assistants (CNAs), nurses, and social workers toward hospice care in nursing homes. ⋯ A majority of staff responded favorably regarding hospice care in nursing homes. About one-third of nursing home staff rated coordination of care lower than other aspects, and many qualitative comments highlighted examples of when hospice was not responsive to patient needs, representing important opportunities for improvement.
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Body wasting in the context of chronic illness is associated with reduced quality of life and impaired survival. Recent clinical trials have investigated different approaches to improve patients' skeletal muscle mass and strength, exercise capacity, and survival in the context of cachexia and body wasting, many of them in patients with cancer. The aim of this article was to summarize clinical trials published over the past 2 years. Therapeutic approaches discussed include appetite stimulants, such as megestrol acetate, L-carnitine, or melatonin, anti-inflammatory drugs, such as thalidomide, pentoxyphylline, or a monoclonal antibody against interleukin-1α as well as ghrelin and the ghrelin agonist anamorelin; nutritional support, and anabolics, such as enobosarm and testosterone.
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To examine the independent associations between atrial fibrillation (AF) and objectively measured mobility in a nationally representative cohort. ⋯ AF is independently associated with lower usual gait speed in community-dwelling adults and this effect is magnified in those aged 70 and older. This may place them at increased risk of falls, hospitalization, cognitive decline, and mortality, as well as stroke and heart failure. Early recognition and treatment of AF is vital to improve physical function and reduce this risk.