Browsing by Subject "geriatrics"
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Item Broader Implications of Modeling and Simulation (M&S) Tools in Pharmacotherapeutic Decisions: A Cautionary Optimism(Frontiers Media S.A., 2020-04-29) Chaturvedula, Ayyappa; Palasik, Brittany N.; Cho, Hae Jin; Goyal, NavinItem Demographics of a University Based Geratric Medicine House Call Program(1999-05-01) Dunn, Leslie K.There has been a steady decline in the frequency of house calls by physicians during the 20th century. The reasons most commonly given for not making house calls are time constraints and poor reimbursements for the amount of time spent (1). Unlike younger age groups, those 65 and older tend to have physical limitations that prohibit routine visits to clinics (2). In a university based geriatric practice, there is a subgroup of individuals who are unable to access health care or see a physician without considerable expense and effort via ambulance transportation services. Without a physician house call visit, these older adults would not have routine access to health care (3). The Gerontology Assessment and Planning Program (GAP) at the University of North Texas Health Science Center at Fort Worth (UNTHSC) is involved in providing a physician directed house call program. By 2030, it is estimated that the older adults will comprise 25% of the total population (4). Encouraging independent living supported by community-based services will result in a greater number of homebound older adults requiring house calls by physicians (5). The challenge is to determine those likely to require house call services and the medical conditions and physical disabilities leading to the need for in home services. To understand the conditions and needs of these geriatric patients, a retrospective chart review was conducted. The study reviewed the demographic characteristics of the patients seen through the house call program, prevalent sources of referrals, health assessment at the point of admission into the house call program, profile of primary care givers and factors in the decision making process that physicians used to place patients on the service. Outcome data are presented including hospital admissions and deaths while on the house call program.Item Knebl, Janice, D.O.(1994-04-15) Knebl, Janice; Hailey, BlakeDr. Knebl is Associate Professor of Medicine for the Department of Medicine and Chief for the Geriatrics Division. She discusses her current and future work with the Health Science Center. Interviewed by Blake Hailey, April 15, 1994Item Lessons Learned from Age-Friendly, Team-Based Training(MDPI, 2023-08-25) Murphy, Sara C.; Severance, Jennifer J.; Camp, Kathlene; Knebl, Janice; Fairchild, Thomas J.; Soto, IsabelAccording to the Institute of Medicine, immediate steps must be taken across the United States to educate and train the healthcare workforce to work collaboratively to address the needs of the growing older adult population. The Geriatric Practice Leadership Institute (GPLI) was designed to support professional teams working in acute and post-acute care in transforming their organization into a designated Age-Friendly Health System. The program was built around the Institute for Healthcare Improvement's Age-Friendly Health Systems 4Ms framework. This framework focuses on What Matters, Medication, Mentation, and Mobility (the 4Ms) in supporting care for older adults. The GPLI program is an online, seven-month team-based program with four to seven participants from one organization per team. Additionally, each team selected, developed, and completed a quality improvement project based on Age-Friendly Health Systems 4Ms. The curriculum also includes organizational culture, leadership, and interprofessional team-building modules. Using a post-completion survey, the experiences of 41 participants in the GPLI program were assessed. All respondents found the information in the program 'very' or 'extremely' valuable, and their executive sponsor 'very' or 'extremely' valuable in supporting their team's involvement and project. The GPLI program has trained over 200 healthcare professionals and teams that have successfully implemented projects across their organizations.Item PATTERNS OF MEDICATION-RELATED PROBLEMS IDENTIFIED DURING A SIX-MONTH MEDICATION MANAGEMENT PROGRAM.(2013-04-12) Liou, AshleyPurpose: Using data from a parent study that evaluated a comprehensive medication management program, this study sought to follow the types of medication-related problems (MRPs) identified at baseline and describe patterns of MRPs over the course of the intervention. The study also examined the most prevalent drug classes contributing to MRPs. Methods: The study examined MRPs at baseline and at 6 months. Drugs were consolidated into a representative therapeutic class. Data on MRPs and drugs had been previously recorded by clinical pharmacists in the study database. Results: 273 MRPs were found at baseline and were reduced to 22 MRPs at 6 months. The most prevalent MRPs at baseline were suboptimal drug (31%), suboptimal dosing (23%), nonadherence (21%), and undertreatment (19%). In comparison, the most prevalent MRP at 6 months was nonadherence (64%), followed by suboptimal drug (14%). At baseline, the most prevalent drugs contributing to overall MRPs were calcium and vitamin D in the category of suboptimal dosing. At 6 months, calcium and vitamin D continued to be the most frequent set of drugs contributing to overall MRPs (32% of the 22 drugs). The second most frequent contributor was antilipidemics, occurring 14% overall. Conclusions: The medication management program was successful in significantly reducing the number and type of MRPS over 6 months. Calcium, vitamin D, and antilipidemics were identified as the most common set of drugs contributing to MRPs. The most common MRP at baseline was suboptimal drug compared to nonadherence at 6 months.