Factors Associated with Potentially Inappropriate Transfer to the Emergency Department among Nursing Home Residents.

Objectives: To determine the factors associated with the potentially inappropriate transfer of nursing home (NH) residents to emergency departments (EDs) and to compare hospitalization costs before and after transfer of individuals addressed inappropriately vs those addressed appropriately.

Design: Multicenter, observational, case-control study.

Setting And Participants: 17 hospitals in France, 1037 NH residents.

Effect of a geriatric intervention aiming to improve polypharmacy in nursing homes.

Purpose: To examine the effect of an intervention comprising professional support by a geriatrician engaged in a quality care indicators' audit for nursing home (NH) staff on reducing polypharmacy.

Methods: Of a total of 3709 NH residents, 90 NHs (2026 residents) were allocated to a light intervention and 85 NHs (1683 residents) to a strong intervention group.

Results: Mixed-effect linear model found no significant variation in the total number of medications over time (β-coefficient for interaction 0.

Systematic Dementia Screening by Multidisciplinary Team Meetings in Nursing Homes for Reducing Emergency Department Transfers: The IDEM Cluster Randomized Clinical Trial.

Importance: Dementia is often underdiagnosed in nursing homes (NHs). This potentially results in inappropriate care, and high rates of emergency department (ED) transfers in particular.

Objective: To assess whether systematic dementia screening of NH residents combined with multidisciplinary team meetings resulted in a lower rate of ED transfer at 12 months compared with usual care.

The Temporal Trend in the Transfer of Older Adults to the Emergency Department for Traumatic Injuries: A Retrospective Analysis According to Their Place of Residence.

Objectives: There has been an increase in the number of visits by older individuals to emergency departments (EDs). The primary cause of this is trauma. The objective of this study was to evaluate the temporal changes in the use of EDs by older individuals for traumatic injuries, characterize their trauma, and specify the mode of transport to the ED according to their place of residence (community-dwelling or nursing home resident).

Impact of a geriatric intervention conducted in nursing homes on inappropriate prescriptions of antipsychotics.

Purpose: To study the effect of a quality assurance approach in a nursing home, with or without the intervention of a geriatrician, on the potentially inappropriate prescription of antipsychotics (PIPA) at 18 months; and to identify the factors associated with PIPA after 18 months of intervention (T18).

Methods: We used data from a multicentre individually tailored controlled trial (IQUARE study). The study population comprised residents included in the IQUARE study with at least one potentially inappropriate prescription of antipsychotics at baseline (T0) who were still in nursing home at T18 (n = 636; nursing homes = 175).

Mortality and Antipsychotic Drug Use in Elderly Patients With Parkinson Disease in Nursing Homes.

Objectives: To evaluate mortality rate in elderly and very elderly (≥85 years) residents with Parkinson disease (PD) in nursing homes (NHs) with and without antipsychotic drugs.

Design: Cross-sectional study.

Participants: All residents with PD from the 6275 NH residents participating in the Impact d'une démarche QUAlité sur l'évolution des pratiques et le déclin fonctionnel des Résidents en Etablissement d'hébergement pour personnes âgées dépendantes (IQUARE) study.

Prevention of Functional Decline by Reframing the Role of Nursing Homes?

Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process.

[Reinforced accommodation units and the management of patients with dementia].

Dementia is frequently associated with behavioural disorders that can be difficult to manage. In regards to these symptoms, psychoactive drugs are not very effective and have many potential side effects. In order to take care of patients with such severe disorders, specific units called "reinforced hosting units" ("UHR; Unités d'Hébergement Renforcées" in French) have been developed within long term care units.

Organizational Factors Associated With Inappropriate Neuroleptic Drug Prescribing in Nursing Homes: A Multilevel Approach.

Objective: To determine whether the number of attending general practitioners (GPs) in nursing homes and other facility characteristics are associated with inappropriate neuroleptic prescribing.

Design: Cross-sectional study.

Setting: One hundred seventy-five nursing homes in France participating in the IQUARE (Impact d'une démarche QUAlité sur l'évolution des pratiques et le déclin fonctionnel des Résidents en EHPAD) study.