Assessing the Impact of an Interdisciplinary Team Approach Using the ARMOR Protocol on the Rate of Psychotropic Medications and Other Quality Indicators in Long-Term Care Facilities

Abstract

Polypharmacy in older nursing home patients is a well-documented concern. Several large studies have demonstrated an association between treatment with antipsychotics and increased morbidity and mortality in people with dementia, and the economic impact of polypharmacy is also substantial, with annual medicationrelated issues costing $7.6 billion in nursing facilities alone. We chose to use the Assess, Review, Minimize, Optimize, Reassess (ARMOR) protocol for our team-based intervention to address inappropriate prescribing in older residents. A reduction in the use of psychotropic medications was associated with an improvement in activities of daily living and fewer reports of depression but was also linked to an increase in the rate of falls and reports of pain. The lower use of antipsychotics also appears to unmask untreated anxiety, expressed in the results as the increased rate of antianxiety medications.

Hearing Assessment and Rehabilitation for People Living With Dementia

“…Under-identification and lack of support for hearing impairment among PwD are problematic because hearing impairment exacerbates the impact of dementia¸ with lower quality of life, increased depression, functional decline, social isolation, increased dependency, and carer burden all linked to untreated hearing impairment among PwD (Resnick et al 1997;Dawes et al 2019b;Mamo et al 2018). Behavioral and psychological symptoms associated with dementia including agitation, hallucinations, and aggression are also exacerbated with untreated hearing impairment (Haque et al 2012;El Haj et al 2017).…”

“…Effective management of BPSD requires audiologists to work with carers and a coordinated multi-disciplinary healthcare team. Audiologists may have a role in addressing sensory under-stimulation and disorientation that may underlie some BPSDs by providing amplification and optimizing hearing function (Haque et al 2012; Leverett 1991). Audiologists also have a role involving understanding (and helping others to understand) the perspective of the PwD (consistent with the VIPS model) and that some BPSDs are responses to unmet needs, discomfort, or attempts to communicate.…”

Assessing the Efficacy of the ARMOR Tool–Based Deprescribing Intervention for Fall Risk Reduction in Older Patients Taking Fall Risk–Increasing Drugs (DeFRID Trial): Protocol for a Randomized Controlled Trial

“…The ARMOR tool [ 11 ] is designed to guide health care professionals in a structured approach to medication management, emphasizing the importance of regular assessment, review, modification, optimization, and reassessment. It promotes patient-centered care and aims to enhance medication safety and effectiveness.…”

Stumbling Blocks in the Investigation of the Relationship Between Age-Related Hearing Loss and Cognitive Impairment

“…A patient with CI had worn dysfunctional HA equipment for many years because she could neither manage the battery nor report that the HA was not working. Such cases may not be rare, which may increase the difficulties in HA-CI investigations (Haque et al, 2012). Routine maintenance of the HA equipment may be a solution; however, it will impose a financial burden on the patients.…”

“…Last, the technological limitations of the currently used HA equipment may enhance the experimental difficulty. Haque et al (2012). reported a typical scenario in which patients with CI experience problems using HA equipment.…”