Barriers and facilitators to the implementation of PHAROS, a perioperative pharmaceutical management intervention for older adults - a qualitative interview study from the perspective of healthcare providers.

Background: Number of drugs are increasing with older age and present a risk factor for various adverse health outcomes. A comprehensive medication therapy management (MTM) before admission for elective surgery may help reduce unnecessary and potentially inadequate medications (PIM) and thus improve patient health. Our goal was to evaluate the implementation of PHAROS, a perioperative MTM intervention study, from the perspective of health care providers.

Personalised blood pressure management during major noncardiac surgery and postoperative neurocognitive disorders: a randomised trial.

Background: It remains unknown whether there is a causal relationship between intraoperative hypotension and postoperative neurocognitive disorders. We tested the hypothesis that personalised-compared to routine-intraoperative blood pressure management reduces the incidence of postoperative neurocognitive disorders in patients having major noncardiac surgery.

Methods: In this single-centre trial, 328 elective major noncardiac surgery patients were randomly allocated to receive personalised blood pressure management (i.

Cognitive Deficits in Executive and Language Functions Predict Postoperative Delirium.

Objectives: Postoperative delirium (POD) remains the most common complication in older adults, with cognitive impairment being the main risk factor. Patients with mild cognitive impairment, in particular, have much to lose from delirium; despite this, their cognitive impairment might be clinically overlooked. Understanding which cognitive domains are particularly predictive in this regard may improve the sensitivity of preoperative testing and allow for a more targeted application of resource-intensive measures to prevent delirium in the perioperative period.

The effect of delirium preventive measures on the occurrence of postoperative cognitive dysfunction in older adults undergoing cardiovascular surgery. The DelPOCD randomised controlled trial.

Study Objective: This trial examines the effect of delirium preventive measures on the incidence of postoperative cognitive dysfunction in older adults.

Design: In a randomised approach, a delirium prevention and a standard care group were compared regarding manifestation of postoperative cognitive dysfunction at seven days, three and twelve months postoperatively (primary outcome). To correct for practice effects and age-depended cognitive decline, a control group of age-matched healthy subjects was included.