Primary Care Variation in Rates of Unplanned Hospitalizations, Functional Ability, and Quality of Life of Older People

AbstractThe combined burden of geriatric conditions, comorbidities, and HIV requires a model of HIV care that offers a comprehensive clinical approach with people 50 years or older with HIV. Golden Compass is an outpatient, multidisciplinary HIV-geriatrics program with an onsite HIV geriatrician, cardiologist, pharmacist, and social worker, offering specialist referrals, care navigation, and classes on improving functional status and cognition. Participants (13 patients and 11 primary care providers) were recruited using a non-probability sampling method to participate in semi-structured interviews on the perceived impact of Golden Compass on care delivered to older people with HIV. Interviews were transcribed verbatim and framework analysis used to analyze the transcripts. The perceived impacts of Golden Compass by patients and providers were organized by the Compass points (Northern: Heart and Mind, Eastern: Bones and Strength, Southern: Navigation and Network, Western: Dental, Hearing, and Vision). Overall, patients valued the focus on functional health and whole-person care, leading to greater trust in the ability of providers. Providers gained new skills through the geriatrics, cardiology and/or pharmacist consultations. The HIV-geriatrics specialty approach of Golden Compass improved functional ability and quality of life for older adults with HIV. Few integrated care programs for older people with HIV have been evaluated. This study adds to the limited literature demonstrating high patient and provider satisfaction with a HIV-care model that incorporated principles of geriatric medicine emphasizing a comprehensive approach to sustaining functional ability and improving quality of life.

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Predictors of the quality of life of older people with heart failure recruited from primary care

Age and Ageing ◽

10.1093/ageing/afj040 ◽

2006 ◽

Vol 35 (2) ◽

pp. 172-177 ◽

Cited By ~ 58

Author(s):

Merryn Gott ◽

Sarah Barnes ◽

Chris Parker ◽

Sheila Payne ◽

David Seamark ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Primary Care ◽

Older People

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Predictors for oral and general health outcomes and quality of life among older people attending general practice (GP) clinics in South Australia

10.21203/rs.3.rs-119291/v1 ◽

2020 ◽

Author(s):

Madhan Balasubramanian ◽

Dominic Keuskamp ◽

Najith Amarasena ◽

David Brennan

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Primary Care ◽

Older People ◽

Health Outcomes ◽

General Health ◽

Chronic Conditions ◽

Living Arrangement ◽

South Australia

Abstract Background: As the proportion and number of older people in Australia continue to grow, innovative means to tackle primary care and prevention are necessary to combat the individual, social and economic challenges of non-communicable diseases.Objective: To assess risk factors (or predictors) for oral and general health outcomes and quality of life of older people (75+ yrs.) attending general practice (GP) clinics in South Australia.Methods: Data were collected from older people attending 48 GP clinics in metropolitan South Australia. Age, sex, education, living arrangement, material standards, chronic conditions and nutrition were assessed as risk factors. Global self-rated oral and general health and quality of life (OHIP Severity and EQ-5D Utility) were included as outcome measures.Results: A total of 459 participants completed the study; response rate was 78%. In the adjusted models, high satisfaction with material standards and good nutritional health were positively associated with all four oral and general health measures. Sex (β=-0.07), age (β=-0.09) and number of chronic conditions (β=-0.13) were negatively associated with EQ-5D, while living arrangement (β=0.06) was positively associated. Further, education level (PR:0.78), living arrangement (PR:0.75) and chronic conditions (PR:1.54) were significantly associated with self-rated general health.Conclusion: Satisfaction with material standards and nutritional risk were consistent predictors for oral and general health outcomes and quality of life of older people visiting GP clinics. Primary care teams involving general practitioners, nurses and allied health practitioners are well poised to assess risk factors for older people, and work alongside the dental team.

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Elderly people's perspectives on quality of life

Ageing and Society ◽

10.1017/s0144686x05003454 ◽

2005 ◽

Vol 25 (4) ◽

pp. 585-600 ◽

Cited By ~ 65

Author(s):

KATARINA WILHELMSON ◽

CHRISTINA ANDERSSON ◽

MARGDA WAERN ◽

PETER ALLEBECK

Keyword(s):

Quality Of Life ◽

Health Status ◽

Older People ◽

Social Relations ◽

Functional Ability ◽

Control Sample ◽

Perception Of Quality ◽

Frequent Response ◽

The Impact

Quality of life has become increasingly important as an outcome in medical research. The influence of health status is often emphasised, but other dimensions are important. In order to improve quality of life, there is a need to know what people themselves consider important to their perception of quality of life. The aim of this study was to investigate what older people consider to be important for their quality of life, and to explore the impact of gender, education and health status on individual perceptions. The study was of 141 randomly selected people aged from 67 to 99 years that formed a control sample for a study of suicide among older people. They were interviewed in person about their health, socio-demographic background and, using an open-ended question, what they considered to constitute quality of life. Their answers were grouped into eight categories, with social relations being the most frequent response, followed by health, activities, functional ability, wellbeing, personal beliefs and attitudes, their own home and personal finances. In addition, they were asked to choose from a ‘show card’ three items that they regarded as important to quality of life. Functional ability was the most frequently selected domain, followed by physical health, social relations and being able to continue to live in one's present home. Our conclusion is that social relations, functional ability and activities influence the quality of life of elderly people as much as health status.

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Pain Characteristics and Quality of Life in Older People at High Risk of Future Hospitalization

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18030958 ◽

2021 ◽

Vol 18 (3) ◽

pp. 958

Author(s):

Maria M Johansson ◽

Marco Barbero ◽

Anneli Peolsson ◽

Deborah Falla ◽

Corrado Cescon ◽

...

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Older People ◽

Pain Intensity ◽

Negative Impact ◽

Multiple Linear Regression Model ◽

Three Dimensions ◽

Individual Treatment ◽

Pain Characteristics

This study deals with how pain characteristics in conjunction with other factors affect quality of life (QoL) in a vulnerable primary care population. We recruited vulnerable older people (75+, n = 825) living in south-eastern Sweden. A postal questionnaire included pain aspects, QoL (EQ-5D-3L, RAND-36 physical functioning, attitudes toward own aging, and life satisfaction), functional status, social networks, and basic demographic information. Pain extent and localization was obtained by digitalization of pain drawings reported on standard body charts. Most respondents were experiencing pain longer than 3 months (88.8%). Pain frequency varied mostly between occasionally (33.8%) and every day (34.8%). A minority reported high pain intensity (13.6%). The lower back and lower legs were the most frequently reported pain locations (>25%). Multiple linear regression model revealed three characteristics of pain (intensity, frequency, and extent) remained inversely associated with the EQ-5D-3L index score (R2 = 0.57). Individually, each of these pain characteristics showed a negative impact on the other three dimensions of QoL (R2 = 0.23–0.59). Different features of pain had impact on different dimensions of QoL in this aging population. A global pain assessment is useful to facilitate individual treatment and rehabilitation strategies in primary care.

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Falls Among the Elderly and Vision: A Narrative Review

Open Medicine Journal ◽

10.2174/1874220301401010054 ◽

2014 ◽

Vol 1 (1) ◽

pp. 54-65 ◽

Cited By ~ 2

Author(s):

Ray Marks

Keyword(s):

Quality Of Life ◽

Older People ◽

Functional Ability ◽

The Elderly ◽

Research Literature ◽

Societal Costs ◽

Factors Influencing ◽

Life Impact ◽

Insight Into

Falls among older people are widespread, and can be catastrophic in terms of injury magnitude, quality of life impact, and increased mortality risk. Among a multitude of factors influencing falls risk rates among older people are deficits in vision, and/or their effects on locomotion, balance, and functional ability. This review discusses the above topic, offers insight into what can be done in this realm based on the current body of literature. Sources drawn from leading peer review articles published over the last 30 years using key words: falls, vision, injury, fracture were retrieved and are analyzed and discussed. On this basis, the importance of falls and their prevention, and future clinical and research directives are highlighted. Expected to increase in prevalence falls cause much undue distress and high personal, as well as societal costs. The research literature on vision and falls, despite having major implications, remains limited at best, at present.

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Protocol for a Nested Randomized Controlled Trial to Evaluate the Feasibility and Preliminary Efficacy of the Mindfulness Based Health Promotion Program on the Quality of Life of Older Adults Assisted in Primary Care—“The MBHP-Elderly Study”

Frontiers in Medicine ◽

10.3389/fmed.2020.563099 ◽

2020 ◽

Vol 7 ◽

Author(s):

Marcelo Vasconcelos Mapurunga ◽

Solange Andreoni ◽

Daniela Rodrigues de Oliveira ◽

Vicente Sarubbi ◽

Ana Cláudia Bonilha ◽

...

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Clinical Trial ◽

Health Promotion ◽

Older People ◽

Psychological Health ◽

Controlled Trial ◽

Control Group ◽

Randomized Controlled

Introduction: Population aging is a global phenomenon that has grown rapidly and progressively all over the world. Interventions that promote health must be studied and implemented to make the aging process be with quality of life. Depression and anxiety are the most common mental health conditions that compromise the quality of life on the elderly and it can cause damage to the autonomy and activities of daily life. Mindfulness training has been shown to improve psychological health and quality of life on adults. Studies involving Mindfulness-Based Interventions (MBIs) with older people are scarce in the literature, but they have been increasing in recent years showing promising results for healthy aging. This trial will investigate the feasibility and preliminary efficacy of an MBI on the quality of life of elderly assisted in the Primary Care.Materials and Methods: A cohort-nested randomized controlled trial with 3 assessment points (baseline, post-intervention and 1-year follow up) will be conducted to compare a MBI program (Mindfulness-Based Health Promotion) to a cognitive stimulation control-group in a Primary Care facility. One-hundred and two older adults will be recruited from a cohort of this facility and they will be randomized and allocated into an intervention group (N = 76) and the control group (N = 76). The primary outcome evaluated will be the improvement of quality of life assessed by the WHOQOL-BREF and WHOQOL-OLD. The secondary outcomes will be cognitive function, psychological health, sleep quality, self-compassion, and religiosity. Qualitative data will be assessed by focus group and the word free evocation technique. The feasibility of the program will also be evaluated by adherence and unwanted effects questionnaires.Discussion: This cohort-nested clinical trial will be the first mixed-methods study with 3 assessment points which will study the feasibility and preliminary efficacy of a mindfulness-based program for older people in Latin America population. If the findings of this study confirm the effectiveness of this program in this population it will be possible to consider it as intervention that might be implemented as public policy addressed to older people in healthcare systems.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03048708. Registered retrospectively on October 11th 2018.

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Balance and healthy aging: a close relationship

Revista Portuguesa de Clínica Geral ◽

10.32385/rpmgf.v36i5.12753 ◽

2020 ◽

Vol 36 (5) ◽

pp. 383-395

Author(s):

Sara Almeida ◽

◽

Cátia Paixão ◽

Alda Marques ◽

◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Older People ◽

Functional Ability ◽

Gait Speed ◽

Prior History ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Objectives: This study explored the: i) correlations between the Balance Evaluation Systems Test (BESTest) and its short-versions (Mini-BESTest and Brief-BESTest), with functional ability, gait speed, physical activity, and health-related quality of life; ii) ability of the Five Times Sit to Stand (5STS), 10 Meter Walk Test (10MWT), Brief Physical Activity Assessment Tool (BPAAT) and World Health Organization Quality of Life-Bref (WHOQoL-Bref) to identify the prior history of falls in community-dwelling older people. Methods: An exploratory cross-sectional study was conducted with healthy older people living in the community. Balance (BESTest and its short versions), functional ability (5STS), gait speed (10MWT), physical activity (BPAAT), and health-related quality of life (WHOQoL-Bref) were assessed. Spearman correlation coefficient and receiver operating characteristics analysis were calculated. Results: One hundred and eighteen individuals (76[69-83.3] years; n=79, 66.9% female) participated in this study. Correlations between balance and functional ability (-0.61< r < -0.51, p<0.001), gait speed (0.69 < r < 0.78, p<0.001), physical activity (0.39 < r < 0.42, p<0.001) and health-related quality of life (0.28 < r < 0.57, p≤0.002) were identified. The following cutoff points to differentiate between prior history of falls were established: 80.5 points for the BESTest, 16.5 points for the Mini-BESTest and 12.5 points for the Brief-BESTest, 13.5s for the 5STS, 1.2m/s for the 10MWT, 1.5 points for the BPAAT and 14.5/66; 14.5/66; 14/62.5; 15.5/72 points for domains I, II, III and IV, respectively, of the WHOQoL-Bref 0-20/100. Conclusion: The BESTest and its short versions correlated with functional ability, gait speed, physical activity, and health-related quality of life in older people. These outcomes can differentiate prior history of falls in community-dwelling older people.

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