Journal of the American Medical Directors Association
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Multicenter Study Observational Study
Anticholinergic drug use and negative outcomes among the frail elderly population living in a nursing home.
Increasing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment. The aim of the present study was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older nursing home residents. ⋯ The use of medications with anticholinergic properties is common among older nursing home residents. Our results suggest that among older nursing home residents the use of anticholinergic drugs is associated with important negative outcomes, such as functional decline, falls, and delirium.
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Randomized Controlled Trial Multicenter Study
Agitation in nursing home residents with dementia (VIDEANT trial): effects of a cluster-randomized, controlled, guideline implementation trial.
To test the effect of a complex guideline-based intervention on agitation and psychotropic prescriptions. ⋯ Complex guideline-based interventions are effective in reducing agitated and disruptive behavior in nursing home residents with dementia. At the same time, increased prescription of ChEIs and antidepressants together with decreased neuroleptic prescription suggests an effect toward guideline-based pharmacotherapy.
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Multicenter Study
Delirium during acute illness in nursing home residents.
To ascertain the incidence of delirium during acute illness in nursing home residents, describe the timing of delirium after acute illness onset, describe risk factors for delirium, and explore the relationship between delirium and complications of acute illness. ⋯ Delirium occurred frequently as a complication of acute illness in the nursing home, and was a risk factor for cognitive function decline. This finding supports the rationale to target individuals at the onset of an acute medical problem in the design of interventions to prevent delirium in the nursing home setting.
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Multicenter Study
Care dependency independently predicts two-year survival in outpatients with advanced chronic organ failure.
Previous studies suggest that care dependency may predict survival in hospitalized patients, but the prognostic value of care dependency in clinically stable outpatients with advanced chronic organ failure remains unknown. The objective of this study was to assess whether and to what extent care dependency predicts 2-year survival in patients with advanced chronic organ failure. ⋯ The level of care dependency independently predicts 2-year survival among clinically stable outpatients with advanced chronic organ failure. Therefore, regular assessment of the level of care dependency should be included in clinical care for patients with advanced chronic organ failure.
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Multicenter Study Comparative Study
A family booklet about comfort care in advanced dementia: three-country evaluation.
To evaluate a booklet on comfort care in dementia from the perspective of family with relevant experience, and assess nursing home resident and family factors associated with evaluations. ⋯ The booklet is suitable to inform Dutch and Canadian families on comfort care in dementia, but implementation in Italy requires further consideration. The booklet may be integrated in advance care planning in long term care, and made available outside long term care settings to serve families who wish to be informed early.