No abstract

Background: A significant number of living labs (LLs) have been developed across Europe and beyond. A fraction of those LLs have established a new approach to maintaining and studying the health, autonomy, and well-being of older adults with dementia. LLs interact with a broad set of stakeholders, including students, academic institutions, private companies, healthcare organizations, and patient representative bodies -even with other LLs. It is crucial to identify what kinds of co-creations should be done and how they can be facilitated through LLs. Despite a growing body of literature, a clear overview and understanding of the services, research, and clinical activities developed in different LL settings for older adults with dementia are still lacking. Aim: The aim is to scope publications examining all types of LL activities which explore the needs of and suggest solutions for older adults with dementia, whether they live in the community or long-term healthcare facilities. Methods: The bibliographic databases to be searched will include Embase.com, Medline Ovid SP, Pubmed (not medline [sb]) and Web of Science, without language or date restrictions. We will examine the bibliographies of all relevant articles found, conduct a search for unpublished studies, and perform a handsearch in relevant journals associated with LLs involved in healthcare (Electronic Journal for Virtual Organization and Networks, Technology Innovation Management Review, Journal of Engineering and Technology Management). We will consider publications in English, French, and German. Results: Bibliographic database searches will be completed in March 2020, retrieved articles will be screened, and the entire study is expected to be completed by December 2020. Discussion: This comprehensive scoping review will provide a global indication of the types and extent of LL activities aimed at older adults with dementia, whether they live in the community or in long-term care facilities.

Ageing populations with multiple chronic conditions challenge low-, middle-, and high-income countries. Older adults frequently depend on complex medication regimens and polypharmacy, both of which can lead to potentially devastating and debilitating medication-related problems and to subsequent far-reaching public health, social, and economic effects. This perspectives article provides an overview of the current state of medication management, reflects on its relevance among polymedicated home-dwelling older adults living with multiple chronic conditions, and proposes patient-centered approaches for optimizing medication management and preventing medication-related problems.

Background Numerous living labs have established a new approach for studying the health, independent living, and well-being of older adults with dementia. Living labs interact with a broad set of stakeholders, including students, academic institutions, private companies, health care organizations, and patient representative bodies and even with other living labs. Hence, it is crucial to identify the types of cocreations that should be attempted and how they can be facilitated through living labs. Objective This study aims to scope publications that examine all types of living lab activities, exploring the needs and expectations of older adults with dementia and seeking solutions, whether they live in the community or long-term health care facilities (LTHFs). Methods This scoping review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations for the extension of scoping reviews. We searched six bibliographic databases for publications up to March 2020, and a forward-backward citation chasing was performed. Additional searches were conducted using Google Scholar. The quality of the selected papers was assessed. Results Of the 5609 articles identified, we read 58 (1.03%) articles and retained 12 (0.21%) articles for inclusion and final analysis. All 12 articles presented an innovative product, developed in 4 main living labs, to assist older adults with cognitive disorders or dementia living in the community or LTHFs. The objectives of these studies were to optimize health, quality of life, independent living, home care, and safety of older adults with cognitive disorders or dementia, as well as to support professional and family caregivers or reduce their burdens. The overall methodological quality of the studies ranged from poor to moderate. Conclusions This scoping review identified several living labs playing a pivotal role in research aimed at older adults with dementia living in the community or LTHFs. However, it also revealed that living labs should conduct more better-quality interventional research to prove the effectiveness of their technological products or service solutions. International Registered Report Identifier (IRRID) RR2-10.2147/SHTT.S233130

Objective: The objective of this review was to provide a comprehensive overview of the measurement properties of the available instruments used by clinicians for identifying adults in need of general or specialized palliative care in hospital settings. Introduction: Identification of patients in need of palliative care has been recognized as an area where many health care professionals need guidance. Differentiating between patients who require general palliative care and patients with more complex conditions who need specialized palliative care is particularly challenging. Inclusion criteria: We included development and validation studies that reported on measurement properties (eg, content validity, reliability, or responsiveness) of instruments used by clinicians for identifying adult patients (>18 years and older) in need of palliative care in hospital settings. Methods: Studies published until March 2020 were searched in four databases: Embase.com, MEDLINE (Ovid), PubMed, and CINAHL (EBSCO). Unpublished studies were searched in Google Scholar, government websites, hospice websites, the Library Network of Western Switzerland, and WorldCat. The search was not restricted by language; however, only studies published in English or French were eligible for inclusion. The title and abstracts of the studies were screened by two independent reviewers against the inclusion criteria. Full-text studies were reviewed for inclusion by two independent reviewers. The quality of the measurement properties of all included studies were assessed independently by two reviewers according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Results: Out of the 23 instruments identified, four instruments were included, as reported in six studies: the Center to Advance Palliative Care (CAPC) criteria, the Necesidades Paliativas (NECPAL), the Palliative Care Screening Tool (PCST), and the Supportive and Palliative Care Indicators Tool (SPICT). The overall psychometric quality of all four instruments was insufficient according to the COSMIN criteria, with the main deficit being poor construct description during development. Conclusions: For the early identification of patients needing palliative care in hospital settings, there is poor quality and incomplete evidence according to the COSMIN criteria for the four available instruments. This review highlights the need for further development of the construct being measured. This may be done by conducting additional studies on these instruments or by developing a new instrument for the identification of patients in need of palliative care that addresses the current gaps in construct and structural validity. Systematic review registration number: PROSPERO CRD42020150074