Holter electrocardiogram monitoring devices are mainly indicated to assess the 24-hour heart rate and rhythm, enabling clinicians and physicians to evaluate the underlying disorders, possibly arrhythmias. The clinical significance of these modalities was apparent in different clinical events, including cardiac and non-cardiac ones. Many applications and clinical advantages were reported since the device was first reported, which changed the way how healthcare settings deal with and monitor cardiac rhythm and associated abnormalities. Evidence shows that Holter monitoring devices are useful in the appropriate patient populace and are very efficacious in diagnosing and following cardiac arrhythmias and other different cardiac conditions, which can significantly enhance the prognosis and management of cardiovascular patients. In this context, it has been shown that primary healthcare physicians should always be aware that many patients might be present with asymptomatic cardiac arrhythmias. However, not many studies have adequately assessed them in the non-cardiac population, which calls for conducting more future investigations. In the present literature review study, we aim to discuss the indications, contraindications, and clinical significance of using the Holter monitoring device based on data from the relevant studies in the literature.

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The most prevalent sleep-related breathing condition, obstructive sleep apnea (OSA), is linked to greater morbidity and poor cardiovascular outcomes. Even though sleep disorders are frequently present, primary care physicians hardly see or treat them. Better OSA symptom and intensity identification and classification to support OSA evaluation and diagnosis were the first outcomes of a task group of the American Academy of Sleep Medicine that produced quality metrics for the treatment of adult patients with the condition in 2015. The OSA screening tools (Berlin questionnaire, Epworth sleepiness scale, STOP Bang) have proven to be effective instruments for screening of sleep disorders. The present primary care practice approach for OSA screening and evaluation is disorganized and inadequate.  Patients with OSA symptomatology are seen by primary care physicians, but they are not regularly screened, assessed, or referred to a sleep specialist. For the OSA screening assessments in general practice, more psychometric investigations are required. The findings from these investigations can be applied in real-world settings to improve OSA identification.

Chronic diseases are quite prevalent and are associated with grave repercussions and considerable target organ dysfunction. Providing such patients with high-quality care can significantly lower their morbidity and mortality risk. Early disease detection, frequently when the patients are generally asymptomatic, is necessary for the provision of proper care that could reduce the chances of hazardous consequences and complications. The arrangement of care delivery with continuity of care has been shown to provide many health benefits. Numerous beneficial health outcomes have been linked to the continuity of care way of structuring the delivery of care. Continuity of care is defined as the process by which the patient and his or her physician care team work together to manage their ongoing medical care in order to achieve the shared purpose of high-quality, affordable healthcare. Additionally, continuity of care is associated with increased follow-up appointment compliance, more frequent cancer screenings, prevention programs usage, fewer emergency room visits, less hospital admissions, among various others. The continuity of care is influenced by a variety of factors, including equity and effectiveness as well as the quality of care throughout time. Research studies have shown that greater treatment continuity is associated with better mental health, a greater sense of satisfaction, and a higher quality of life. Although, the overuse of medical resources, especially through the provision of unnecessary services, is associated with poor continuity of care. The purpose of this research is to review the available information about the effect of continuity of care on chronic diseases.

Inappropriate intake of medications can increase the risk of many morbidities and mortality among the geriatric population. Therefore, assessment of drug underuse, overuse, and inappropriate use has been an area of interest across the different investigations, and according to which, different screening tools were developed to identify these problems and enhance the quality of care to these patients. In the present study, we aim comprehensively discuss the different types of currently reported screening tools that can identify potentially inappropriate medication in the geriatric population. Studies show that assess, review, minimize, optimize, reassess (ARMOR), and medication appropriateness index (MAI) tools are the most commonly reported for this purpose to appropriately evaluate drug administration practices. However, they are time-consuming and need adequately trained personnel, which might not be available within the different settings. Accordingly, we suggest that more than one tool should be used, as we have reviewed all the advantages and disadvantages of the modality within the current study, to adequately facilitate and make the process of evaluation easy and enhance the quality of care for the geriatric population.