Topical nonsteroidal anti-inflammatory drugs for management of osteoarthritis in long-term care patients.

Osteoarthritis is common in patients ≥65 years of age. Although nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed for osteoarthritis pain, they pose age-related cardiovascular, renal, and gastrointestinal risks. Two topical NSAIDs, diclofenac sodium 1% gel (DSG) and diclofenac sodium 1.

A comparative effectiveness trial between a post-acute care hospitalist model and a community-based physician model of nursing home care.

Introduction: To evaluate whether a designated Post-Acute Care Hospitalist (PACH) (an individual physician charged with care of most residents in the nursing home and with set hours to be in the facility each week) could improve some measureable outcomes in the long-term care setting compared with a traditional cadre of community physicians, a comparative trial was designed to measure multiple cost and care variables.

Methods: Data were collected in a historical prospective study design for 6 months before the institution of a PACH model in a nursing home in the Baltimore area. Similar data were collected in a similar setting in the same region during the same time frame.

Pharmacological management of persistent pain in older persons: focus on opioids and nonopioids.

Managing persistent pain is challenging, particularly in older adults who often have comorbidities and physiological changes that affect dosing and adverse effect profiles. The latest guideline issued by the American Geriatrics Society in 2009 is an important clinical resource on prescribing analgesics for older adults. This guideline helps form an evidence-based approach to treating persistent pain, along with other current endorsements, such as the relevant disease-specific recommendations by the American College of Rheumatology, the European League Against Rheumatism, and Osteoarthritis Research Society International, as well as opioid-specific guidelines issued by the American Pain Society, the American Academy of Pain Medicine, the Federation of State Medical Boards of the United States, and the American Society of Interventional Pain Physicians.

Faith in Practice: End-of-Life Care and the Catholic Medical Professional.

Theological discussions on appropriate courses of care for the very ill can be more difficult if information on options and outcomes is lacking. This article provides an historical review of a change in the paradigm of care in the United States and similar developed countries. End-of-life courses can vary based on underlying disease processes and health system resources.