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Barriers and enablers to general practitioner referral of older adults to hearing care: a systematic review using the theoretical domains framework. 全科医生转介老年人听力护理的障碍和促进因素:使用理论领域框架的系统回顾。
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-05-22 DOI: 10.1007/s41999-024-01124-5
E C Davine, P A Busby, S Peters, J J Francis, J Z Sarant
{"title":"Barriers and enablers to general practitioner referral of older adults to hearing care: a systematic review using the theoretical domains framework.","authors":"E C Davine, P A Busby, S Peters, J J Francis, J Z Sarant","doi":"10.1007/s41999-024-01124-5","DOIUrl":"10.1007/s41999-024-01124-5","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this systematic review was to identify and synthesise the literature regarding barriers and enablers affecting general practitioner (GP) referral to hearing care for their older patients (50 years and over).</p><p><strong>Methods: </strong>A search of peer-reviewed articles reporting primary empirical studies was conducted across CINAHL, Ovid Medline and Scopus, with search terms relating to the search domains \"General Practitioner\", \"Referral\", \"Hearing loss\", and \"adults aged 50 and older\". Qualitative and quantitative studies were included if they reported barriers or enablers to referral. A mixed-methods approach was used to synthesise the findings of the included studies, firstly into the Theoretical Domains Framework of behaviour change, and then into more granular sub-themes.</p><p><strong>Results: </strong>The initial search yielded 859 unique studies. Title and abstract screening identified 21 studies of possible relevance, and full text review identified seven studies for inclusion in this review. A total of 19 unique themes were identified and coded to 10 of the 14 domains of the Theoretical Domains Framework; however thematic overlap between studies was low and fewer than half of these themes were consistently identified as either a barrier or enabler. Four main barriers to referral to hearing care were identified: Lack of time, lack of familiarity with diagnostic criteria and tools, lack of knowledge of treatments and higher relative importance of other health conditions.</p><p><strong>Conclusion: </strong>The minimal overlap of themes and low agreement on which of these constitute barriers and enablers for referral indicates a need for further research to provide greater clarity in this area and explain the heterogeneity of these results.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1507-1518"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenges and opportunities for falls prevention: an online survey across European healthcare professionals. 预防跌倒的挑战和机遇:欧洲医疗保健专业人员的在线调查。
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-06-17 DOI: 10.1007/s41999-025-01237-5
Lotta J Seppala, James Frith, Dawn A Skelton, Clemens Becker, Hubert Blain, Rose-Anne Kenny, Annemiek J Linn, Jesper Ryg, Solveig A Arnadottir, Gülistan Bahat, Maria Bonnici, María Ángeles Caballero Mora, Yannis Dionyssiotis, Dvora Frankenthal, Sirpa Hartikainen, Jorunn L Helbostad, Alvaro Casas Herrero, Birkan İlhan, Anna B Jonsdottir, Marija Markovski, Regina Roller-Wirnsberger, Carmelinda Ruggiero, Ingvild Saltvedt, Anna Skalska, Daniel Smedberg, George Soulis, Katarzyna Szczerbińska, Eva Topinkova, Gregor Veninšek, Ellen Vlaeyen, Alban Ylli, Nathalie van der Velde
{"title":"Challenges and opportunities for falls prevention: an online survey across European healthcare professionals.","authors":"Lotta J Seppala, James Frith, Dawn A Skelton, Clemens Becker, Hubert Blain, Rose-Anne Kenny, Annemiek J Linn, Jesper Ryg, Solveig A Arnadottir, Gülistan Bahat, Maria Bonnici, María Ángeles Caballero Mora, Yannis Dionyssiotis, Dvora Frankenthal, Sirpa Hartikainen, Jorunn L Helbostad, Alvaro Casas Herrero, Birkan İlhan, Anna B Jonsdottir, Marija Markovski, Regina Roller-Wirnsberger, Carmelinda Ruggiero, Ingvild Saltvedt, Anna Skalska, Daniel Smedberg, George Soulis, Katarzyna Szczerbińska, Eva Topinkova, Gregor Veninšek, Ellen Vlaeyen, Alban Ylli, Nathalie van der Velde","doi":"10.1007/s41999-025-01237-5","DOIUrl":"10.1007/s41999-025-01237-5","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the challenges and opportunities for the implementation of falls preventive services across Europe.</p><p><strong>Methods: </strong>An online cross-sectional survey among healthcare professionals was initiated by the European Geriatric Medicine Society (EuGMS) Special Interest Group on Falls and Fractures containing a Likert scale and multiple-choice questions on education and knowledge, current practices, barriers, and facilitators for falls prevention. Survey participation for healthcare professionals was encouraged by the EuGMS through an email invitation, website banner, and social media. National representatives from 24 countries further promoted it via societies, local networks, and hospital channels.</p><p><strong>Results: </strong>A total of 1669 multidisciplinary healthcare professionals participated from 34 European countries (median 47 years; 75% female; 40.6% physicians (73.3% geriatricians/trainees), 36% physiotherapists, 23.4% other healthcare professionals). Only 26.9% believed their undergraduate education adequately prepared them for clinical practice in this area. A total of 75.8% of respondents reported opportunistically screening older adults for fall risk often or always during consultations. Gait and balance assessment was considered the most important and was the most frequently performed component of the multifactorial fall risk assessment. The top-five barriers were staffing issues, lack of time, older adults' non-adherence to recommended strategies, workload related to falls prevention, and prioritizing other tasks. The top-five facilitators were more time, easy-to-use guidelines, sufficient resources, increased education and training on falls prevention, and increased collaboration. We observed regional and country-level variation in these top barriers and facilitators.</p><p><strong>Conclusion: </strong>This survey highlights the need for improved undergraduate education in falls prevention across Europe. It is essential to educate and engage governmental bodies and insurers to secure their support and prioritization of falls prevention initiatives. Furthermore, enhancing education, addressing older adults' nonadherence, interdisciplinary collaboration and providing easy-to-use guidelines seem crucial for effective implementation. The falls prevention strategy should be tailored to the local context.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1269-1282"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multimorbidity clusters: translating research evidence into actionable interventions. 多病集群:将研究证据转化为可操作的干预措施。
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-07-11 DOI: 10.1007/s41999-025-01270-4
A Marengoni, F Triolo, A Zucchelli
{"title":"Multimorbidity clusters: translating research evidence into actionable interventions.","authors":"A Marengoni, F Triolo, A Zucchelli","doi":"10.1007/s41999-025-01270-4","DOIUrl":"10.1007/s41999-025-01270-4","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1115-1120"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sex differences in health-related quality of life among individuals at high risk of dementia. 痴呆症高危人群健康相关生活质量的性别差异
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 DOI: 10.1007/s41999-025-01278-w
Ana Sofia Oliveira, Sílvia Lopes, Lara Noronha Ferreira, Vítor Tedim Cruz, Ana Rute Costa
{"title":"Sex differences in health-related quality of life among individuals at high risk of dementia.","authors":"Ana Sofia Oliveira, Sílvia Lopes, Lara Noronha Ferreira, Vítor Tedim Cruz, Ana Rute Costa","doi":"10.1007/s41999-025-01278-w","DOIUrl":"https://doi.org/10.1007/s41999-025-01278-w","url":null,"abstract":"<p><strong>Purpose: </strong>Dementia represents an increasing challenge to health systems globally, with a notable impact on health-related quality of life (HRQoL). Nevertheless, the potential effect of sex on the relation between individuals' characteristics and HRQoL, particularly in the early stages of this disease, remains unclear. Therefore, the present study aims to evaluate the association between sociodemographic, lifestyle and health-related factors with HRQoL among individuals at high risk of dementia, according to sex.</p><p><strong>Methods: </strong>This cross-sectional study was based on baseline data from the MIND-Matosinhos randomized controlled trial, targeting Portuguese adults at high risk of dementia [n = 207; 59.9% female; median age = 70.0 (interquartile range: 11)]. HRQoL was measured using the EQ-5D-5L. The associations between explanatory variables and HRQoL scores (dichotomized by the median) were quantified through odds ratios (OR) and 95% confidence intervals (CI), stratified by sex.</p><p><strong>Results: </strong>Overall, females reported lower HRQoL when compared with males [median (interquartile range): 0.875 (0.190) vs. 0.923 (0.129); p = 0.004]. Problems in mobility (43.6% vs. 27.7%; p = 0.021), pain/discomfort (71.8% vs. 44.6%; p < 0.001) and anxiety/depression (66.9% vs. 45.8%; p = 0.002), as well as the existence of any problem in five dimensions (7.3% vs. 3.6%; p = 0.004), were more frequently referred by females than males. A stronger association between poorer self-perceived health status and lower HRQoL was observed among females (OR = 8.75, 95% CI:3.64-21.03) compared to males (OR = 1.88, 95% CI:0.72-4.89; p for interaction = 0.020).</p><p><strong>Conclusion: </strong>Health status is associated with HRQoL, distinctively amongst males and females. These findings emphasize the need for sex-specific public health strategies to improve HRQoL in a vulnerable population of individuals at high risk of dementia.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of a multifaceted intervention on antibiotic use for common infections in nursing homes in Spain. A before and after study. 对西班牙养老院常见感染抗生素使用的多方面干预的影响。A学习前后。
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-04-22 DOI: 10.1007/s41999-025-01193-0
Ramon Monfà, Ana García-Sangenís, Rosa Morros, Carlota Manuela Zárate Sáez, Jesús Mateos-Nozal, María N Vaquero Pinto, Carmen Sáez Bejar, Elena López Pérez, Consuelo Rodríguez Jiménez, Rosa Magallón-Botaya, Priscila Matovelle, Alicia Navarro Sanmartín, Carl Llor
{"title":"The impact of a multifaceted intervention on antibiotic use for common infections in nursing homes in Spain. A before and after study.","authors":"Ramon Monfà, Ana García-Sangenís, Rosa Morros, Carlota Manuela Zárate Sáez, Jesús Mateos-Nozal, María N Vaquero Pinto, Carmen Sáez Bejar, Elena López Pérez, Consuelo Rodríguez Jiménez, Rosa Magallón-Botaya, Priscila Matovelle, Alicia Navarro Sanmartín, Carl Llor","doi":"10.1007/s41999-025-01193-0","DOIUrl":"10.1007/s41999-025-01193-0","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to assess the impact of a multifaceted intervention aimed at nursing home staff on antibiotic use and hygiene elements for nursing home residents with common infections.</p><p><strong>Methods: </strong>Before-and-after study carried out in nursing homes in five areas of Spain. Nursing staff registered residents with common infections and documented hygiene practices over three months, before and after a 2-h educational intervention in autumn 2023. The intervention focused on the initial registration results, antibiotic guidelines, infection prevention, and management strategies for nursing homes. Indicators for potentially unnecessary antibiotic use and non-first-line antibiotics were developed, and results from both registration periods (Feb-Apr 2023 and Feb-Apr 2024) were compared to assess impact.</p><p><strong>Results: </strong>Of 34 nursing homes, 23 completed the intervention and the two registrations (67.6%). Staff reported 1003 infections in the first registration and 789 in the second. The overall antibiotic prescription rate was 84.6%. Potentially inappropriate antibiotic use for urinary tract infections decreased from 70.3 to 59.9% (P < 0.005) and use for respiratory infections dropped from 78.1 to 62.7% (P < 0.001), with inappropriate use decreasing from 46.3 to 31% (P < 0.001). The mean duration of antibiotics for cystitis reduced from 7 to 5.4 days (P < 0.05). The intervention had no impact on hygiene practices.</p><p><strong>Conclusion: </strong>Potentially unnecessary antibiotic use was lower after the intervention, whereas hygiene practices were unchanged. A more intensive, multifaceted educational approach is needed for a greater impact.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1465-1473"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The cross-sectional relationship of physical frailty and cognitive impairment in older Poles: analysis of the PolSenior2 data. 老年波兰人身体虚弱和认知障碍的横断面关系:PolSenior2数据分析。
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-05-17 DOI: 10.1007/s41999-025-01220-0
Anna Skalska, Karolina Piotrowicz, Hanna Kujawska-Danecka, Kacper Jagiełło, Alicja Klich Rączka, Małgorzata Mossakowska, Tomasz Zdrojewski, Tomasz Grodzicki, Jerzy Gąsowski
{"title":"The cross-sectional relationship of physical frailty and cognitive impairment in older Poles: analysis of the PolSenior2 data.","authors":"Anna Skalska, Karolina Piotrowicz, Hanna Kujawska-Danecka, Kacper Jagiełło, Alicja Klich Rączka, Małgorzata Mossakowska, Tomasz Zdrojewski, Tomasz Grodzicki, Jerzy Gąsowski","doi":"10.1007/s41999-025-01220-0","DOIUrl":"10.1007/s41999-025-01220-0","url":null,"abstract":"<p><strong>Aim: </strong>To assess the relation between pre-frailty and frailty, and its components on one hand and the presence, degree and components of cognitive impairment.</p><p><strong>Methods: </strong>This is a nationwide epidemiologic survey of health determinants in older Poles (PolSenior2). We assessed physical frailty using the approach by Fried et al. and cognitive impairment with the Mini-Mental Status Examination (MMSE). We calculated population estimates (95% CI) of conditions under study, with sampling weights to account for the complex survey design, with the age-sex post-stratification matching to the population of Poland. We used logistic regression to model cognitive impairment as function of frailty phenotype.</p><p><strong>Results: </strong>Mean (SD) age of 5378 participants (58.0% women) was 75.0 (9.4) years. Frailty was diagnosed in 23.5% of respondents, and 54.6% were pre-frail. Normal cognition was found in 51.3%, 23.0% had suspected mild cognitive impairment (MCI), and suspected: 16.3% mild, 6.5% moderate and 2.9% severe dementia. Robust phenotype was present in 35.7% normal cognition persons, 4.7% in moderate dementia, and 0.0% in severe dementia. Frailty increased from 9.2% in normal cognition to 57.4% and 85.3% in moderate dementia and severe dementia. Frailty component that was associated with abnormalities in all MMSE domains was exhaustion. In the presence of exhaustion, the best-preserved function was registration, and the most pronounced was attention deficit.</p><p><strong>Conclusion: </strong>Frailty and cognitive impairment are closely associated. While exhaustion was standing out among the frailty components, it was associated with impaired orientation and attention deficits. These data may inform both the prevention and rehabilitation and nutritional counseling.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1329-1339"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving usability of the STOPP/START version 3 criteria: development of a practice tool for clinicians, students and researchers. 提高STOPP/START第3版标准的可用性:为临床医生、学生和研究人员开发一种实践工具。
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-06-17 DOI: 10.1007/s41999-025-01214-y
O Dalleur, F X Sibille, A Mouzon, F Vaillant, S Marien, A Spinewine, B Boland
{"title":"Improving usability of the STOPP/START version 3 criteria: development of a practice tool for clinicians, students and researchers.","authors":"O Dalleur, F X Sibille, A Mouzon, F Vaillant, S Marien, A Spinewine, B Boland","doi":"10.1007/s41999-025-01214-y","DOIUrl":"10.1007/s41999-025-01214-y","url":null,"abstract":"<p><strong>Background: </strong>The STOPP/START criteria are aimed to be used by clinicians to perform medication review to optimize pharmacotherapy in older adults. The STOPP/START.version 3 (SS.v3) published in European Geriatric Medicine in 2023 updated and significantly extended the previous version. SS.v3 is more open to criticism for its poor usability in daily clinical practice. The present study aimed at contributing to SS.v3 by highlighting the new content of its criteria and by providing clinicians, students and researchers with a user-friendly presentation to facilitate medication review.</p><p><strong>Methods: </strong>The SS.v3 criteria were reviewed by seven geriatricians and clinical pharmacists with expertise in pharmacotherapy in older adults. The 190 SS.v3 criteria were carefully compared to the 115 SS.v2 criteria in order to identify the new ones and those with clinically significant modifications. A single-entry table was developed for the medications (STOPP.v3) and the medical conditions (START.v3).</p><p><strong>Results: </strong>Among the 133 STOPP.v3 criteria, we identified 54 new (41%) and 25 modified (19%) ones. The 57 START.v3 criteria include 24 new (42%) and 17 modified (30%) ones. The single-entry table is a comprehensive presentation of SSv3 in 3 pages. It is systematically organized and upfront presents the medication for the STOPP criteria and the condition for the START criteria, enhancing its usability.</p><p><strong>Conclusion: </strong>This work highlights many new and modified SS.v3 criteria that clinicians, students and researchers should be aware of. The single-entry table for STOPP medications and START clinical conditions may facilitate medication review for older adults in daily clinical practice.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1403-1413"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study. 评估在急诊科出现非特异性投诉的老年人的护理途径:一项前后研究。
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-05-07 DOI: 10.1007/s41999-025-01226-8
M G A M van der Velde, M A C Jansen, F Derkx-Verhagen, I P B Tournoij, F S Jonkers, H R Haak, M N T Kremers
{"title":"Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study.","authors":"M G A M van der Velde, M A C Jansen, F Derkx-Verhagen, I P B Tournoij, F S Jonkers, H R Haak, M N T Kremers","doi":"10.1007/s41999-025-01226-8","DOIUrl":"10.1007/s41999-025-01226-8","url":null,"abstract":"<p><strong>Purpose: </strong>Managing older patients presenting at the Emergency Department (ED) poses challenges due to their predisposition to present with nonspecific complaints (NSC). With an ageing population and ED overcrowding, significance of NSC is expected to grow. Therefore, we implemented a structured care pathway to address the complexity of NSC presentations. The aim of this study is to evaluate the effectivity of this care pathway.</p><p><strong>Methods: </strong>We conducted a before-and-after study to evaluate the NSC care pathway, which included risk stratification, standardized assessment and diagnostic measurements. A control group receiving standard care was established in two hospitals (hospital 1 and 2) before implementation. Patient enrollment occurred from April 2021 to November 2024. Outcomes included length of stay in the ED (LOS-ED) and in hospital (LOS-H), revisits, diagnostic completeness (i.e. 100% agreement between all ED and hospital discharge diagnoses) and perceived quality of care.</p><p><strong>Results: </strong>In total, 164 control and 235 intervention patients were included in this study. Median LOS-ED and LOS-H did not show significant differences between the control and intervention patients. Implementation of the care pathway showed non-significant trends towards improved diagnostic completeness (47.1% vs 37.2%, p = 0.096). This might be associated with the non-significant observed decrease in 30-day readmissions (7.5% vs. 12.7%, p = 0.256). Patient-reported outcomes indicated a positive experience with the quality of care.</p><p><strong>Conclusion: </strong>The care pathway did not improve LOS-ED and LOS-H as hypothesized, possibly due to logistical barriers and patient variability. However, trends suggested improved diagnostic completeness and fewer 30-day readmission rates. Further research initiatives are needed to enhance patient outcomes and care for NSC patients.</p><p><strong>Trial registry number: </strong>NL8960, date 9-10-2020.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1537-1549"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Validation of the acutely presenting older patient screener for short term mortality prediction in older patients hospitalized for COVID-19. 急性表现老年患者筛查对COVID-19住院老年患者短期死亡率预测的验证
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-04-22 DOI: 10.1007/s41999-025-01200-4
Rosalinde A L Smits, Bas F M van Raaij, Steffy W M Jansen, Jessica M van der Bol, Carolien M J van der Linden, Harmke A Polinder-Bos, Hanna C Willems, Ewout W Steyerberg, Maarten van Smeden, Jacobijn Gussekloo, Simon P Mooijaart, Stella Trompet
{"title":"Validation of the acutely presenting older patient screener for short term mortality prediction in older patients hospitalized for COVID-19.","authors":"Rosalinde A L Smits, Bas F M van Raaij, Steffy W M Jansen, Jessica M van der Bol, Carolien M J van der Linden, Harmke A Polinder-Bos, Hanna C Willems, Ewout W Steyerberg, Maarten van Smeden, Jacobijn Gussekloo, Simon P Mooijaart, Stella Trompet","doi":"10.1007/s41999-025-01200-4","DOIUrl":"10.1007/s41999-025-01200-4","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to validate the acutely presenting older patient (APOP) screener, routinely used on the Emergency Department to predict risk of adverse outcomes in older people, for prediction of in-hospital mortality and 30-days-mortality in older patients hospitalized for COVID-19.</p><p><strong>Methods: </strong>Patients ≥ 70 years from a multicenter cohort hospitalized for COVID-19 with measured APOP risk were included. External validation analysis of the APOP screener for in-hospital mortality and 30-days-mortality was performed including discrimination and calibration.</p><p><strong>Results: </strong>389 patients (median age 80 (IQR 75-85) years, 41.4% female, 138 APOP high risk) were included. APOP high risk patients more often lived institutionalized, (26% vs. 4%; p < 0.001), had more comorbidities (Charlson Comorbidity Index 2 (1-3) vs. 2 (0-3); p = 0.002) and were less often fit (Clinical Frailty Scale 1-3 17% vs. 62%; p < 0.001). 84 patients died in hospital and 114 within 30 days. APOP high risk patients had a higher risk of in-hospital-death [OR 1.6 (95% CI 1.0-2.6)] and death within 30 days [OR 2.7 (95% CI 1.7-4.2)]. The APOP screener discriminated poorly for in-hospital mortality [AUC 0.56 (95% CI 0.48-0.63)] and for 30-days-mortality [AUC 0.62 (95% CI 0.55-0.68)]. Calibration plots revealed overestimation of the screener for both mortality risks.</p><p><strong>Conclusion: </strong>The APOP screener had a poor predictive performance for in-hospital mortality and 30-days-mortality in older people hospitalized for COVID-19. Screening tools routinely used on the ED may not be useful to predict mortality in different than usual clinical circumstances such as during a pandemic of a novel disease.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1519-1526"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and care profile of patients admitted to an intermediate stay palliative care unit (UCPME) in the community of Madrid. 马德里社区中级姑息治疗病房(UCPME)住院患者的临床和护理概况
IF 3.6 3区 医学
European Geriatric Medicine Pub Date : 2025-08-01 Epub Date: 2025-05-05 DOI: 10.1007/s41999-025-01216-w
Concepción Jiménez Rojas, Gemma Cuesta Castellón, Saleta Goñi Rosón, Lucía Gómez González, Elena Cano Esteban, Javier Gómez Pavón
{"title":"Clinical and care profile of patients admitted to an intermediate stay palliative care unit (UCPME) in the community of Madrid.","authors":"Concepción Jiménez Rojas, Gemma Cuesta Castellón, Saleta Goñi Rosón, Lucía Gómez González, Elena Cano Esteban, Javier Gómez Pavón","doi":"10.1007/s41999-025-01216-w","DOIUrl":"10.1007/s41999-025-01216-w","url":null,"abstract":"<p><strong>Introduction: </strong>We present data on the clinical care activity and trajectories of a prospective cohort of 400 patients admitted to an intermediate stay palliative care unit (UCPME) in Madrid.</p><p><strong>Materials and methods: </strong>Epidemiological data and clinical progression variables were collected. The main differences between oncological and non-oncological patients and age-related differences were described.</p><p><strong>Results: </strong>295 oncologic and 105 non-oncological patients were admitted to palliative care. Patients with non-oncological conditions were older (p < 0.001). The referral source was home in 38% and hospital departments in 63%. 350 patients (87.5%) died. Early mortality occurred in 48%. Occupational therapy was provided to 13.8%. Intravenous continuous drug was used in 41% and subcutaneous in 48.5%. Palliative sedation for refractory symptoms was required in 54.5%. Advance care planning was conducted in 96% of admissions.</p><p><strong>Conclusions: </strong>The care processes revealed a few differences in clinical trajectories between oncological and non-oncological conditions or across age groups.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1447-1451"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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