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Hintergrund: Medikamente mit anticholinergen (ACh) Nebenwirkungen sind mit vielfältigen negativen Outcomes (z.B. Stürze) assoziiert. Existierende Instrumente zur Erhebung der anticholinergen Belastung sind heterogen, inkonsistent in der Bewertung einzelner Wirkstoffe, berücksichtigen [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Supplemental material, sj-docx-1-ggm-10.1177_23337214221140222 for Health economic perspective on a community-based intervention for older people at risk of care dependency – results of a prospective quasi-experimental study by David Lampe, Lena Hasemann, Thomas Nebling, Ulrich Thiem and Wolfgang Greiner in Gerontology and Geriatric Medicine

Additional file 1. Details on intervention components, relevant parameters and analyses

Hintergrund und Stand (inter)nationaler Forschung: Das quartiersbezogene Innovationsfondsprojekt NetzWerk GesundAktiv (NWGA), ein sektorenübergreifendes Hilfs- und Betreuungsnetzwerk, wird an einem gerontologisch-geriatrischen Zentrum koordiniert. Versicherten 70+ Jahre mit Funktionseinschränkung [zum vollständigen Text gelangen Sie über die oben angegebene URL]

BACKGROUND: Medications with an unfavorable risk-benefit profile in the elderly, and for which there are safer alternatives, are designated as potentially inappropriate medications (PIM). The RIME trial (Reduction of Potentially Inappropriate Medication in the Elderly) was based on PRISCUS, a list of PIM that was developed in 2010 for the German pharmaceuticals market. In this trial, it was studied whether special training and the PRISCUS card could lessen PIM and undesired drug-drug interactions (DDI) among elderly patients in primary care.; METHODS: A three-armed, cluster-randomized, controlled trial was carried out in two regions of Germany. 137 primary care practices were randomized in equal numbers to one of two intervention groups-in which either the primary care physicians alone or the entire practice team received special training-or to a control group with general instructions about medication. The primary endpoint was the percentage of patients with at least one PIM or DDI (PIM/DDI) per practice. The primary hypothesis was that at 1 year this endpoint would be more effectively lowered in the intervention groups compared to the control group.; RESULTS: Among 1138 patients regularly taking more than five drugs, 453 (39.8%) had at least one PIM/DDI at the beginning of the trial. The percent - ages of PIM/DDI at the beginning of the trial and 1 year later were 43.0% and 41.3% in the intervention groups and 37.0% and 37.6% in the control group. The estimated intervention effect of any intervention (69 practices) versus control (68 practices) was 2.3% (p = 0.36), while that of team training (35 practices) versus physician training (34 practices) was 4.3% (p = 0.22).; CONCLUSION: The interventions in the RIME trial did not significantly lower the percentage of patients with PIM or DDI.

Background/research question: Multimorbidity and polypharmacy increase the risk for potentially inappropriate medications (PIMs), underuse and worsening of health-related quality of life (wHRQoL). In heterogeneous general practice populations, it would be helpful to identify those patients at high[for full text, please go to the a.m. URL], Nützliche patientenrelevante Forschung; 21. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Background: Aging populations are facing multimorbidity and polypharmacy, inappropriate prescriptions, and underuse, which may contribute towards worsening of health-related quality of life (wHRQoL). In heterogeneous primary care populations, it would be helpful to identify those patients at highest[for full text, please go to the a.m. URL], 53. Kongress für Allgemeinmedizin und Familienmedizin

Malnutrition is widespread in older people and represents a major geriatric syndrome with multifactorial etiology and severe consequences for health outcomes and quality of life. The aim of the present paper is to describe current approaches and evidence regarding malnutrition treatment and to highlight relevant knowledge gaps that need to be addressed. Recently published guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) provide a summary of the available evidence and highlight the wide range of different measures that can be taken—from the identification and elimination of potential causes to enteral and parenteral nutrition—depending on the patient’s abilities and needs. However, more than half of the recommendations therein are based on expert consensus because of a lack of evidence, and only three are concern patient-centred outcomes. Future research should further clarify the etiology of malnutrition and identify the most relevant causes in order to prevent malnutrition. Based on limited and partly conflicting evidence and the limitations of existing studies, it remains unclear which interventions are most effective in which patient groups, and if specific situations, diseases or etiologies of malnutrition require specific approaches. Patient-relevant outcomes such as functionality and quality of life need more attention, and research methodology should be harmonised to allow for the comparability of studies.

Background/research question: Multimorbidity and inappropriate polypharmacy are common in older patients and may lead to medication-related harm resulting in hospitalization and worsening of health-related quality of life (HRQoL). Considering the complex interplay between conditions and medications[for full text, please go to the a.m. URL], EbM und Digitale Transformation in der Medizin; 20. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

\(\bf Purpose\) Acute lung injury is a life threatening condition often requiring mechanical ventilation. Lung-protective ventilation with tidal volumes of 6 mL/kg predicted body weight (PBW, calculated on the basis of a patient’s sex and height), is part of current recommended ventilation strategy. Hence, an exact height is necessary to provide optimal mechanical ventilation. However, it is a common practice to visually estimate the body height of mechanically ventilated patients and use these estimates as a reference size for ventilator settings. We aimed to determine if the common practice of estimating visual height to define tidal volume reduces the possibility of receiving lung-protective ventilation. \(\bf Methods\) In this prospective observational study, 28 mechanically ventilated patients had their heights visually estimated by 20 nurses and 20 physicians. All medical professionals calculated the PBW and a corresponding tidal volume with 6 ml/kg/PBW on the basis of their visual estimation. The patients' true heights were measured and the true PBW with a corresponding tidal volume was calculated. Finally, estimates and measurements were compared. \(\bf Results\) 1033 estimations were undertaken by 153 medical professionals. The majority of the estimates were imprecise and resulting data comprised taller body heights, higher PBW and higher tidal volumes (all p\(\leq\)0.01). When estimates of patients' heights are used as a reference for tidal-volume definition, patients are exposed to mean tidal volumes of 6.5 \(\pm\) 0.4 ml/kg/PBW. 526 estimation-based tidal volumes (51.1%) did not provide lung-protective ventilation. Shorter subjects (