Potentially Inappropriate Prescribing for Older Persons: Revisited (APPG on Dementia / Newsmax / European Journal of Clinical Pharmacology)

Summary

The All-Party Parliamentary Group on Dementia (APPG), back in 2008, asserted that perhaps half of dementia patients may be receiving inappropriate medications. While the extent to which this position may have changed in recent years is debatable, the allegation has been picked-up in a recent news item on potentially inappropriate prescribing for the elderly.

Full Text Link

Reference

Half of Dementia Patients Get Inappropriate Meds. [Online]: Newsmax; Health, October 6th 2017.

This relates to an academic article dating back a few years:

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Reference

Renom-Guiteras A. Meyer, G. [and] Thürmann, PA. (2015). The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries. European Journal of Clinical Pharmacology. July 2015; 71(7): 861-75.

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Posted in Acute Hospitals, All-Party Parliamentary Group (APPG) on Dementia, Antipsychotics, Commissioning, Community Care, Falls Prevention, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, Integrated Care, International, Mental Health, Models of Dementia Care, National, Person-Centred Care, Pharmacological Treatments, Quick Insights, Standards, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Scoping the Potential Role(s) of Community Pharmacists in Medication Management for Community-Dwelling People With Dementia (Health Expectations)

Summary

A new article has appeared on the roles for community pharmacists in assisting people with dementia dwelling in the community, their informal carers – and health and social care professionals more widely – in achieving safer and more effective medications management.

Full Text Link

Reference

Maidment, ID. Aston, L. [and] Moutela, T. [et al] (2017). A qualitative study exploring medication management in people with dementia living in the community and the potential role of the community pharmacist. Health Expectations: an International Journal of Public Participation in Health Care and Health Policy. October 2017; 20(5): 929-942.

Posted in Antipsychotics, Commissioning, Community Care, Falls Prevention, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, Local Interest, Management of Condition, Mental Health, Models of Dementia Care, National, NHS, Person-Centred Care, Personalisation, Pharmacological Treatments, Quick Insights, Standards, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

More Questions About NHS Sustainability and Service Quality: A Further Round in the Debate (BBC News / King’s Fund / BMA / RCEM / NHS Digital / Department of Health / NHS England / NHS Confederation)

Summary

Professor Ted Baker, the new Chief Inspector of Hospitals for the Care Quality Commission (CQC) has voiced concerns about unsuitable antiquated models of care in the NHS (due to a historic 15-20 year mis-direction of funding), growing pressures for urgent and emergency hospital care, problems with staffing levels and recruitment, and increasingly squeezed NHS capacity.

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Reference

NHS ‘not fit for 21st Century’, says chief hospital inspector. London: BBC Health News, September 30th 2017.

The Royal College of Nursing has reported similar concerns from front-line nursing staff:

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Reference

Triggle, N. (2017). NHS staff shortages ‘mean patients dying alone’ in hospitals. London: BBC Health News, September 29th 2017.

Earlier “doom and gloom” laden projections:

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Reference

Triggle, N. (2017). The worst is yet to come for the NHS – hospital chiefs. London: BBC Health News, September 3rd 2017.

Further BBC News commentary:

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Reference

Pym, H. (2017). As winter looms, NHS debate warms up. London: BBC Health News, September 7th 2017.

Possibly of interest, a recent King’s Fund briefing indicates that the number of NHS hospital beds in England has roughly halved over the past 30 years. Questions are raised about the feasibility of further proposed bed reductions.

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Reference

Ewbank, L. Thompson, J. [and] McKenna, H. (2017). NHS hospital bed numbers: past, present, future. [Online]: King’s Fund, September 29th 2017.

Rising Delays in Emergency Department Admissions?

The number of patients waiting more than 12 hours for admission in emergency departments has increased a hundred-fold over the past five years, according to the BMA using data obtained by the Royal College of Emergency Medicine (RCEM):

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Reference

Delays rise a hundred-fold. [Online]: British Medical Association (BMA), September 27th 2017.

Trends in Hospital Admitted Patient Care Activity (2016-17)

In 2016-17 there were 16.5 million recorded Finished Admission Episodes (FAEs); an increase of 1.8% from the previous year and an increase of 27.5% since 2006-07. Finished Consultant Episodes (FCEs) for the 65-84 year old age group have increased fastest over the last ten years.

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Reference

Hospital Admitted Patient Care Activity: 2016-17. London: NHS Digital, October 3rd 2017.

Lobbying?

A briefing from the NHS Confederation outlines the challenges facing the NHS and suggests how MPs and other parliamentarians might support the health service at national and local levels.

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Reference

Healthcare on the brink: how parliamentarians can support their local NHS. NHS Confederation briefing; Issue No.300. London: NHS Confederation, September 26th 2017.

The Latest CQC Report

The Care Quality Commission (CQC) has alleged that parts of the NHS may soon be “straining at the seams” and facing a “precarious” future”.

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Reference

Triggle, N. (2017). NHS future precarious, says regulator. London: BBC Health News, October 10th 2017.

On the Positive Side

The NHS has prepared specially for Winter this year – more so than ever before – and ongoing demands for additional funding / hospital bailouts have not gone unheard.

Earlier this month, 19 hospitals across England were awarded £13 million for emergency care, with the explicit aims of improving patient flow in A&E departments and achieving better preparedness for high Winter demand.

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Reference

New £13 million funding to help hospital A&Es prepare for winter. [Online]: Department of Health, September 8th 2017.

National Service Specification for Integrated Urgent Care Services

The NHS England national service specification defines an alternative model of service delivery (said to move from an “assess and refer” to a “consult and complete” model). This involves an outline for an Integrated Urgent Care Clinical Assessment Service (IUC CAS). The IUC CAS is intended to ensure patients accessing health services always receive a complete episode of care, involving receipt of either advice, a prescription, or an appointment for further assessment and / or treatment.

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Reference

NHS England’s Integrated Urgent Care Delivery Team (2017). Integrated Urgent Care Service Specification. Leeds: NHS England, August 25th 2017.

Safety and Quality in Emergency Care: Best Practice

Professor Ted Baker (see above) has released a letter to NHS trusts in England which summarises points of good practice (as taken from successful emergency care departments in 16 trusts rated good or outstanding). The main themes identified are:

  • Ambulance arrivals.
  • First clinical assessment.
  • Non-use of inappropriate physical spaces.
  • Specialist referrals.
  • Escalation.
  • Deteriorating patients.
  • Patient outcomes.
  • Staff.

Full Text Link

Reference

Safety and quality of emergency care. [Letter from Ted Baker to NHS trusts about emergency care]. London: Care Quality Commission (CQC), September 29th 2017.

Further details to follow.

 

Posted in Acute Hospitals, BBC News, Commissioning, CQC: Care Quality Commission, Department of Health, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, Integrated Care, King's Fund, Local Interest, National, NHS, NHS Confederation, NHS England, Quick Insights, RCN, Royal Wolverhampton NHS Trust, Standards, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Under-Claimed SMI Council Tax Discount? (BBC News / MoneySavingExpert)

Summary

People diagnosed as severely mentally impaired (SMI) should by rights be exempt from paying council tax, with the result that two-person households often qualify for a 25% discount on council tax. Persons with a severe mental impairment living alone could claim a 100% discount.

“A person is severely mentally impaired if they have a severe impairment of intelligence and social functioning which appears to be permanent, such as dementia”.

In reality, certain local councils fail to ensure that those individuals entitled in law actually claim or receive the discount. Freedom of Information requests by the MoneySavingExpert.com (MSE) website revealed unaccountable variations and disparities between different councils, with similar population sizes, in the take-up (and the presumed promotion) of this discount. The MSE site offers practical advice on how to claim.

Full Text Link

Reference

Bloch-Budzier, S. (2017). ‘Mentally impaired’ missing out on council tax discount. London: BBC Health News, September 29th 2017.

This relates to:

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Reference

Good, K. Nowottny, S. [and] French, M. [et al] (2017). The disregarded discount: MoneySavingExpert.com report into the ‘Severely Mentally Impaired’ (SMI) council tax discount. [Online]: MoneySavingExpert.com, September 2017.

Posted in BBC News, Community Care, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, Local Interest, Management of Condition, Models of Dementia Care, National, Patient Information, Person-Centred Care, Practical Advice, Quick Insights, Scotland, Standards, Statistics, UK, Universal Interest, Wales | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Maintaining Strength for Healthier Ageing (BBC News / NHS Choices / Lancet)

Summary

The Chartered Society of Physiotherapy (CSP) has warned that perhaps one quarter of over-65s don’t do sufficient strength exercises to maintain general physical fitness and help avoid the risk of falls. Conducting strength exercises can be an integral part of everyday life; it need not involve privileged lifestyle activities which are exotic or expensive.

“Carrying the shopping, gardening, or vacuuming, can help older people to lead healthier lives for longer…”.

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Reference

Hughes, D. (2017). Carrying the shopping can improve strength in over-65s, say experts. London: BBC Health News, September 29th 2017.

Possibly also of interest, there is a further study on the benefits of mundane day-to-day physical activity for enduring cardiovascular health.

“ …researchers estimate that 8% of all deaths and 4.6% of all cardiovascular disease events in the population could be prevented if everyone met the current physical activity recommendations: doing at least 150 minutes of moderate activity each week”.

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Reference

Any type of physical exercise is good for the heart. London: NHS Choices; Behind the Headlines, September 22nd 2017.

This relates to:

Full Text Link (Note: This article requires a suitable Athens password, a journal subscription or payment for access).

Reference

Lear, SA. Hu, W. [and] Rangarajan, S. [et al] (2017). The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet. September 21st 2017. [Epub ahead of print].

Posted in BBC News, Community Care, Falls Prevention, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), In the News, International, Management of Condition, NHS Choices, Non-Pharmacological Treatments, Person-Centred Care, Practical Advice, Quick Insights, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Further Evidence on the Link Between Hearing Loss and Dementia / Cognitive Decline (Laryngoscope Investigative Otolaryngology / Journal of Neurology)

Summary

A number of systematic reviews and meta-analyses provide further consolidation in the evidence for an association between hearing loss and an increased risk of cognitive decline and / or dementia in older adults.

Full Text Link

Reference

Thomson, RS. Auduong, P. [and] Miller, AT. [et al] (2017). Hearing loss as a risk factor for dementia: a systematic review. Laryngoscope Investigative Otolaryngology. March 16th 2017; 2(2): 69-79.

Possibly also of interest:

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Reference

Hardy, CJ. Marshall, CR. [and] Golden, HL. [et al] (2016). Hearing and dementia. Journal of Neurology. November 2016; 263(11): 2339-2354. Review.

Exploring intervention mapping for reducing the impact of different sensory impairments:

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Reference

Leroi, I. Pye, A. [and] Armitage, CJ. [et al] (2017). Research protocol for a complex intervention to support hearing and vision function to improve the lives of people with dementia. Pilot and Feasibility Studies. September 11th 2017; 3: 38.

Posted in For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), International, Mental Health, Models of Dementia Care, Person-Centred Care, Quick Insights, Statistics, Systematic Reviews, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

More on the Disproportionately High Impact of Dementia Upon Women (GADAA)

Summary

Women comprise roughly 65% of people with dementia in the UK. They are disproportionately affected by the condition in terms of having to assume caring responsibilities. The main section headings in this report comprise:

  • Chapter 1: Key Challenges.
    • An Overlooked Majority.
    • Women as Care Partners.
    • Stigma, Discrimination and Violence.
  • Chapter 2: National Responses.
    • Prevalence.
    • Differing Impact.
    • Caring.
    • Implementation.
    • Conclusion.
  • Chapter 3: International Frameworks.
    • WHO Global Action Plan.
    • Regional Frameworks.
    • Sustainable Development Goals.
    • CEDAW.
    • International Civil Society Responses.
  • Chapter 4: Conclusions.
    • Recommendations.

The World Health Organization (WHO) has recognised the impact of dementia on women as a global challenge. Improvement of woman’s health, social care and rights (amongst a wide range of other priorities) were adopted as important issues by the Global Plan of Action on the Public Health Response to Dementia 2017–2025 at the 70th World Health Assembly in May 2017.

Full Text Link

Reference

Corfield, S. (2017). Women and dementia: a global challenge. London: Global Alzheimer’s & Dementia Action Alliance (GADAA) / Alzheimer’s Society, February 2017.

Organisational notes:

“Alzheimer’s Society, Alzheimer’s Disease International, Age International and Dementia Alliance International form the GADAA Steering Committee. Alzheimer’s Society hosts the GADAA secretariat”.

Posted in Alzheimer's Society, Alzheimer’s Disease International (ADI), Charitable Bodies, Commissioning, Community Care, Diagnosis, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, International, Management of Condition, Mental Health, Models of Dementia Care, National, Non-Pharmacological Treatments, Person-Centred Care, Quick Insights, Standards, Statistics, UK, Universal Interest, World Health Organization (WHO) | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment