How to Teach Medical Students About Pain and Dementia: E-Learning, Experiential Learning, or Both?

Objective: Pain management in persons with mild to moderate dementia poses unique challenges because of altered pain modulation and the tendency of some individuals to perseverate. We aimed to test the impact of an e-learning module about pain in communicative people with dementia on third-year medical students who had or had not completed an experiential geriatrics course.

Design: Analysis of pre- to postlearning changes and comparison of the same across the student group.

Nursing Home Provider Perceptions of Telemedicine for Providing Specialty Consults.

Background: Nursing homes (NHs) provide care to a complex patient population and face the ongoing challenge of meeting resident needs for specialty care. A NH telemedicine care model could improve access to remote specialty providers.

Introduction: Little is known about provider interest in telemedicine for specialty consults in the NH setting.

Underuse of indicated medications among physically frail older US veterans at the time of hospital discharge: results of a cross-sectional analysis of data from the Geriatric Evaluation and Management Drug Study.

Background: Medication underutilization, or the omission of a potentially beneficial medication indicated for disease management, is common among older adults but poorly understood.

Objectives: The aims of this work were to assess the prevalence of medication underuse and to determine whether polypharmacy or comorbidity was associated with medication underuse among physically frail older veterans transitioning from the hospital to the community.

Methods: This was a cross-sectional analysis of patients who were discharged from 11 US veterans' hospitals to outpatient care, based on data from the Geriatric Evaluation and Management Drug Study, a substudy of the Veterans Affairs Cooperative Study of geriatric evaluation and management.

Central nervous system medication use and incident mobility limitation in community elders: the Health, Aging, and Body Composition study.

Purpose: To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation.

Methods: This 5-year longitudinal cohort study included 3055 participants from the health, aging and body composition (Health ABC) study who were well-functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, and antidepressants) was determined yearly (except year 4) during in-home or in-clinic interviews.

Effect of central nervous system medication use on decline in cognition in community-dwelling older adults: findings from the Health, Aging And Body Composition Study.

Objectives: To evaluate whether combined use of multiple central nervous system (CNS) medications over time is associated with cognitive change.

Design: Longitudinal cohort study.

Setting: Pittsburgh, Pennsylvania, and Memphis, Tennessee.

Number and dosage of central nervous system medications on recurrent falls in community elders: the Health, Aging and Body Composition study.

Background: Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (>or=2) falls.

Methods: This longitudinal cohort study included 3,055 participants from the Health, Aging and Body Composition study who were well functioning at baseline.

Use of osteoporosis medications in older nursing facility residents.

Introduction: Epidemiologic studies demonstrated that 70% to 85% of nursing home residents have osteoporosis. Few studies report comprehensive information about treatment of osteoporosis in nursing facilities.

Objective: To determine the prevalence of osteoporosis treatment and identify resident characteristics associated with the use of antiresorptive medications or supplements indicated to treat osteoporosis in nursing homes.

Epidemiology of medication-related adverse events in nursing homes.

Background: Nursing home residents are prescribed more medications than patients in any other clinical setting. Although pharmacotherapy for older nursing home residents is usually safe and effective, it can lead to medication-related adverse events such as adverse drug reactions (ADRs), adverse drug withdrawal events (ADWEs), and therapeutic failures (TFs).

Objective: This article reviews the descriptive (incidence) and analytic (risk factor) epidemiology of medication-related adverse events occurring in nursing home residents as reported in the literature during the last 2 decades.

Use of medication technicians in US nursing homes: part of the problem or part of the solution?

Objectives: To determine the relation between organizational characteristics and medication technician (MT) use and quantify the impact of MTs on increasing the likelihood of using medications, employing the example of antiosteoporosis medications.

Design: Cross-sectional study.

Setting: The setting included 6344 Medicare/Medicaid certified nursing homes in 23 states.

Geriatric pharmacology: safer prescribing for the elderly patient.

Adverse drug effects are common in elderly patients but can often be avoided. Judicious prescribing practices require the clinician to be aware of age-related changes in drug absorption, distribution, metabolism, and elimination. Clinicians may need to adjust drug dose, frequency, or the choice of drug altogether as they consider the physiologic changes of aging.