Ethical and Legal Challenges in Caring for Older Adults with Multimorbidities: Best Practices for Nurses DOI Open Access

Abdulaziz M. Alodhialah,

Ashwaq A. Almutairi, Mohammed Almutairi

и другие.

Healthcare, Год журнала: 2024, Номер 12(16), С. 1585 - 1585

Опубликована: Авг. 9, 2024

This study explores the ethical and legal challenges faced by nurses in caring for older adults with multimorbidities, focusing on issues related to patient autonomy, polypharmacy, end-of-life care. Through semi-structured interviews 15 Riyadh, Saudi Arabia, research highlights complexities of obtaining informed consent from patients cognitive impairments dilemmas balancing autonomy safety. The management polypharmacy emerged as a significant concern, emphasizing importance thorough documentation coordination among healthcare providers prevent adverse drug interactions. End-of-life care advance directives posed further challenges, particularly when family members disagreed patients’ documented wishes. underscores need comprehensive strategies, including ongoing education, clear communication, supportive institutional policies, address these effectively. findings suggest that enhancing nurses’ understanding principles requirements is crucial improving ensuring compliance regulatory standards. Future should aim develop evidence-based guidelines support nursing practice managing challenges.

Язык: Английский

Anticholinergic drug exposure is associated with prevalence, worsening and incidence of dysphagia among hospitalized older adults DOI Creative Commons
Lucia Muglia, Alessia Beccacece, Luca Soraci

и другие.

The journal of nutrition health & aging, Год журнала: 2025, Номер 29(5), С. 100507 - 100507

Опубликована: Фев. 13, 2025

Язык: Английский

Процитировано

0

The prevalence and evolution of binary multimorbidity pattern in middle-aged and elderly population in China, from an insight of health metrics DOI Creative Commons
Yu Wang, Xiaojun Hu

Data Science and Informetrics, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

Процитировано

0

An analysis of protective health behavior and polypharmacy among older patients: a nationwide cohort study DOI Creative Commons
Zhaoyan Piao, Kyung Sun Oh, Euna Han

и другие.

BMC Geriatrics, Год журнала: 2024, Номер 24(1)

Опубликована: Июль 30, 2024

Abstract Background This study analyzed the relationship between protective health behaviors and polypharmacy in individuals aged 65 years older. Methods We used data from a nationwide survey (KNHANES) 2012 to 2016 conjunction with insurance claims databases. A total of 3297 adults or older were included study. Polypharmacy was defined as more than 30 prescription days 6 months five different drugs. Health-related (BMI, smoking, drinking, regular walking, living alone) extracted for before measuring polypharmacy. multivariable logistic regression on each behavior, well composite score behavior. Subgroup analysis also conducted by age sex. Results Among behaviors, BMI < 25 (OR, 0.76; 95% CI, 0.66–0.88) never smoking 0.78; 0.62–0.98) associated lower risk significantly both sex subgroups (male: OR, 0.71; 0.56–0.88; female: 0.81; 0.67–0.99) 65–79 subgroup 0.74; 0.63–0.86). The association only significant 0.55–0.91). Participants had participants zero one which statistically 0.52; 0.29–0.94). Conclusions finds that such obesity are higher Furthermore, we confirm high is Our findings indicate need geriatric-centered management prevent

Язык: Английский

Процитировано

3

Association between polypharmacy and 2-year outcomes among Chinese older inpatients: a multi-center cohort study DOI Creative Commons
Xiaomeng Liu,

Rubing Zhao,

Xingyu Zhou

и другие.

BMC Geriatrics, Год журнала: 2024, Номер 24(1)

Опубликована: Сен. 9, 2024

Язык: Английский

Процитировано

1

Risk factors correlated to potentially inappropriate medications in the elderly DOI Creative Commons
Xiaojuan Zhu, Feng Zhang, Yong Zhao

и другие.

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Апрель 3, 2024

Abstract Backgroud The prevalence of multimorbidity ( ≥2 chronic disorders in the same individual), polypharmacy ≥5 medications individual) and potentially inappropriate (PIMs) elderly patients was very high. Methods This is a cross-sectional analysis 276 aged ≥65 years old. PIMs analyzed based on Beers criteria (2019 edition) Chinese criteria, were divided into non-PIMs, 1PIMs group both critieria. Logistic regression wasconducted to investigate factors related PIMs. Results as high 96.74% (n=267). 91.30% (n=252) had polypharmacy. Determined by 40.22% (n=111) 41.30% (n=114) 1 PIMs, 26.09% (n=72) 13.77% (n=38) 2 or more Based with prescribed compared non-PIMs (median [inter-quartile range, IQR]: 10[7–12] vs.7[5-9]), significant (11[9.25-13] vs 8[7-11]); Similar results found criteria. Further logistic showed that strongest predictor increased number determined (P<0.001). Gender, diseases age not risk factor correlated our study. Conclusion common,

Язык: Английский

Процитировано

0

Structured medication reviews for adults with multimorbidity and polypharmacy in primary care: a systematic review protocol DOI Creative Commons
Elena Lammila-Escalera, Geva Greenfield, Reham Aldakhil

и другие.

BMJ Open, Год журнала: 2024, Номер 14(5), С. e082825 - e082825

Опубликована: Май 1, 2024

Introduction Polypharmacy is common among individuals with multimorbidity, often leading to inappropriate medication use and associated an increased risk of frailty, hospitalisation mortality. Structured reviews (SMRs) have emerged as a promising method for optimising use. However, research examining their efficacy limited. This review aims evaluate the impact SMRs on improving outcomes adults multimorbidity polypharmacy in primary care settings. Additionally, this seeks identify prevailing patterns trends mode delivery SMRs. Methods analysis A systematic will be conducted using Ovid MEDLINE, EMBASE, Web Science CINAHL (1997–present). Primary include medication-related measures such dose, frequency dosage form. Secondary under investigation physical, mental, functional health service outcomes, reported. Two independent reviewers conduct screening data extraction, resolving disagreements through discussion. Once eligible studies are identified, extracted summarised tabular format. The bias articles assessed either Cochrane Risk Bias 2 tool or Newcastle-Ottawa scale, depending design retrieved. Subgroup performed demographic variables modes where supports. If appropriate, meta-analysis determine reported outcomes. not possible due heterogeneity, narrative synthesis approach adopted. Ethics dissemination proposed exempt from ethical approval it collate summarise peer-reviewed, published evidence. protocol subsequent disseminated peer-reviewed journals, conferences patient-led lay summaries. PROSPERO registration number CRD42023454965.

Язык: Английский

Процитировано

0

PREVALÊNCIA DA POLIFARMÁCIA ASSOCIADA A FUNCIONALIDADE EM PESSOAS IDOSAS HOSPITALIZADAS DOI Creative Commons
Danielle Bordin, Laurieli Pereira de Oliveira, Lara Simone Messias Floriano

и другие.

Revista Enfermagem Atual In Derme, Год журнала: 2024, Номер 98(3), С. e024347 - e024347

Опубликована: Июль 1, 2024

As Doenças Crônicas não Transmissíveis são uma crescente na população idosa. Essas, dentre outras causas, desencadeiam um aumento no consumo de medicamentos, levando a polifarmácia. Objetivo: Analisar prevalência da polifarmácia associada funcionalidade em pessoas idosas hospitalizadas. Metodologia: Estudo transversal, quantitativo, realizado com indivíduos hospitalizados 60 anos ou mais (n=673). Foi realizada coleta dados à beira leito, utilizando o instrumento validado Índice Vulnerabilidade Clínico-Funcional. Empregou-se como variável dependente uso concomitante cinco medicamentos (polifarmácia) e as variáveis independentes foram questões relacionadas características funcionais – autopercepção saúde, esquecimento relatado por familiar, piorado nos últimos meses, dificuldade para caminhar, quedas último ano incontinência esfincteriana. Realizou-se teste qui-quadrado regressão logística. Resultados: A foi 28% esteve deixar tomar banho sozinho (OR=1,70;IC95%=1,16-2,50;p=0,007), esfincteriana (OR=2,08;IC95%=1,41-3,07;p<0,001) meses (OR=1,97; IC95%=1,33-2,93; p=0,001). Conclusão: Verificou-se alta nas hospitalizadas, sendo que esta condição atrelada ao ato sozinho, indício comprometimento cognitivo.

Процитировано

0

Association between reproductive lifespan and multimorbidity among Chinese postmenopausal women DOI
Jiao Jiao,

Xuehua Feng,

Ailing Gong

и другие.

Menopause The Journal of The North American Menopause Society, Год журнала: 2024, Номер 31(11), С. 945 - 951

Опубликована: Июль 30, 2024

Although menopause is considered a risk factor for multimorbidity, few studies have explored the association between reproductive lifespan and multimorbidity. This study aimed to explore multimorbidity in postmenopausal Chinese women.

Язык: Английский

Процитировано

0

Changes in patterns of multimorbidity and associated with medical costs among Chinese middle-aged and older adults from 2013 to 2023: an analysis of repeated cross-sectional surveys in Xiangyang, China DOI Creative Commons

Changyu Ju,

Hongjia Liu,

Yongxiang Gong

и другие.

Frontiers in Public Health, Год журнала: 2024, Номер 12

Опубликована: Авг. 7, 2024

Background Multimorbidity has become a major public health problem among Chinese middle-aged and older adults, the most costly to care system. However, previous population-based studies of multimorbidity have focused on limited number chronic diseases, diagnosis was based participants’ self-report, which may oversimplify problem. At same time, there were few reports relationship between patterns costs. This study analyzed changes people in China over past decade, their association with medical costs, representative hospital electronic record data. Methods Two cross-sectional surveys data used obtain adults aged 45 years Xiangyang 2013 ( n = 20,218) 2023 63,517). Latent Class Analysis analyze multimorbidity, gray correlation analysis ordered logistics model assess expenses. The classification diseases International Classification Diseases, Tenth Revision codes (ICD-10). Results detection rate disease increased (70.74 vs. 76.63%, p &lt; 0.001), from 6 9 (2013: Malignant tumors pattern, non-specific ischemic heart + hypertension cerebral infarction kidney lens pattern; new 2023: Nutritional metabolism disorders lower respiratory malignant gastrointestinal pattern) China. cost all patients been reduced (RMB: 8216.74 7247.96, IQR: 5802.28–15,737 5014.63–15434.06). top three specific both malignancy tumor pattern. Hypertension type 2 diabetes are important components patterns. Compared single disease, only pattern at risk higher costs (aOR:1.23, 95% CI: 1.03, 1.47), whereas significantly associated 2023, except for (aOR:0.35, 0.32, 0.39). Moreover, odds not consistent across Among them, [adjusted ratio (aOR):4.66, 95%CI: 4.31, 5.05] (aOR: 3.63, 3.35, 3.92) two highest risk. Meanwhile, men (aOR:1.12, 95CI:1.09, 1.16), no spouse (aOR:1.09, 95CI: 1.16) had positive effect while total self-pay 0.45, 0.29, 0.70), surgery 0.05, 0.05), rural residence 0.92, 0.89, 0.95), hospitalization days 1–5 0.04, 0.04), 6–9 0.15, 0.16) negative impact Conclusion diversified decade rising Smart, decisive comprehensive policy interventions needed effectively manage NCDS factors reduce economic burden country.

Язык: Английский

Процитировано

0

Ethical and Legal Challenges in Caring for Older Adults with Multimorbidities: Best Practices for Nurses DOI Open Access

Abdulaziz M. Alodhialah,

Ashwaq A. Almutairi, Mohammed Almutairi

и другие.

Healthcare, Год журнала: 2024, Номер 12(16), С. 1585 - 1585

Опубликована: Авг. 9, 2024

This study explores the ethical and legal challenges faced by nurses in caring for older adults with multimorbidities, focusing on issues related to patient autonomy, polypharmacy, end-of-life care. Through semi-structured interviews 15 Riyadh, Saudi Arabia, research highlights complexities of obtaining informed consent from patients cognitive impairments dilemmas balancing autonomy safety. The management polypharmacy emerged as a significant concern, emphasizing importance thorough documentation coordination among healthcare providers prevent adverse drug interactions. End-of-life care advance directives posed further challenges, particularly when family members disagreed patients’ documented wishes. underscores need comprehensive strategies, including ongoing education, clear communication, supportive institutional policies, address these effectively. findings suggest that enhancing nurses’ understanding principles requirements is crucial improving ensuring compliance regulatory standards. Future should aim develop evidence-based guidelines support nursing practice managing challenges.

Язык: Английский

Процитировано

0