Publications by authors named "Virva Hyttinen"
The role of functioning in predicting nursing home placement or death among older home care patients.
Scand J Prim Health Care
December 2023
Objective: There have been few studies predicting institutionalization or death in home care settings. We examined risk factors for nursing home placement (NHP) and death among home care patients.
Design: A prospective one-year follow-up study.
Background: Up to 90% of people with dementia experience behavioural and psychological symptoms of dementia (BPSD) as part of their illness. Psychotropics are not recommended as the first-line treatment of BPSD because older people are more prone to adverse reactions. In this study, we evaluate the impact of the Finnish clinical guidelines of BPSD (published in 2017) on psychotropic use in people with dementia.
View Article and Find Full Text PDFBackground: Certain medications should be used with caution in older persons, which challenges rational prescribing. Potentially inappropriate medications (PIMs) are defined as medicines whose potential risk of harm typically outweighs the clinical benefits in geriatric population. Earlier studies have found regional differences in PIM use, but the factors underlying this phenomenon are unclear.
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- Evaluated the impact of the Meds75+ database on the use of potentially inappropriate medications (PIMs) in older adults, finding no significant decrease after its implementation.
- Used a quasi-experimental approach to analyze medication data for over 920,000 individuals aged 75 and older between 2009 and 2020, linking various health registers for comprehensive data.
- Results showed a decrease in PIM prevalence but no significant change in overall levels or trends, suggesting the need for further research into barriers to using medication criteria in clinical settings.
Background: There are several national and international criteria available for identifying potentially inappropriate medications (PIMs) for older people. The prevalence of PIM use may vary depending on the criteria used. The aim is to examine the prevalence of potentially inappropriate medication use in Finland according to the Meds75+ database, developed to support clinical decision-making in Finland, and to compare it with eight other PIM criteria.
View Article and Find Full Text PDFAims: To assess the validity and completeness of the Care Register for Social Welfare among community-dwelling people with Alzheimer's disease in Finland.
Methods: The study was carried out in the Medication Use and Alzheimer's disease (MEDALZ) study population, which includes 70,719 people who received a clinically verified diagnosis of Alzheimer's disease between 2005 and 2011 and the people matched with them for comparison (=282,862). The data were linked to the Care Register for Social Welfare, which contains data on care periods for nursing homes and sheltered housing with 24-h assistance during the time period 1994-2015.
Background: Educational interventions can reduce potentially inappropriate medication (PIM) use in older people. Their effectiveness has been measured mainly as changes in PIM use. In this economic evaluation, we analyse the impact of an educational intervention in terms of costs and quality-adjusted life years (QALYs).
View Article and Find Full Text PDFObjectives: To clarify the diagnostic utility and the cost-effectiveness of whole-exome sequencing (WES) as a routine early-diagnostic tool in children with progressive neurological disorders.
Methods: Patients with infantile-onset severe neurological diseases or childhood-onset progressive neurological disorders were prospectively recruited to this WES study, in the pediatric neurology clinic at Helsinki University Hospital during 2016-2018. A total of 48 patients underwent a singleton WES.
Objectives: Clinical diagnostics in adults with hereditary neurological diseases is complicated by clinical and genetic heterogeneity, as well as lifestyle effects. Here, we evaluate the effectiveness of exome sequencing and clinical costs in our difficult-to-diagnose adult patient cohort. Additionally, we expand the phenotypic and genetic spectrum of hereditary neurological disorders in Finland.
View Article and Find Full Text PDFObjectives: Several implementation strategies can reduce potentially inappropriate medication (PIM) prescribing. Although use of PIMs has declined in recent years, it remains prevalent. Various strategies exist to improve the appropriateness of medication use.
View Article and Find Full Text PDFThis study examines how parents of pediatric patients might differ in their views and attitudes towards genetic technology and information when compared to adult patients. There is surprisingly little evidence on how parents compare to other parts of population in their attitudes. Previous empirical studies often relate health-related preferences and attitudes to factors such as age, education, and income instead of parental status, thus evading comparison of parents to others as health-related decision makers.
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- * Out of 28,497 participants, 37.5% began PIMs between 2002 and 2013, with female gender and higher income being significant factors in the younger group, while these did not apply to the older group.
- * The research highlights age- and gender-related differences in PIM initiation, showing that while patient-related factors played a major role, physician variability in prescribing practices decreased over the study period. *
Article Synopsis
- The study aimed to explore the link between potentially inappropriate medication (PIM) use and its effects on hospitalizations due to fractures, overall mortality, and hospital costs in older adults in Finland over a 12-year period.
- Researchers followed 20,666 individuals aged 65 and over who had no prior PIM use, analyzing data from national registers to assess risks and costs associated with PIM use through methods like propensity score matching and Cox regression.
- Results showed that PIM use was weakly linked to higher risks of fractures and death, with associated hospital costs being 15% greater for PIM users compared to non-users, suggesting careful prescribing practices are needed for older patients.
Background: Potentially inappropriate medications (PIMs) increase the risk of adverse drug reactions and events and have been associated with greater health care service use, such as an increased risk of hospitalization.
Objective: The aim of this study is to evaluate the association between PIM use and hip fractures in a nationwide cohort of community-dwelling persons ≥65 years old with Alzheimer's disease (AD).
Methods: The study, which is based on the Finnish nationwide MEDALZ cohort, included all persons diagnosed with AD between 2005 and 2011 (n = 70 718).
Background: Various criteria have been created to define potentially inappropriate medications (PIMs) to help improve the quality and safety of medicine use in older patients. Individuals with Alzheimer's disease (AD) may be at higher risk of adverse drug events associated with PIMs (such as falls).
Objective: Our objective was to determine the risk factors for PIM initiation in a nationwide cohort of community dwellers aged ≥65 years with and without AD.
Background: Potentially inappropriate medications (PIMs) are defined as those medicines having a greater potential risk than benefit for older adults. In this systematic literature review, we evaluate the current evidence on health care service use and health care costs associated with PIMs among older adults.
Methods: A literature search was conducted in August 2015 without publication date restrictions using the databases PubMed and Scopus.