Publications by authors named "Maria Inacio"
Objective: To identify quality and safety indicators routinely used to monitor, evaluate, and improve care transitions for older adults globally.
Design: A scoping literature review.
Setting And Participants: This review identified indicators used internationally to monitor and evaluate the quality and safety of care transitions by older adults.
Article Synopsis
- Pine wilt disease, caused by the pinewood nematode Bursaphelenchus xylophilus, poses significant risks to global pine forests, and its management presents logistical challenges and ecological concerns.
- Esteya spp., specifically Esteya vermicola and Esteya floridanum, show promise as biological control agents against the nematode, with studies evaluating their competitive abilities against other fungi and their metabolic capabilities.
- Results indicate both Esteya spp. effectively suppress the pinewood nematode in lab settings, suggesting that applying these fungi to pine trees could enhance their protection against the nematode and related fungal pathogens.
Validity of Pharmaceutical Claims Data for Determining Medication Exposure in Long-Term Care Facilities.
Pharmacoepidemiol Drug Saf
December 2024
Article Synopsis
- - The study aimed to evaluate how accurate pharmaceutical claims are compared to medication administration charts in long-term care facilities (LTCFs) by analyzing data from 279 residents across 5 facilities.
- - Researchers found that pharmaceutical claims had a high positive predictive value (PPV) of over 75% for most medications, particularly at the 3-digit ATC classification level, and sensitivity for specific drug classes like diabetes agents and beta-blockers was also very high.
- - The analysis concluded that claims data is reliable for tracking medication exposure, suggesting that exposure periods of 90-120 days are generally adequate, although longer durations might be necessary for medications in larger pack sizes.
Article Synopsis
- This study analyzed the performance of long-term care services (LTCS) in Australia, focusing on 12 quality indicators to determine achievable benchmarks of care (ABC©) based on top-performing facilities.
- The research included data from 2,746 LTCS and over 244,000 residents aged 65 and older in 2019, revealing that certain quality indicators had low benchmark rates, with 17-59% of LTCS meeting ABC for severe health concerns.
- Results showed that smaller and government-owned LTCS were more likely to achieve these benchmarks, highlighting the importance of these characteristics for quality care delivery.
The pinewood nematode (PWN) is a phytoparasite that causes pine wilt disease (PWD) in conifer species. This plant parasitic nematode has heavily contributed to pine deforestation in Asian countries, e.g.
View Article and Find Full Text PDFObjectives: A Star Rating system (1 to 5 stars) of long-term care facilities in Australia is based on 4 sub-categories: compliance, quality measures, residents' experience, and staffing. The objectives were to examine associations between facility characteristics and the odds of receiving a 4- or 5-star rating, and changes in ratings between the earliest reporting period (October-December 2022) to the most recent (April-June 2023).
Design: Cross-sectional, ecological study, with an additional longitudinal component.
Article Synopsis
- The study aimed to analyze the use of glucose-lowering medicine (GLM) among diabetes patients before and after they entered long-term care facilities (LTCFs).
- Over 50,000 residents aged 65 and older were assessed, revealing a slight decrease in GLM prevalence after LTCF entry but an increase in the number of doses administered.
- Results indicated that GLM use peaked within the first 3 months after moving to an LTCF, primarily due to increased insulin usage, suggesting a need for careful monitoring of diabetes treatment during this transitional period.
Background: The impact of Home Medicines Reviews (HMRs) on long-term health outcomes among individuals receiving long-term in-home aged care services is unknown.
Objectives: To examine associations between HMR provision and hospitalization, long-term care facility (LTCF) entry and mortality among older people receiving long-term in-home aged care services.
Methods: This retrospective cohort study included individuals aged 65-105 years from three Australian states who accessed in-home aged care services between 2013 and 2017.
Article Synopsis
- High antibiotic prescriptions in aged care could lead to increased antibiotic-resistant pathogens in residents, raising concerns about treatment failures.
- A study analyzed stool samples from 164 residents in South Australia, linking antibiotic use over the past year to the presence and quantity of antibiotic resistance genes (ARGs).
- Findings revealed that over 1100 unique ARGs were identified, with doxycycline being a major risk factor for high ARG levels, particularly influencing resistance to penicillins and cephalosporins, highlighting the need for cautious antibiotic use in this population.
Article Synopsis
- The rice root-knot nematode (RRKN) is a significant pest in rice production, causing up to a 70% loss in crop yields in major rice-producing countries.
- With a shift towards sustainable pest management, there is a need for alternative solutions as some harmful pesticides are being phased out.
- The study examined the nematicidal effects of volatile phytochemicals from rice plants, finding that compounds like carvacrol and eugenol effectively kill RRKN with lower toxicity and better environmental safety compared to traditional synthetic nematicides.
Objectives: To assess changes following the 2013-21 Home Care Package (HCP) reforms in the rate of HCPs provided to Australians aged 65 years or older, the characteristics of people who have received HCPs, and the capacity of the program to meet demand for its services during 2018-21.
Study Design: Repeated cross-sectional population-based study; analysis of Australian Institute of Health and Welfare GEN Aged Care and Australian Department of Health Home Care Packages program data.
Setting, Participants: HCPs provided to non-Indigenous Australians aged 65 years or older, 2008-09 to 2020-21.
Background: Depression is associated with inferior outcomes following hip or knee arthroplasty, though it remains unclear if this relationship is modifiable. This study examined the association between pharmacologic treatment of depression and patient-reported outcomes.
Methods: This retrospective cohort study of 1,651 total hip arthroplasty (THA) and 1,792 total knee arthroplasty (TKA) procedures between October 2012 and June 2019 used institutional registry data linked to nationwide pharmaceutical claims.
Aged care service use by Aboriginal and Torres Strait Islander people after aged care eligibility assessments, 2017-2019: a population-based retrospective cohort study.
Med J Aust
July 2024
Objective: To characterise the socio-demographic characteristics, aged and health care needs, and aged care services used by older Aboriginal and Torres Strait Islander people assessed for aged care service eligibility.
Study Design: Population-based retrospective cohort study; analysis of Registry of Senior Australians (ROSA) National Historical Cohort data.
Setting, Participants: Aboriginal and Torres Strait Islander people aged 50 years or older who were first assessed for aged care service eligibility (permanent residential aged care, home care package, respite care, or transition care) during 1 January 2017 - 31 December 2019.
Objective: Population-based data on the required needs for palliative care in residential aged care have been highlighted as a key information gap. This study aimed to provide a comprehensive estimate of palliative care needs among Australia's residential aged care population using a validated algorithm based on causes of death.
Methods: A population-based retrospective cohort study was conducted using data from the Registry of Senior Australians of non-Indigenous residents of residential aged care services in New South Wales, Victoria, and South Australia aged older than 65 years, who died between 2016 and 2017 (n = 71,677).
Older individuals residing in long-term care facilities (LTCFs) are often living with multimorbidity and exposed to polypharmacy, and many experience medication-related problems. Because randomized controlled trials seldom include individuals in LTCFs, pharmacoepidemiological studies using real-world data are essential sources of new knowledge on the utilization, safety, and effectiveness of pharmacotherapies and related health outcomes in this population. In this commentary, we discuss recent pharmacoepidemiological research undertaken to support the investigations and recommendations of a landmark public inquiry into the quality and safety of care provided in the approximately 3000 Australian LTCFs that house more than 240 000 residents annually, which informed subsequent national medication-related policy reforms.
View Article and Find Full Text PDFObjective: The objective of this review is to identify quality indicators used to monitor the quality and safety of care provided to older people (≥ 65 years old) in 8 care settings: primary care; hospital/acute care; aged care (including residential aged care and home or community care); palliative care; rehabilitation care; care transitions; dementia care; and care in rural areas.
Introduction: There is a need for high-quality, holistic, person-centered care for older people. Older people receive care across multiple care settings, and population-level monitoring of quality and safety of care across settings represents a significant challenge.
ObjectiveThis study aimed to examine the national variation in government-subsidised healthcare costs of residents in long-term care facilities (LTCFs) and costs differences by resident and facility characteristics.MethodsA retrospective population-based cohort study was conducted using linked national aged and healthcare data of older people (≥65years) living in 2112 LTCFs in Australia. Individuals' pharmaceutical, out-of-hospital, hospitalisation and emergency presentations direct costs were aggregated from the linked healthcare data.
View Article and Find Full Text PDFObjectives: This study investigates which local area characteristics, included in the Healthy Ageing/Vulnerable ENvironment (HAVEN) Index, are the strongest factors predicting transition into permanent residential aged care (PRAC) and mortality, and the geographic distribution of these factors.
Methods: A retrospective cohort study of older individuals living in the community in Adelaide who received their first eligibility assessment for age care services between 2013 and 2015 (n = 16,939) was conducted. The study cohort, from the Registry of Senior Australians (ROSA), was linked by postcode to HAVEN Index items, selected following item response theory (IRT) analysis to determine the strongest local area factors associated with PRAC and mortality.
Objective: Moving into a long-term care facility (LTCF) requires substantial personal, societal and financial investment. Identifying those at high risk of short-term mortality after LTCF entry can help with care planning and risk factor management. This study aimed to: (i) examine individual-, facility-, medication-, system- and healthcare-related predictors for 90-day mortality at entry into an LTCF and (ii) create risk profiles for this outcome.
View Article and Find Full Text PDFAims: To examine national trends in glucose lowering medicine (GLM) use among older people with diabetes in long-term care facilities (LTCFs) during 2009-2019.
Methods: A repeated cross-sectional study of individuals ≥65 years with diabetes in Australian LTCFs (n = 140,322) was conducted. Annual age-sex standardised prevalence of GLM use and number of defined daily doses (DDDs)/1000 resident-days were estimated.
Objectives: Dementia guidelines recommend antipsychotics are only used for behavioral and psychological symptoms when non-drug interventions fail, and to regularly review use. Population-level clinical quality indicators (CQIs) for dementia care in permanent residential aged care (PRAC) typically monitor prevalence of antipsychotic use but not prolonged use. This study aimed to develop a CQI for antipsychotic use >90 days and examine trends, associated factors, and variation in CQI incidence; and examine duration of the first episode of use among individuals with dementia accessing home care packages (HCPs) or PRAC.
View Article and Find Full Text PDFBackground: To analyze patient perception of functional status related to activity and participation of rehabilitated and nonrehabilitated individuals with peripheral arterial disease.
Methods: Cross-sectional study assessing the activity and participation domain using the Human Activity Profile (HAP) questionnaire and the Participation Scale, respectively. Groups were compared using Chi-squared test and unpaired t-test.