Medication Reviews and Clinical Outcomes in Persons with Dementia: A Scoping Review DOI Creative Commons

Rishabh Sharma,

N.C. Mahajan,

Sarah Abu Fadaleh

et al.

Pharmacy, Journal Year: 2023, Volume and Issue: 11(5), P. 168 - 168

Published: Oct. 20, 2023

Persons diagnosed with dementia are often faced challenges related to polypharmacy and inappropriate medication use could benefit from regular reviews. However, the of such reviews has not been examined in this population. Therefore, current scoping review was designed identify gaps knowledge regarding impact on clinical outcomes older adults dementia. Relevant studies were identified by searching three databases (Ovid MEDLINE, Ovid EMBASE, Scopus) inception January 2022 a combination keywords medical subject headings. After removal duplicates ineligible articles, 22 publications initial 8346 included review. A total 57 identified, including those pertaining evaluation (n = 17), drug-related interventions 11), problems 10), dementia-related behavioral symptoms 8), cost-effectiveness 2), hospital admissions 1), as well classified other 7). Gaps through paucity measuring management capacity adherence, quality life, mortality.

Language: Английский

Dissemination of the Care Ecosystem Collaborative Care Model for Dementia DOI Creative Commons
Alissa Bernstein Sideman, Sarah Dulaney, Jennifer Merrilees

et al.

Journal of the American Geriatrics Society, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 6, 2025

ABSTRACT Background Dementia represents a growing healthcare challenge in the United States. The Care Ecosystem, an effective collaborative care model, bridges medical and social needs for individuals with dementia. purpose of this study was to describe how Ecosystem has been disseminated lessons learned from experience. Methods Interested site leaders both health systems community‐based organizations reviewed online implementation support materials consulted directors. Those that decided move forward were invited join monthly ‘Implementation Meetings.’ Observations these meetings review minutes combined surveys interviews, which analyzed using qualitative descriptive methods. Results Implementation efforts resulted adoption at 28 eight organizations, including 22 participants Medicare's Guiding Improved Experience (GUIDE) payment model. Meetings facilitated learning adaptation supported fidelity core model elements. Ecosystem's flexible approach open‐source enabled tailored implementations align local contexts population needs. Conclusions exemplifies scalable dementia care, guided by science principles bridge gap between research real‐world application. Its success improving patient outcomes reducing costs underscores its potential enhance delivery on broader scale. Future should focus refining strategies, enhancing monitoring, expanding partnerships sustain scale practices across diverse settings.

Language: Английский

Citations

0
Stakeholder Engagement to Inform and Refine an Existing Dementia Care Model in Home-Based Primary Care: The Co-Creation of Dementia Care Quality at Home DOI

Ayush Thacker,

M S Sy, Bruce Leff

et al.

Journal of Applied Gerontology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 6, 2025

Millions of Americans have Alzheimer’s Disease and Related Dementias (ADRD). While people with ADRD can live well, many become homebound are not able to access office-based primary care. Existing dementia care interventions improve patient caregiver outcomes but tailored living dementia, their caregivers, or home-based (HBPC) practices clinicians who for them. This study aimed adapt existing models the HBPC setting through qualitative focus groups caregivers ( n = 24) 22). Using FRAME framework intervention adaptation, Framework analysis method, our findings include that identified behavior management, decision-making, safety as key areas where they needed more help from practice. We co-created Dementia Care Quality at Home (DCQH) address this gap by adapting an model home HBPC. Evaluation will determine if refinement based on feedback enhances feasibility acceptability DCQH.

Language: Английский

Citations

0
Scoping review of outpatient dementia care programs in the U.S. from 2011-2023 DOI
Mariya Kovaleva, Fayron Epps, Bonnie Mowinski Jennings

et al.

Geriatric Nursing, Journal Year: 2025, Volume and Issue: 62, P. 203 - 214

Published: Feb. 26, 2025

Language: Английский

Citations

0
Medicine Optimisation and Deprescribing Intervention Outcomes for Older People with Dementia or Mild Cognitive Impairment: A Systematic Review DOI Creative Commons
Nicola Andrews, Cindy Brooks, Michèle Board

et al.

Drugs & Aging, Journal Year: 2025, Volume and Issue: unknown

Published: March 11, 2025

Polypharmacy is common amongst older people with dementia or mild cognitive impairment (MCI), increasing the risk of medication-related harm. Medicine optimisation and deprescribing to reduce polypharmacy considered feasible, safe can lead improved health. However, for those living MCI, this be challenging. This systematic review aimed summarise evidence on outcomes medicine interventions MCI. Literature was searched using CINAHL, Embase, Medline, PsychINFO, Web Science Cochrane Library from database inception January 2024. Papers reporting data specific MCI interventional research studies any design in setting were included. A narrative synthesis conducted owing heterogeneity study designs outcomes. Quality assessed Mixed Methods Appraisal Tool. total 32 papers 28 included, samples ranging 29 17,933 patients a mean patient age 74 88 years. Of studies, 60% undertaken long-term care settings. Involvement and/or carers limited. grouped as either incorporating medication component (n = 13), education 5) both 14). Studies primarily focussed outcomes, generally showing positive effect decreasing number improving appropriateness medications. Fewer reported clinical (behavioural psychological symptoms dementia, falls, quality life cognition) mixed findings. reduction no change mortality hospital attendance demonstrated safety few these The mixed. reduced increased medications, although less frequently reported, seemed showed an absence worsening highlights need further research, particularly at home, more focus greater involvement informal carers. protocol published International Prospective Register Systematic Reviews (PROSPERO) [Ref: CRD42023398139].

Language: Английский

Citations

0
High‐risk medication use among older adults with cognitive impairment living alone in the United States DOI
Matthew E. Growdon, Bocheng Jing, Kristine Yaffe

et al.

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: unknown

Published: July 26, 2024

Abstract Background More than one‐fourth of older adults with cognitive impairment (CI) live alone; these individuals often lack support for medication management and face a high risk adverse drug events. We characterized the frequency types high‐risk medications used by CI living alone and, context, compared patterns those in others. Methods This was cross‐sectional study National Health Aging Trends Study (NHATS) data Medicare claims (2015–2017). ascertained status from NHATS use Part D claims. (those effects or low tolerance misuse) among versus others using logistic regression models adjusted demographic/clinical factors. Results The unweighted sample included 1569 CI, whom 491 (weighted national estimate, 31%) were alone. In living‐alone group, mean age 79.9 years 66% female, 64% reported managing on their own without difficulty, 14% 18% received total management. Older median 5 (IQR, 3–8), 16% took ≥10 medications, 46% ≥1 (anticholinergic/sedating: 24%; opioid: 13%; anticoagulant: 10%; sulfonylurea: insulin: 9%). Compared others, similar ( p > 0.05 unadjusted/adjusted comparisons). Those more likely both to take at least one not receive help management: 34% 23% < Conclusions many medications; nearly half medications. Our findings can inform optimization interventions supporting this vulnerable population.

Language: Английский

Citations

2
Long‐term effects of collaborative dementia care on quality of life and caregiver well‐being DOI Creative Commons
Katherine L. Possin, Sarah Dulaney, Alissa Bernstein Sideman

et al.

Alzheimer s & Dementia, Journal Year: 2024, Volume and Issue: 21(1)

Published: Nov. 19, 2024

Collaborative dementia care models with navigation, including the Care Ecosystem, improve outcomes for persons living (PLWDs) and their caregivers. The effects of continuous over long periods have not been studied. In this randomized clinical trial 456 PLWD-caregiver dyads high caregiver burden, we evaluated cumulative 5-year treatment effect on PLWD quality life, health utilization, depression, self-efficacy, burden. Five-year participation was associated higher lower self-efficacy (all p's < 0.05) a trend burden (p = 0.07). Treatment were most robust during first 2 years. emergency department visits hospitalizations significant. benefits collaborative life well-being are sustained 5 years, may experience greatest benefit navigation years using trial. better person caregiver. in

Language: Английский

Citations

2
Implementation and review of the care ecosystem in an integrated healthcare system DOI Creative Commons
Michael Rosenbloom, Bhavani Kashyap,

Ana Diaz‐Ochoa

et al.

BMC Geriatrics, Journal Year: 2023, Volume and Issue: 23(1)

Published: Aug. 24, 2023

Abstract Background and objectives The University of California, San Francisco Memory Aging Center (UCSF-MAC) led the development tested a collaborative care model delivered by lay team navigators (CTNs) with support from multidisciplinary known as Care Ecosystem (CE). We evaluated outcomes related to feasibility CE in non-academic healthcare system, including acceptability, adoption, fidelity original UCSF model. Research Design methods at HealthPartners consisted two CTNs, social worker, an RN, program coordinator, behavioral neurologist. Intake forms were developed collect demographic, baseline, annual data one year dementia severity caregiver status. Experience surveys completed 6 12 months participating caregivers. All was entered into REDCap. Results A total 570 PWD-caregiver dyads recruited CE: 53% PWDs female, average age 75.2 ± 9.43, 19% living within rural communities. Of 173 assessed year, 30% responded intake 58% experience surveys. At progressed disease functional impairment, although burden mood remained unchanged. observed significant reduction reported emotional challenges associated caregiving, sleep problems, obtaining help year. 86% caregivers feeling supported their CTN nearly always or quite frequently, 88% rated highly responsive what important them. Discussion implications feasible well-received system.

Language: Английский

Citations

5
Potentially inappropriate prescribing for people with dementia in ambulatory care: a cross-sectional observational study DOI Creative Commons

Nourah A. Alageel,

Carmel Hughes, Monira Alwhaibi

et al.

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: April 10, 2024

Studies have shown that potentially inappropriate prescribing (PIP) is highly prevalent among people with dementia (PwD) and linked to negative outcomes, such as hospitalisation mortality. However, there are limited data on appropriateness for PwD in Saudi Arabia. Therefore, we aimed estimate the prevalence of PIP investigate associations between other patient characteristics an ambulatory care setting.

Language: Английский

Citations

1
The Maelstrom of Medications—Optimization of Prescribing During the Course of Dementia DOI
Matthew E. Growdon, Alexander K. Smith

JAMA Internal Medicine, Journal Year: 2023, Volume and Issue: 183(10), P. 1108 - 1108

Published: Aug. 21, 2023

Older adults living with dementia and the caregivers clinicians caring for them must navigate a maelstrom of medications. In dementia, multimorbidity is norm, polypharmacy exceedingly common.1

Language: Английский

Citations

2
Pragmatic implementation of comprehensive dementia care management: The Cedars‐Sinai C.A.R.E.S. Program preliminary data DOI
Zaldy S. Tan, Nabeel Qureshi,

Erica Spivack

et al.

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: 72(8), P. 2532 - 2543

Published: March 25, 2024

The United States faces a growing challenge with over 6.5 million people living dementia (PLwD). PLwD and their caregivers struggle cognitive, functional, behavioral, psychosocial issues. As care shifts to home settings, receive inadequate support but bear increasing responsibilities, leading higher healthcare costs. In response, the Centers for Medicare & Medicaid Services (CMS) introduced Guiding an Improving Dementia Experience (GUIDE) Model. study explores real-world implementation of Cedars-Sinai C.A.R.E.S. Program, pragmatic model, detailing its recruitment process initial outcomes.

Language: Английский

Citations

0