20 results on '"Flamaing, Johan"'
Search Results
2. Determinants influencing the implementation of multifactorial falls risk assessment and multidomain interventions in community- dwelling older people: a systematic review.
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Vandervelde, Sara, Bosch, Natalie Van den, Vlaeyen, Ellen, Casterlé, Bernadette Dierckx de, Flamaing, Johan, Belaen, Goedele, Tuand, Krizia, Vandendriessche, Thomas, and Milisen, Koen
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RISK assessment ,MEDICAL information storage & retrieval systems ,INDEPENDENT living ,CINAHL database ,SYSTEMATIC reviews ,MEDLINE ,GERIATRIC assessment ,MEDICAL databases ,ONLINE information services ,ACCIDENTAL falls ,OLD age - Abstract
Background Multifactorial falls risk assessment and multidomain interventions are recommended by the World guidelines for falls prevention and management. To successfully implement these interventions, it is important to understand determinants influencing the implementation. Methods A literature search was conducted for this systematic review on the 3 December 2021 and updated on the 3 April 2023 in five databases: PubMed (including MEDLINE), EMBASE (via Embase.com), Cochrane Central Register of Controlled Trials (via Cochrane Library), Web of Science Core Collection and CINAHL (via EBSCO). Studies were included if they reported on determinants influencing the implementation of a multifactorial falls risk assessment and/or multidomain interventions in community-dwelling older people. Editorials, opinion papers, systematic reviews and studies focusing on one population (e.g. Parkinson) were excluded. Two researchers independently screened the articles on title, abstract and full text. The quality was evaluated based on a sensitivity analysis. 'The Comprehensive Integrated Checklist of Determinants of practice' was used to categorise the determinants. Results Twenty-nine studies were included. Determinants were classified as barriers (n = 40) and facilitators (n = 35). The availability of necessary resources is the most reported determinant. Other commonly reported determinants are knowledge, intention/beliefs and motivation at the levels of older people and healthcare professionals, fitting of the intervention into current practice, communication, team and referral processes and financial (dis)incentives. Conclusions Mapping of the barriers and facilitators is essential to choose implementation strategies tailored to the context, and to enhance the uptake and effectiveness of a multifactorial falls risk assessment and/or multidomain interventions. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Reducing the use of physical restraints in home care: development and feasibility testing of a multicomponent program to support the implementation of a guideline
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Vandervelde, Sara, Scheepmans, Kristien, Milisen, Koen, van Achterberg, Theo, Vlaeyen, Ellen, Flamaing, Johan, and Dierckx de Casterlé, Bernadette
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- 2021
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4. A systematic review of the intervention components, adherence and outcomes of enhanced recovery programmes in older patients undergoing elective colorectal surgery
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Fagard, Katleen, Wolthuis, Albert, D’Hoore, André, Verhaegen, Marleen, Tournoy, Jos, Flamaing, Johan, and Deschodt, Mieke
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- 2019
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5. Prediction of functional decline in older hospitalized patients: a comparative multicenter study of three screening tools
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Deschodt, Mieke, Wellens, Nathalie I. H., Braes, Tom, De Vuyst, Annelies, Boonen, Steven, Flamaing, Johan, Moons, Philip, and Milisen, Koen
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- 2011
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6. Validity of the interRAI Acute Care based on test content: a multi-center study
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Wellens, Nathalie I. H., Deschodt, Mieke, Boonen, Steven, Flamaing, Johan, Gray, Len, Moons, Philip, and Milisen, Koen
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- 2011
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7. Translation and adaption of the interRAI suite to local requirements in Belgian hospitals
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Wellens Nathalie IH, Flamaing Johan, Moons Philip, Deschodt Mieke, Boonen Steven, and Milisen Koen
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Aged ,Geriatric assessment ,Inpatient ,interRAI Acute Care ,Minimum Data Set ,Validation studies ,Instrument translation ,Geriatrics ,RC952-954.6 - Abstract
Abstract Background The interRAI Suite contains comprehensive geriatric assessment tools designed for various healthcare settings. Although each instrument is developed for a particular population, together they form an integrated health evaluation system. The interRAI Acute Care Minimum Data Set (interRAI AC) is tailored for hospitalized older persons. Our aim in this study was to translate and adapt the interRAI AC to the Belgian hospital context, where it can be used together with the interRAI Home Care (HC) and the interRAI Long Term Care Facility (LTCF). Methods A systematic, comprehensive, and rigorous 10-step approach was used to adapt the interRAI AC to local requirements. After linguistic translation by an official translator, five researchers assessed the translation for appropriate hospital jargon. Three researchers double-checked for translation accuracy and proposed additional items. A provisional version was converted into the three official languages of Belgium—Flemish, French, and German. Next, a multidisciplinary panel of nine experts judged item relevance to the Belgian care context and advised which country-specific items should be added. After these suggestions were incorporated into the interRAI AC, hospital staff from nine Flemish hospitals field-tested the tool in their practice. After evaluating field-test results, we compared the interRAI AC with Belgian versions of the interRAI HC and interRAI LTCF. Next, the Flemish, French, and German versions of the Belgian interRAI portfolio were harmonized. Finally, we submitted the Belgian interRAI AC to the interRAI organization for ratification. Results Eighteen administrative items of the interRAI AC were adapted to the Belgian healthcare context (e.g., usual residence, formal community services prior to admission). Fourteen items assessing the ‘informal caregiver’, and 17 items, including country-specific items, were added (e.g., advanced directive for euthanasia). Conclusions The interRAI AC was adapted to local requirements using a meticulous and recursive 10-step approach. As use of the interRAI Suite continues to grow worldwide and as it continues to expand to other care settings and populations, this procedure can guide future translations. This procedure might also be used by others facing similar challenges of complex translation and adaptation situations, where multidimensional instruments are used across multiple care settings in multiple languages.
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- 2012
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8. PNEUMOCOCCAL COLONIZATION IN OLDER PERSONS IN A NONOUTBREAK SETTING
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Flamaing, Johan, Peetermans, Willy E., Vandeven, Jos, and Verhaegen, Jan
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Aged ,Health ,Seniors - Abstract
To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02700.x Byline: Johan Flamaing (*), Willy E. Peetermans ([dagger]), Jos Vandeven ([double dagger]), Jan Verhaegen ([double dagger]) Author Affiliation: (*)Department of Geriatric Medicine ([dagger])Department of General Internal Medicine and Infectious Diseases ([double dagger])Department of Microbiology, University Hospitals Leuven, Leuven, Belgium
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- 2010
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9. Predicting hospitalisation-associated functional decline in older patients admitted to a cardiac care unit with cardiovascular disease: a prospective cohort study.
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Van Grootven, Bastiaan, Jeuris, Anthony, Jonckers, Maren, Devriendt, Els, Dierckx de Casterlé, Bernadette, Dubois, Christophe, Fagard, Katleen, Herregods, Marie-Christine, Hornikx, Miek, Meuris, Bart, Rex, Steffen, Tournoy, Jos, Milisen, Koen, Flamaing, Johan, and Deschodt, Mieke
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CORONARY care units ,FUNCTIONAL loss in older people ,FUNCTIONAL independence measure ,LONGITUDINAL method ,OLDER patients ,HOSPITAL admission & discharge ,CARDIAC patients ,CARDIOVASCULAR diseases - Abstract
Background: Up to one in three of older patients who are hospitalised develop functional decline, which is associated with sustained disability, institutionalisation and death. This study developed and validated a clinical prediction model that identifies patients who are at risk for functional decline during hospitalisation. The predictive value of the model was compared against three models that were developed for patients admitted to a general medical ward.Methods: A prospective cohort study was performed on two cardiac care units between September 2016 and June 2017. Patients aged 75 years or older were recruited on admission if they were admitted for non-surgical treatment of an acute cardiovascular disease. Hospitalisation-associated functional decline was defined as any decrease on the Katz Index of Activities of Daily Living between hospital admission and discharge. Predictors were selected based on a review of the literature and a prediction score chart was developed based on a multivariate logistic regression model.Results: A total of 189 patients were recruited and 33% developed functional decline during hospitalisation. A score chart was developed with five predictors that were measured on hospital admission: mobility impairment = 9 points, cognitive impairment = 7 points, loss of appetite = 6 points, depressive symptoms = 5 points, use of physical restraints or having an indwelling urinary catheter = 5 points. The score chart of the developed model demonstrated good calibration and discriminated adequately (C-index = 0.75, 95% CI (0.68-0.83) and better between patients with and without functional decline (chi2 = 12.8, p = 0.005) than the three previously developed models (range of C-index = 0.65-0.68).Conclusion: Functional decline is a prevalent complication and can be adequately predicted on hospital admission. A score chart can be used in clinical practice to identify patients who could benefit from preventive interventions. Independent external validation is needed. [ABSTRACT FROM AUTHOR]- Published
- 2020
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10. Is preoperative state anxiety a risk factor for postoperative delirium among elderly hip fracture patients?
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Van Grootven, Bastiaan, Detroyer, Elke, Devriendt, Els, Sermon, An, Deschodt, Mieke, Flamaing, Johan, Dubois, Christophe, and Milisen, Koen
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RISK of delirium ,ANXIETY ,BLOOD pressure ,CONFIDENCE intervals ,BONE fractures ,HIP joint injuries ,ORTHOPEDIC surgery ,PROBABILITY theory ,PSYCHOLOGICAL tests ,QUESTIONNAIRES ,SURGICAL complications ,SECONDARY analysis ,PREOPERATIVE period ,STATE-Trait Anxiety Inventory ,ODDS ratio - Abstract
Aim To determine if preoperative state anxiety is a risk factor for postoperative delirium in older hip fracture patients. Methods A secondary data analysis comprising data from a prospective non-randomized trial including 86 patients with a hip fracture aged 65 years and older was carried out. State anxiety was measured preoperatively using the State-Trait Anxiety Inventory. Delirium and its severity was measured pre- and postoperatively (day 1, 3, 5, 8) by trained research nurses using the Confusion Assessment Method and Delirium Index. Results A total of 24 patients (27.9%) developed delirium postoperatively. Preoperative state anxiety (State-Trait Anxiety Inventory) was not associated with postoperative delirium (r
b = 0.135, P = 0.353), duration of postoperative delirium (rho = 0.038, P = 0.861) or severity of postoperative delirium (rho = 0.153, P = 0.160). Independent predictors of postoperative delirium were lower MMSE scores ( OR 0.75, 95% CI 0.60-0.95, P = 0.015), osteosynthesis surgery ( OR 3.66, 95% CI 1.02-13.15, P = 0,047) and lowest intraoperative diastolic blood pressure ( OR 0.92, 95% CI 0.85-0.99, P = 0.031). Conclusion No relationship between state anxiety and postoperative delirium was found, but significant methodological hurdles were observed and discussed providing important groundwork for further research in this area. Further research should focus on reliable measurement of state anxiety in cognitively impaired older populations. Geriatr Gerontol Int 2016; 16: 948-955. [ABSTRACT FROM AUTHOR]- Published
- 2016
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11. The interRAI Acute Care instrument incorporated in an eHealth system for standardized and web-based geriatric assessment: strengths, weaknesses, opportunities and threats in the acute hospital setting.
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Devriendt, Els, Wellens, Nathalie I. H., Flamaing, Johan, Declercq, Anja, Moons, Philip, Boonen, Steven, and Milisen, Koen
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GERIATRIC assessment ,ELECTRONIC health records ,SWOT analysis ,HOSPITAL care ,MEDICAL care ,COMPUTER software - Abstract
Background: The interRAI Acute Care instrument is a multidimensional geriatric assessment system intended to determine a hospitalized older persons' medical, psychosocial and functional capacity and needs. Its objective is to develop an overall plan for treatment and long-term follow-up based on a common set of standardized items that can be used in various care settings. A Belgian web-based software system (BelRAI-software) was developed to enable clinicians to interpret the output and to communicate the patients' data across wards and care organizations. The purpose of the study is to evaluate the (dis)advantages of the implementation of the interRAI Acute Care instrument as a comprehensive geriatric assessment instrument in an acute hospital context. Methods: In a cross-sectional multicenter study on four geriatric wards in three acute hospitals, trained clinical staff (nurses, occupational therapists, social workers, and geriatricians) assessed 410 inpatients in routine clinical practice. The BelRAI-system was evaluated by focus groups, observations, and questionnaires. The Strengths, Weaknesses, Opportunities and Threats were mapped (SWOT-analysis) and validated by the participants. Results: The primary strengths of the BelRAI-system were a structured overview of the patients' condition early after admission and the promotion of multidisciplinary assessment. Our study was a first attempt to transfer standardized data between home care organizations, nursing homes and hospitals and a way to centralize medical, allied health professionals and nursing data. With the BelRAI-software, privacy of data is guaranteed. Weaknesses are the time-consuming character of the process and the overlap with other assessment instruments or (electronic) registration forms. There is room for improving the user-friendliness and the efficiency of the software, which needs hospital-specific adaptations. Opportunities are a timely and systematic problem detection and continuity of care. An actual shortage of funding of personnel to coordinate the assessment process is the most important threat. Conclusion: The BelRAI-software allows standardized transmural information transfer and the centralization of medical, allied health professionals and nursing data. It is strictly secured and follows strict privacy regulations, allowing hospitals to optimize (transmural) communication and interaction. However, weaknesses and threats exist and must be tackled in order to promote large scale implementation. [ABSTRACT FROM AUTHOR]
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- 2013
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12. Convergent Validity of the Cognitive Performance Scale of the interRAI Acute Care and the Mini-Mental State Examination.
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Wellens, Nathalie I. H., Flamaing, Johan, Tournoy, Jos, Hanon, Tina, Moons, Philip, Verbeke, Geert, Boonen, Steven, and Milisen, Koen
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The article discusses research in geriatric psychiatry, with a focus on the validity of the Cognitive Performance Scale (CPS) derived from the cognitive geriatric assessment interRAI/Minimum Data Set instruments. Topics include comparisons between CPS and the Mini-Mental State Examination (MMSE), assessing cognitive functioning in older people, and cognitive impairment.
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- 2013
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13. Clinical Changes in Older Adults During Hospitalization: Responsiveness of the inter RAI Acute Care Instrument.
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Wellens, Nathalie I. H., Verbeke, Geert, Flamaing, Johan, Moons, Philip, Boonen, Steven, Tournoy, Jos, and Milisen, Koen
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HOSPITAL care of older people ,ANALYSIS of variance ,CHI-squared test ,CRITICAL care medicine ,RESEARCH ,STATISTICAL sampling ,STATISTICS ,T-test (Statistics) ,DATA analysis ,SECONDARY analysis ,REPEATED measures design ,RESEARCH methodology evaluation ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Objectives To evaluate the responsiveness of the Minimum Data Set inter RAI Acute Care ( AC), a comprehensive geriatric assessment system, to detect clinical changes in patient status during hospital stays. Design An explorative secondary data-analysis comparing prospectively collected data with the inter RAI AC before hospitalization, upon admission, and at discharge. Setting Clinicians from multiple disciplines in nine geriatric and eight nongeriatric wards of nine acute hospitals performed the assessment. Participants The inter RAI AC was administered serially to 256 geriatric inpatients (aged 83.2 ± 5.2; 60% female). Measurements Responsiveness (capacity to detect changes in patients) was calculated for the output scales on five domains: activities of daily living ( ADLs), cognition, communication, depressive symptoms, and pain. Internal responsiveness was evaluated using the Friedman test and Guyatt technique. Results Significant differences in clinical status were found for all five domains, based on the Friedman test. Post hoc tests revealed differences between each assessment period, except for cognition and communication from admission to discharge and for depressive symptoms from before admission to discharge. The Guyatt Responsiveness Index showed good to excellent capacity to detect longitudinal changes during hospitalization for cognition, communication, and pain and substantial performance for ADLs and depressive symptoms. Conclusion In older inpatients, fluctuations in ADLs, cognition, communication, depressive symptoms, and pain can be captured using the inter RAI AC output scales, enabling clinicians to evaluate longitudinal changes from admission to discharge and to provide a comparison with patient status before the acute onset of the illness. These results support the use of these scales in geriatric and nongeriatric wards. [ABSTRACT FROM AUTHOR]
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- 2013
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14. Methods to assess the reliability of the interRAI Acute Care: a framework to guide clinimetric testing. Part II.
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Wellens, Nathalie I. H., Milisen, Koen, Flamaing, Johan, and Moons, Philip
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GERIATRIC assessment ,RESEARCH methodology evaluation ,AFFECT (Psychology) ,HOSPITAL care of older people ,COGNITION ,COMMUNICATION ,CONCEPTUAL structures ,STATISTICAL correlation ,FRAIL elderly ,PSYCHOLOGICAL tests ,PSYCHOMETRICS ,RELIABILITY (Personality trait) ,RESEARCH evaluation ,STATISTICS ,DECISION making in clinical medicine ,ACTIVITIES of daily living ,INTER-observer reliability - Abstract
The interRAI Acute Care is a comprehensive geriatric assessment tool that provides a holistic picture of complex and frail hospitalized older persons. It is designed to support holistic care planning and to transfer patient data across settings. Its usefulness in clinical decision making depends on the extent to which clinicians can rely on the patient data as accurate and meaningful indicators of patients functioning. But its multidimensional character implies challenges for clinimetric testing as some of the traditional analyses techniques cannot be unconditionally applied. The objective was to present an overview of methods to examine the reliability of the interRAI Acute Care. For each line of evidence, examples of hypotheses and research questions are listed. [ABSTRACT FROM AUTHOR]
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- 2012
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15. Methods to assess the validity of the interRAI Acute Care: a framework to guide clinimetric testing.
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Wellens, Nathalie I. H., Milisen, Koen, Flamaing, Johan, and Moons, Philip
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GERIATRIC assessment ,RESEARCH methodology evaluation ,COGNITION ,COMPARATIVE studies ,CONCEPTUAL structures ,STATISTICAL correlation ,DISCRIMINANT analysis ,EXPERIMENTAL design ,PSYCHOLOGICAL tests ,PSYCHOMETRICS ,RESEARCH evaluation ,ACTIVITIES of daily living - Abstract
The objective was to present an overview of methods to examine the validity of the minimum data set of the interRAI Acute Care (interRAI AC). Because of the multidimensional character of this comprehensive geriatric assessment tool, clinimetric testing of the interRAI AC can be more complex than that of one-dimensional instruments. Thus to facilitate testing of the interRAI AC, we translated this complexity into a structured methodological framework that outlines procedures to assess various lines of evidence. Our framework combined traditional clinimetric techniques and the standards of psychological testing. For each line of evidence, examples of hypotheses and research questions were summarized. Future clinimetric testing can use these guidelines as a basis to obtain and provide a wide and diverse body of evidence. [ABSTRACT FROM AUTHOR]
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- 2012
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16. The Effectiveness of Inpatient Geriatric Evaluation and Management Units: A Systematic Review and Meta-Analysis.
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Van Craen, Katleen, Braes, Tom, Wellens, Nathalie, Denhaerynck, Kris, Flamaing, Johan, Moons, Philip, Boonen, Steven, Gosset, Christiane, Petermans, Jean, and Milisen, Koen
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HEALTH outcome assessment ,GERIATRIC care units ,HOSPITAL care of older people ,FRAIL elderly ,MEDICAL care - Abstract
OBJECTIVES: To examine how geriatric evaluation and management units (GEMUs) are organized and to examine the effectiveness of admission on a GEMU. DESIGN: Systematic review and meta-analysis based on literature search of multiple databases and the references lists of all identified articles and by contacting authors. SETTING: GEMUs. PARTICIPANTS: Elderly people admitted to a GEMU. MEASUREMENTS: Quality of the studies was assessed on 10 criteria. The outcome parameters were mortality, institutionalization, functional decline, readmission, and length of stay at different follow-up points. A random-effects meta-analysis was performed using Hedges' gu and variance of relative risk (RR). RESULTS: GEMUs are organized in a heterogeneous way and the included studies gave no thorough description of comprehensive geriatric assessment (CGA). Involvement of a multidisciplinary team was a key element in all GEMUs. The individual trials showed that admission to a GEMU has one or more favorable effects on the outcomes of interest, with two significant effects in the meta-analysis: less functional decline at discharge from the GEMU (RR=0.87, 95% confidence interval (CI)=0.77–0.99; P=.04) and a lower rate of institutionalization 1 year after discharge (RR=0.78, CI=0.66–0.92; P=.003). For the other outcomes in the meta-analysis, a GEMU did not induce significantly different outcomes than usual care. CONCLUSION: This meta-analysis shows a significant effect in favor of the GEMU group on functional decline at discharge and on institutionalization after 1 year. There is heterogeneity between the studies, poor quality of some randomized controlled trials, and shortage of information about CGA. Multidisciplinary CGA offered in a GEMU may add value to the care for frail older persons admitted to the hospital, but the limitations confirm the need for well-designed studies using explicit CGA and more-structured and -coherent assessment instruments such as the Minimum Data Set Resident Assessment Instrument. [ABSTRACT FROM AUTHOR]
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- 2010
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17. Structure and processes of interdisciplinary geriatric consultation teams in acute care hospitals: A scoping review.
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Deschodt, Mieke, Claes, Veerle, Van Grootven, Bastiaan, Van den Heede, Koen, Flamaing, Johan, Boland, Benoit, and Milisen, Koen
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GERIATRIC assessment , *CINAHL database , *CRITICAL care medicine , *EXPERIMENTAL design , *HEALTH care teams , *HOSPITAL wards , *HOSPITAL medical staff , *MEDICAL information storage & retrieval systems , *INTERPROFESSIONAL relations , *RESEARCH methodology , *MEDICAL referrals , *MEDLINE , *NURSE practitioners , *NURSES , *SYSTEMATIC reviews , *EVIDENCE-based medicine , *ORGANIZATIONAL structure , *PROFESSIONAL practice , *OCCUPATIONAL roles , *THEMATIC analysis , *DESCRIPTIVE statistics , *HOSPITAL nursing staff - Abstract
Background and objectives Interdisciplinary geriatric consultation teams are implemented in the acute hospital setting in several high-income countries to provide comprehensive geriatric assessment for the increasing numbers of older patients with a geriatric profile hospitalized on non-geriatric units. Given the inconclusive evidence on this care model's effectiveness to improve patient outcomes, health care policy and practice oriented recommendations to redesign the structure and process of care provided by interdisciplinary geriatric consultation teams are needed. A scoping review was conducted to explore the structure and processes of interdisciplinary geriatric consultation teams in an international context. As nurses are considered key members of these teams, their roles and responsibilities were specifically explored. Design The revised scoping methodology framework of Arksey and O’Malley was applied. Data sources An electronic database search in Ovid MEDLINE, CINAHL and EMBASE and a hand search were performed for the identification of descriptive and experimental studies published in English, French or Dutch until April 2014. Review methods Thematic reporting with descriptive statistics was performed and study findings were validated through interdisciplinary expert meetings. Results Forty-six papers reporting on 25 distinct interdisciplinary geriatric consultation teams in eight countries across three continents were included. Eight of the 12 teams (67%) reporting on their composition, stated that nurses and physicians were the main core members with head counts varying from 1 to 4 members per profession. In 80% of these teams nurses were required to have completed training in geriatrics. Advanced practice nurses were integrated in eleven out of fourteen interdisciplinary geriatric consultation teams from the USA. Only 32% of teams used formal screening to identify patients most likely to benefit from their intervention, using heterogeneous screening methods, and scarcely providing information on the responsibilities of nurses. Nurses were involved in the medical, functional, psychological and social assessment of patients in 68% of teams, either in a leading role or in collaboration with other professions. Responsibilities of interdisciplinary geriatric consultation teams’ nurses regarding in-hospital follow-up or transitional care at hospital discharge were infrequently specified (16% of teams). Conclusions This scoping review identified that the structure and processes of care provided to geriatric patients by interdisciplinary geriatric consultation teams are highly heterogeneous. Despite nurses being key team members, only limited information on their specific roles and responsibilities was identified. More research in this area is required in order to inform health care policy and to formulate practice oriented recommendations to redesign the interdisciplinary geriatric consultation team care model aiming to improve its effectiveness. [ABSTRACT FROM AUTHOR]
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- 2016
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18. The effect of a trAnSitional Pharmacist Intervention in geRiatric inpatients on hospital visits after dischargE (ASPIRE): Protocol for a randomized controlled trial.
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Hias, Julie, Hellemans, Laura, Laenen, Annouschka, Walgraeve, Karolien, Liesenborghs, Astrid, De Geest, Sabina, Luyten, Jeroen, Spriet, Isabel, Flamaing, Johan, Van der Linden, Lorenz, and Tournoy, Jos
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GERIATRIC care units , *RANDOMIZED controlled trials , *PHARMACISTS , *MEDICATION reconciliation , *INAPPROPRIATE prescribing (Medicine) , *OLDER patients - Abstract
Unplanned rehospitalizations occur frequently in older patients. Drug-related problems constitute a major and largely preventable cause with inappropriate prescribing being a substantial culprit. Solutions are needed to reduce this risk by targeting pharmacotherapy both during and after hospital stay. Therefore, we aim to perform a randomized controlled trial in geriatric inpatients to investigate the impact of a multifaceted clinical pharmacy intervention on health-related outcomes. The study concerns a monocenter, non-blinded, randomized controlled trial that will take place at the acute geriatric wards of a large academic hospital. Patients being in a palliative stage with active therapy withdrawal or patients discharged to another ward within the same hospital or another hospital are excluded. In total, 828 patients will be randomized (1:1) to the usual care or intervention group. The multifaceted clinical pharmacy intervention comprises medication reconciliation at admission and discharge, medication review, patient/caregiver education, intensified communication with primary care providers and post-discharge follow-up, which also includes a telepharmacology service. The primary endpoint is defined as the time to an all-cause, unplanned hospital revisit within six months after discharge. Other health-related outcomes such as drug-related readmissions, quality of life and number of potentially inappropriate medications will be analyzed as secondary endpoints. Patient inclusion started in February 2021. This study will provide useful insights regarding the impact of clinical pharmacy interventions on geriatric wards with the goal to optimize health-related outcomes such as hospital revisits. Trial registration: ClinicalTrials.gov Identifier: NCT04617340 • We plan to investigate a multifaceted clinical pharmacy intervention in geriatric inpatients. • The study targets geriatric inpatients owing to their high risk of unplanned hospital revisits. • A transitional care step was included as medication review alone has not been shown to be effective. • Our randomized controlled trial is powered for the time to a first unplanned hospital revisit within six months. [ABSTRACT FROM AUTHOR]
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- 2022
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19. Structure and processes of interdisciplinary geriatric consultation teams in acute care hospitals : a scoping review
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Deschodt, Mieke, Claes, Veerle, Van Grootven, Bastiaan, Van Den Heede, Koen, Flamaing, Johan, Boland, Benoit, and Milisen, Koen
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R245 ,Geriatrics ,Health Services for the Aged ,Journal Article ,Nursing ,W 1 Serials. Periodicals ,2013-14 ,Geriatric Assessment ,Hospitals ,Review Literature ,Aged - Published
- 2015
20. Implementation of geriatric consultation teams (GCT) in acute hospitals in three European countries
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Deschodt, Mieke, Claes, Veerle, Van Den Heede, Koen, Van Grootven, Bastiaan, Boland, Benoit, Flamaing, Johan, and Milisen, Koen
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Europe ,R245 ,Geriatrics ,Journal Article ,Health Services Research ,W 1 Serials. Periodicals ,2013-14 ,Geriatric Assessment ,Multidisciplinary meeting (MDM) ,Aged - Abstract
69-70 Background: GCTs are multidisciplinary teams advising and sensitizing healthcare professionals in the hospital for elderly care. They were large-scale implemented in the Netherlands, France, and Belgium despite lacking evidence on effectiveness. This study aimed to understand how GCT implementation was facilitated. Methods: Systematic database and grey literature search; cross-sectional survey. Results: GCT implementation was supported using a Senior Friendly Hospital (SFH) Quality Label in the Netherlands, and legislation in France and Belgium. Forty-six (47%) hospitals in the Netherlands were awarded the Quality Label in 2013 and 82 (83%) had a GCT. The majority (n = 56, 68%) of the GCTs scored 75% or more on the GCT quality indicators, a minimal standard for SFH eligibility. The Dutch National Society for Clinical Geriatrics specified different ways to implement consultation based interventions: clinical geriatric consults, geriatric or structural comanagement. In 2002 the Ministry of Health in France decreed on the Geriatric Care Network (GCN) for better elderly management stating that the GCN should include a GCT and a geriatric unit, short-stay unit, day hospital and rehabilitation unit. It also regulated GCT activities and provided the possibility for out of hospital consultation. In 2011, 216 French public acute care hospitals (31%) had a GCT. In Belgium a Care Program for Older Hospitalized Patients was published in 2007, and revised in 2014, by the Ministery of Public Health: acute hospitals should have an acute geriatric hospitalization ward, outpatient’s clinic, and day care hospital, a GCT, and an external liaison service. Over 90% of 108 Belgian acute hospitals had a GCT in 2013. Structural financing for GCT activities is provided since 2014. For evaluating GCTs, France and the Netherlands apply quality indicators. Conclusions: Although a heterogeneous approach for patient screening, assessment, and follow-up was found, legislation, structural financing and quality indicators were facilitators to promote implementation of geriatric care models on a national level in Europe. Conférence : American Geriatrics Society 2015 Annual Scientific Meeting location:National Harbor, Maryland date:14-17 May 2015
- Published
- 2015
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