Prescription Changes During Geriatric Care Episodes: A Trend Analysis Conducted in Sweden

Reimers, Marianne; Eriksdotter, Maria; Seiger, Åke; Fastbom, Johan

doi:10.1007/s40266-017-0509-z

Cited by 8 publications

(8 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The features of HF patients in our study resembled those of general geriatric patients in Sweden concerning age, sex, and referral origin [17] as previously reported recently.…”

Section: The Patient Populationsupporting

confidence: 88%

Few geriatric heart failure patients investigated according to clinical guidelines: a retrospective review of patient records

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background Research on heart failure (HF) has often focused on younger patients. The aim of this study was to analyze extent of investigation and treatment among older patients prior to referral to inpatient geriatric care for worsening of HF. Methods Data on etiology, ejection fraction (EF) by echocardiography (ECHO), level of functioning according to New York Heart Association (NYHA), analysis of N-terminal-pro-brain natriuretic peptide (NT-Pro-BNP), ongoing treatment, adherence to guidelines, and information from previous caregiver were collected from patient records prior to admission from a sample of 134 patients. Results Few patients had been examined by a cardiologist (14%) during the year prior to referral. EF assessment had been performed in 78% (n = 105). The patients were categorized as having HF with reduced (HFrEF 28%), preserved (HFpEF 53%) or mid-range (HFmrEF 19%) EF. HFpEF patients had older EF assessments (mean 517 days) than those with HFrEF (385 days). In 61% (n = 82) at least one assessment with NT-Pro-BNP had been performed, being older among patients with HFpEF (290 days vs 16 days). There was a strong positive correlation (OR 4.9, p = 0.001) between having recent assessments of EF and NT-Pro-BNP (n = 30, 21%) and being presented with etiology in the referral, adjusted for EF, age, sex, and comorbidity. Among the HFrEF patients, 78% were treated with ACEI/ARB and BB according to ESC guidelines but reaching only half of target doses. In the HFpEF group the corresponding treatment was 46%. Among patients with EF ≤ 35% only 14% were treated with mineral receptor antagonists, ie low adherence to guidelines. Conclusions HF care in this population of older individuals showed deficiencies. There was little contact with cardiologists, lack of information of etiology in referrals and low adherence to treatment guidelines. Improving adherence to HF guidelines regarding investigation and treatment for HF in older people is therefore urgent and calls for more collaboration between specialists in cardiology and geriatric medicine.

show abstract

“…The features of HF patients in our study resembled those of general geriatric patients in Sweden concerning age, sex, and referral origin [17] as previously reported recently.…”

Section: The Patient Populationsupporting

confidence: 88%

Few geriatric heart failure patients investigated according to clinical guidelines: a retrospective review of patient records

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…This difference might be due to our data being based on patient record data at discharge where physicians register those diagnoses relevant for the hospital stay. The results regarding the number of continuous medications in our study were lower compared to the same study [ 31 ], but the same as another Swedish study [ 32 ]. Geriatricians might be more prone to reducing the number of medications if possible, which might explain the lower number in our study [ 33 ].…”

Section: Discussionsupporting

confidence: 56%

Health status and health care utilization after discharge from geriatric in-hospital stay – description of a register-based study

Rydwik

Lindqvist

Willers

et al. 2021

BMC Health Serv Res

View full text Add to dashboard Cite

Background This study is the first part of a register-based research program with the overall aim to increase the knowledge of the health status among geriatric patients and to identify risk factors for readmission in this population. The aim of this study was two-fold: 1) to evaluate the validity of the study cohorts in terms of health care utilization in relation to regional cohorts; 2) to describe the study cohorts in terms of health status and health care utilization after discharge. Methods The project consist of two cohorts with data from patient records of geriatric in-hospital stays, health care utilization data from Stockholm Regional Healthcare Data Warehouse 6 months after discharge, socioeconomic data from Statistics Sweden. The 2012 cohort include 6710 patients and the 2016 cohort, 8091 patients; 64% are women, mean age is 84 (SD 8). Results Mean days to first visit in primary care was 12 (23) and 10 (19) in the 2012 and 2016 cohort, respectively. Readmissions to hospital was 38% in 2012 and 39% in 2016. The validity of the study cohorts was evaluated by comparing them with regional cohorts. The study cohorts were comparable in most cases but there were some significant differences between the study cohorts and the regional cohorts, especially regarding amount and type of primary care. Conclusion The study cohorts seem valid in terms of health care utilization compared to the regional cohorts regarding hospital care, but less so regarding primary care. This will be considered in the analyses and when interpreting data in future studies based on these study cohorts. Future studies will explore factors associated with health status and re-admissions in a population with multi-morbidity and disability.

show abstract

“…A possible challenge in this trial may be the gradual change towards shortened length of hospital stay for geriatric inpatients in Sweden. 28 A further shortened average length of hospital stay may limit the possibilities to show significant effects of the interventions during the hospital stay. Thus, in intervention 1, the participants will be encouraged to continue with the exercises at home.…”

Section: Discussionmentioning

confidence: 99%

Study protocol for the ‘preventing functional decline in acutely hospitalised older patients (PREV_FUNC)’ study: effects of two multicomponent exercise programmes on physical function – a three-armed randomised controlled trial

Welmer,

Sandberg,

Sandlund

et al. 2023

BMJ Open

View full text Add to dashboard Cite

IntroductionAcutely hospitalised older patients often live with frailty and have an increased risk of impaired physical function. Previous studies suggest that exercise might mitigate the risk of physical impairment; however, further research is needed to compare the effect of different types of exercise interventions. In this paper, we report a protocol for a trial that aims to examine (1) if multicomponent exercise interventions (interventions that include both mobility and strengthening exercises) have effects on physical function compared with usual care in older adults and (2) if a comprehensive multicomponent exercise programme is more effective than a simple multicomponent exercise programme that only include walking and sit-to-stand exercises.Methods and analysisThis is a three-armed randomised controlled trial, with two intervention groups (comprehensive and simple exercise programme) and a control group receiving usual care. We will include 320 participants aged ≥75 years from geriatric medical departments of four hospitals in Stockholm, Sweden. Assessments will be conducted at hospital admission, discharge and 3 months thereafter concerning physical function (primary outcome), activities of daily living, health-related quality of life, sarcopenia and falls. The number of readmissions will be registered up to 1 year after discharge. Data will be analysed with linear mixed effects models, according to the intention-to-treat approach.Ethics and disseminationEthical approval for this trial has been granted by the Swedish Ethical Review Authority (approval number 2022-03032-01). Data collection will consider the information requirement, the requirement of consent, confidentiality obligations and the utilisation requirement. Trial findings will be disseminated through multiple channels, including scientific publications and conferences, and workshops with healthcare professionals and the public.Trial registration numberNCT05366075

show abstract

Prescription Changes During Geriatric Care Episodes: A Trend Analysis Conducted in Sweden

Cited by 8 publications

References 19 publications

Few geriatric heart failure patients investigated according to clinical guidelines: a retrospective review of patient records

Few geriatric heart failure patients investigated according to clinical guidelines: a retrospective review of patient records

Health status and health care utilization after discharge from geriatric in-hospital stay – description of a register-based study

Study protocol for the ‘preventing functional decline in acutely hospitalised older patients (PREV_FUNC)’ study: effects of two multicomponent exercise programmes on physical function – a three-armed randomised controlled trial

Contact Info

Product

Resources

About