Latest & greatest articles for geriatrics

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Top results for geriatrics

181. A controlled trial of inpatient and outpatient geriatric evaluation and management. (Abstract)

A controlled trial of inpatient and outpatient geriatric evaluation and management. Over the past 20 years, both inpatient units and outpatient clinics have developed programs for geriatric evaluation and management. However, the effects of these interventions on survival and functional status remain uncertain.We conducted a randomized trial involving frail patients 65 years of age or older who were hospitalized at 11 Veterans Affairs medical centers. After their condition had been stabilized (...) , patients were randomly assigned, according to a two-by-two factorial design, to receive either care in an inpatient geriatric unit or usual inpatient care, followed by either care at an outpatient geriatric clinic or usual outpatient care. The interventions involved teams that provided geriatric assessment and management according to Veterans Affairs standards and published guidelines. The primary outcomes were survival and health-related quality of life, measured with the use of the Medical Outcomes

2002 NEJM Controlled trial quality: predicted high

182. The impact of geriatric post-discharge services on mental state

The impact of geriatric post-discharge services on mental state The impact of geriatric post-discharge services on mental state The impact of geriatric post-discharge services on mental state Cole M G Authors' objectives To determine the impact of geriatric post-discharge services on mental state. Searching MEDLINE and HealthSTAR were searched from January 1975 to May 2000, using the keywords 'home care services'(exploded) or 'patient readmission'(exploded) and 'aged' and 'clinical trials (...) ' (exploded). The Cochrane Database of Systematic Reviews was also searched. The bibliographies of retrieved articles were screened for additional references. Study selection Study designs of evaluations included in the review Studies were included if they were controlled trials and original research, published in English or French. All the included trials were randomised. Specific interventions included in the review Any geriatric post-discharge service was included. Services included multi-disciplinary

2001 DARE.

183. Tolerability and effectiveness of atypical antipsychotics in male geriatric inpatients

Tolerability and effectiveness of atypical antipsychotics in male geriatric inpatients Tolerability and effectiveness of atypical antipsychotics in male geriatric inpatients Tolerability and effectiveness of atypical antipsychotics in male geriatric inpatients Verma S, Orengo C A, Kunik M E, Hale D, Molinari V A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of atypical antipsychotics for the treatment of male geriatric inpatients. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population The study population comprised men admitted to a VA Medical Centre geriatric inpatient unit with various psychiatric disorders. Setting The setting was a hospital. The economic analysis was carried

2001 NHS Economic Evaluation Database.

184. A randomized clinical trial of outpatient geriatric evaluation and management

A randomized clinical trial of outpatient geriatric evaluation and management A randomized clinical trial of outpatient geriatric evaluation and management A randomized clinical trial of outpatient geriatric evaluation and management Boult C, Boult L B, Morishita L, Dowd B, Kane RL, Urdangarin C F Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions (...) followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The geriatric evaluation and management (GEM) service, an outpatient programme for the management of older persons at high risk of hospital admission, was examined. The main aim of the programme was to prevent disability among high-risk older outpatients. GEM participants received primary care from a GEM team, which comprised a geriatrician, gerontological nurse practitioner, nurse

2001 NHS Economic Evaluation Database.

185. Geriatric rehabilitation following fractures in older people: a systematic review

Geriatric rehabilitation following fractures in older people: a systematic review Geriatric rehabilitation following fractures in older people: a systematic review Geriatric rehabilitation following fractures in older people: a systematic review Cameron I, Crotty M, Currie C, Finnegan T, Gillespie L, Gillespie W, Handoll H, Kurrle S, Madhok R, Murray G, Quinn K, Torgerson D Authors' objectives To identify, critically appraise and synthesise the published evidence for the effectiveness and cost (...) on studies meeting the inclusion criteria. Specific interventions included in the review Interventions included were those designed to improve function (mobility and self-care) and/or reduce hospital stay. These fell into three broad categories: 1. Packages of care: Geriatric orthopaedic rehabilitation unit (GORU), geriatric hip fracture programme (GHFP), early supported discharge (ESD) programme and application of a clinical pathway. 2. The consequences of the introduction of prospective payment system

2000 DARE.

186. Geriatric rehabilitation following fractures in older people: a systematic review

Geriatric rehabilitation following fractures in older people: a systematic review Geriatric rehabilitation following fractures in older people: a systematic review Geriatric rehabilitation following fractures in older people: a systematic review Cameron I, Crotty M, Currie C, Finnegan T, Gillespie L, Gillespie W, Handoll H, Kurrie S, Madhok R, Murray G, Quinn K, Torgerson D Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation Cameron I, Crotty M, Currie C, Finnegan T, Gillespie L, Gillespie W, Handoll H, Kurrie S, Madhok R, Murray G, Quinn K, Torgerson D. Geriatric rehabilitation following fractures in older people: a systematic review. Health Technology Assessment 2000; 4(2): 1-105 Authors' objectives The objectives of this review were to identify, critically appraise and synthesise the published evidence for the effectiveness and cost

2000 Health Technology Assessment (HTA) Database.

187. Clinical and economic effects of pharmacy services in a geriatric ambulatory clinic

Clinical and economic effects of pharmacy services in a geriatric ambulatory clinic Clinical and economic effects of pharmacy services in a geriatric ambulatory clinic Clinical and economic effects of pharmacy services in a geriatric ambulatory clinic Blakey S A, Hixson-Wallace J A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed (...) by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The provision of a clinical pharmacy service in a geriatric primary care clinic was studied. Type of intervention Primary prevention. Economic study type Cost-effectiveness analysis. Study population The patient population comprised men attending a Veterans Affairs Medical Centre in the USA. No detailed characteristics of the population were provided. Setting The setting was primary care

2000 NHS Economic Evaluation Database.

188. Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia. Full Text available with Trip Pro

Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia. To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture.Preplanned subanalysis of randomised intervention study. Settting: Jyväskylä Central Hospital, Finland.243 independently living patients aged 65 years or older admitted to hospital with hip fracture.After surgery patients in the intervention (...) group (n=120) were referred to the geriatric ward whereas those in the control group were discharged to local hospitals.Length of hospital stay, mortality, and place of residence three months and one year after surgery for hip fracture.The median length of hospital stay of hip fracture patients with moderate dementia (mini mental state examination score 12-17) was 47 days in the intervention group (n=24) and 147 days in the control group (n=12, P=0.04). The corresponding figures for patients

2000 BMJ Controlled trial quality: uncertain

189. The impact of a geriatrics evaluation and management unit compared to standard care in a community teaching hospital

The impact of a geriatrics evaluation and management unit compared to standard care in a community teaching hospital The impact of a geriatrics evaluation and management unit compared to standard care in a community teaching hospital The impact of a geriatrics evaluation and management unit compared to standard care in a community teaching hospital Stewart M, Suchak N, Scheve A, Popat-Thakkar V, David E, Laquinte J, Gloth F M Record Status This is a critical abstract of an economic evaluation (...) that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of an acute inpatient geriatrics unit, that is, a geriatric evaluation and management (GEM) unit, for the care of frail elderly patients. The GEM unit was staffed by an interdisciplinary team consisting of a physician's assistant, a social worker

1999 NHS Economic Evaluation Database.

190. A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients

A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients Nikolaus T, Specht-Leible N, Bach M, Oster P, Schlierf G Record Status This is a critical abstract of an economic evaluation that meets the criteria (...) for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology This paper compared three approaches to the management of elderly hospitalised patients: 1. Intervention, i.e. comprehensive geriatric assessment with additional in-hospital and post-discharge follow-up by an interdisciplinary home intervention team. 2. Assessment, i.e

1999 NHS Economic Evaluation Database.

191. Cost-effectiveness of outpatient geriatric assessment with an intervention to increase adherence

Cost-effectiveness of outpatient geriatric assessment with an intervention to increase adherence Cost-effectiveness of outpatient geriatric assessment with an intervention to increase adherence Cost-effectiveness of outpatient geriatric assessment with an intervention to increase adherence Keeler B K, Robalino D A, Frank J C, Hirsch S H, Maly R C, Reuben D B Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract (...) contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The health intervention under study was outpatient comprehensive geriatric assessment (CGA) with an intervention to improve adherence to recommendations among elderly subjects. The intervention involved a team comprising a geriatrician, a geriatric nurse practitioner (NP), a social worker, and a physical therapist

1999 NHS Economic Evaluation Database.

192. Impact of geriatric home screening services on mental state: a systematic review

Impact of geriatric home screening services on mental state: a systematic review Impact of geriatric home screening services on mental state: a systematic review Impact of geriatric home screening services on mental state: a systematic review Cole M G Authors' objectives To determine the impact of geriatric home screening services on mental state. Searching MEDLINE was searched from January 1976 to June 1997; HealthSTAR was searched from January 1975 to June 1997. Keywords used for searches (...) were "health services for the aged" exploded, and "clinical trials" exploded. Bibliographies of relevant reports were searched for additional studies. Only trials published in English or French were included. Study selection Study designs of evaluations included in the review Controlled trials (randomised and non-randomised) which included at least one measure of mental state. Specific interventions included in the review Geriatric home screening services; Questionnaire or health visits to assess

1998 DARE.

193. A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community

A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

1995 NHS Economic Evaluation Database.

194. A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. Full Text available with Trip Pro

A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. The prevention of disability in elderly people poses a challenge for health care and social services. We conducted a three-year, randomized, controlled trial of the effect of annual in-home comprehensive geriatric assessment and follow-up for people living in the community who were 75 years of age or older. The 215 people in the intervention group were seen at home by gerontologic nurse (...) significantly more visits to physicians among the participants in the intervention group than among those in the control group (mean number of visits per month, 1.41 in year 2 and 1.27 in year 3 in the intervention group, as compared with 1.11 and 0.92 visits, respectively, in the control group; P = 0.007 and P = 0.001, respectively). The cost of the intervention for each year of disability-free life gained was about $46,000.A program of in-home comprehensive geriatric assessments can delay the development

1995 NEJM Controlled trial quality: uncertain

195. A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients. (Abstract)

A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients. Although many studies describe benefits from the comprehensive assessment of elderly patients by an interdisciplinary team (comprehensive geriatric assessment), the most supportive evidence for the process has come from programs that rely on specialized inpatient units and long hospital stays. We examined whether an inpatient geriatric consultation service might also be beneficial in a trial involving (...) hospital stay, a new fracture, and age of 80 years or older. Of the 1337 patients assigned to the experimental group, 1261 (94 percent) received a comprehensive geriatric assessment in the form of a consultation, with limited follow-up; the 1016 patients assigned to the control group received usual care. The functional and health status of the patients was measured at base line and 3 and 12 months later; survival was assessed at 12 months. Subgroups of patients who might be presumed to benefit from

1995 NEJM Controlled trial quality: uncertain

196. An economic appraisal of two strategies in geriatric screening

An economic appraisal of two strategies in geriatric screening An economic appraisal of two strategies in geriatric screening An economic appraisal of two strategies in geriatric screening Johansen G Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions (...) drawn. Health technology Screening to identify previously unreported needs for geriatric care. Type of intervention Screening. Economic study type Cost-effectiveness analysis. Study population Individuals over 70 years of age, from a coastal community who were not admitted to a hospital or nursing home. Most of the study population werepreviously associated with the fishing industry and educated only to primary school level. Setting Healthcare clinic/community. The economic study was carried out

1994 NHS Economic Evaluation Database.

197. Comprehensive geriatric assessment: a meta-analysis of controlled trials. (Abstract)

Comprehensive geriatric assessment: a meta-analysis of controlled trials. There is disagreement on the usefulness of comprehensive geriatric assessment (CGA) due to conflicting results from individual trials. We did a meta-analysis on 28 controlled trials comprising 4959 subjects allocated to one of five CGA types and 4912 controls. Published data were supplemented with reanalysed data provided by the original investigators. We calculated combined odds ratios of important outcomes by pooling (...) data from individual trials with multivariate logistic regression. Combined odds ratio (95% confidence interval) of living at home at follow-up was 1.68 (1.17-2.41) for geriatric evaluation and management units, 1.49 (1.12-1.98) for hospital-home assessment services, and 1.20 (1.05-1.37) for home assessment services. Covariate analysis showed that programmes with control over medical recommendations and extended ambulatory follow-up were more likely to be effective. Our analysis suggests that CGA

1993 Lancet

198. A randomized, controlled trial of a geriatric assessment unit in a community rehabilitation hospital. (Abstract)

A randomized, controlled trial of a geriatric assessment unit in a community rehabilitation hospital. We conducted a randomized trial in a community rehabilitation hospital to determine the effect of treatment in a geriatric assessment unit on the physical function, institutionalization rate, and mortality of elderly patients. Functionally impaired elderly patients (mean age, 78.8 years) who were recovering from acute medical or surgical illnesses and were considered at risk for nursing home (...) placement were randomly assigned either to the geriatric assessment unit (n = 78) or to a control group that received usual care (n = 77). The two groups were similar at entry and were stratified according to the perceived risk of an immediate nursing home placement. After six months, the patients treated in the geriatric assessment unit had significantly more functional improvement in three of eight basic self-care activities (P less than 0.05). Those in the lower-risk stratum had significantly more

1990 NEJM Controlled trial quality: uncertain

199. Consultative geriatric assessment for ambulatory patients. A randomized trial in a health maintenance organization. (Abstract)

Consultative geriatric assessment for ambulatory patients. A randomized trial in a health maintenance organization. Previous studies have shown that comprehensive geriatric assessment and follow-up can improve the health of hospitalized elderly patients. To evaluate the effectiveness of consultative geriatric assessment and limited follow-up for ambulatory patients, we randomized 600 elderly patients who were enrolled in a health maintenance organization into three groups: (1) consultation (...) by a geriatric assessment team, (2) consultation by a "second opinion" internist, and (3) only traditional health maintenance organization services (control patients). The geriatric assessment team identified previously unrecognized problems in 35% of patients and advised changes in medication regimens for more than 40%. Nevertheless, patients who received assessment achieved only a small benefit in cognitive function after 3 months, which was not sustained for 1 year. There was no difference among groups

1990 JAMA Controlled trial quality: uncertain

200. Effectiveness of geriatric rehabilitative care after fractures of the proximal femur in elderly women: a randomised clinical trial. Full Text available with Trip Pro

Effectiveness of geriatric rehabilitative care after fractures of the proximal femur in elderly women: a randomised clinical trial. To compare postoperative collaborative care between orthopaedic surgeons and physicians in geriatric medicine with routine orthopaedic care in elderly women with proximal femoral fracture.Exclusion of patients dying before fit enough to enter trial, those with pathological fractures, those likely to be discharged within seven days of entering the trial, and those

1988 BMJ Controlled trial quality: uncertain