Coronavirus (COVID-19) Update: FDA Continues to Combat Fraudulent COVID-19 Medical Products - FDA Press Releases

FDA provides an update on its efforts to combat COVID-19 fraud

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Choosing Inpatient vs Home Treatment: Why Patients Accept or Decline Hospital at Home - American Geriatric Society

BACKGROUND/OBJECTIVES

Hospital at home (HaH) provides interdisciplinary acute care in the home as a substitute for inpatient hospitalization. Studies have demonstrated that HaH care is associated with better quality care, fewer complications, and better patient and caregiver experience. Still, some patients decline HaH. The objective of the study was to characterize patients who accept vs decline HaH care and describe reasons for their decisions in the context of a Center for Medicare and Medicaid Innovation demonstration of HaH.

DESIGN/SETTING/PARTICIPANTS

A total of 442 patients with Medicare or other eligible insurance, 18 years or older, who met study eligibility criteria were offered HaH at Mount Sinai Hospitals in New York, NY, between September 1, 2014, and August 31, 2017.

MEASUREMENTS

Reasons for accepting or declining HaH were recorded. Age, sex, insurance type, and admission diagnoses of HaH acceptors and refusers were compared in univariate analyses.

RESULTS

Of the 442 patients offered HaH, 66.7% accepted. Main reasons for enrolling in HaH included being more comfortable at home (78.2%) and being near family (40.7%). Specific reasons given for refusing HaH included preferring in‐hospital care (15.0%) and concern that HaH would not meet care needs (12.9%).

CONCLUSION

Two‐thirds of patients offered HaH care opted to receive it. The reasons for declining HaH provided by those who chose not to participate should be considered for quality improvement, and reasons for acceptance may be helpful in marketing and other efforts to promote HaH participation.

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How Should We Counsel Asian Americans about Fracture Risk? - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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We Need More Wisdom, Not More Paper: A Reply to Merel and Gaster - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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Advance Directives for Dementia Can Elicit Preferences to Improve Patient Care - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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Response to Dr Sulmasy - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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Why Dementia‐Specific Advance Directives Are a Misguided Idea - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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AGS Position Statement: Resource Allocation Strategies and Age‐Related Considerations in the COVID‐19 Era and Beyond - American Geriatric Society

Abstract

COVID‐19 continues to impact older adults disproportionately, from severe illness and hospitalization to increased mortality risk. Concurrently, concerns about potential shortages of healthcare professionals and health supplies to address these needs have focused attention on how resources are ultimately allocated and used. Some strategies misguidedly use age as an arbitrary criterion, which inappropriately disfavors older adults.

This statement represents the official policy position of the American Geriatrics Society (AGS). It is intended to inform stakeholders including hospitals, health systems, and policymakers about ethical considerations to consider when developing strategies for allocating scarce resources during an emergency involving older adults. Members of the AGS Ethics Committee collaborated with interprofessional experts in ethics, law, nursing, and medicine (including geriatrics, palliative care, emergency medicine, and pulmonology/critical care) to conduct a structured literature review and examine relevant reports. The resulting recommendations defend a particular view of distributive justice that maximizes relevant clinical factors and de‐emphasizes or eliminates factors placing arbitrary, disproportionate weight on advanced age. The AGS positions include: (1) avoiding age per se as a means for excluding anyone from care; (2) assessing comorbidities and considering the disparate impact of social determinants of health; (3) encouraging decision makers to focus primarily on potential short‐term (not long‐term) outcomes; (4) avoiding ancillary criteria such as “life‐years saved” and “long‐term predicted life expectancy” that might disadvantage older people; (5) forming and staffing triage committees tasked with allocating scarce resources; (6) developing institutional resource allocation strategies that are transparent and applied uniformly; and (7) facilitating appropriate advance care planning. The statement includes recommendations that should be immediately implemented to address resource allocation strategies during COVID‐19, aligning with AGS positions. The statement also includes recommendations for post‐pandemic review. Such review would support revised strategies to ensure that governments and institutions have equitable emergency resource allocation strategies, avoid future discriminatory language and practice, and have appropriate guidance to develop national frameworks for emergent resource allocation decisions.

This article is protected by copyright. All rights reserved.

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Rationing Limited Health Care Resources in the COVID‐19 Era and Beyond: Ethical Considerations Regarding Older Adults - American Geriatric Society

Abstract

COVID‐19 continues to impact older adults disproportionately with respect to serious consequences ranging from severe illness and hospitalization to increased mortality risk. Concurrently, concerns about potential shortages of healthcare professionals and health supplies to address these issues have focused attention on how these resources are ultimately allocated and used. Some strategies, for example, misguidedly use age as an arbitrary criterion, which disfavors older adults in resource allocation decisions. This is a companion manuscript to the American Geriatrics Society (AGS) position statement, “Resource Allocation Strategies and Age‐Related Considerations in the COVID‐19 Era and Beyond.” It is intended to inform stakeholders including hospitals, health systems, and policymakers about ethical considerations that should be considered when developing strategies for allocation of scarce resources during an emergency involving older adults. This review presents the legal and ethical background for the position statement and discusses the following issues that informed the development of the AGS positions: (1) age as a determining factor; (2) age as a tiebreaker; (3) criteria with a differential impact on older adults; (4) individual choices and advance directives; (5) racial/ethnic disparities and resource allocation; and (6) scoring systems and their impact on older adults. It also considers the role of advance directives as expressions of individual preferences in pandemics.

This article is protected by copyright. All rights reserved.

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Coronavirus (COVID-19) Update: Daily Roundup May 6, 2020 - FDA Press Releases

Coronavirus (COVID-19) Update: Daily Roundup

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FDA Approves First Targeted Therapy to Treat Aggressive Form of Lung Cancer - FDA Press Releases

FDA approves Tabrecta (capmatinib) for the treatment of adult patients with non-small cell lung cancer (NSCLC) that has spread. Tabrecta is the first FDA-approved therapy to treat NSCLC with specific MET exon 14 skipping mutations.

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Transforming Undergraduate Student Perceptions of Dementia through Music and Filmmaking - American Geriatric Society

BACKGROUND

With nearly 6 million people with dementia (PWD) in the United States, there is a critical need to build an interprofessional dementia workforce. Among the novel approaches to expanding a new workforce, music and the arts show promise for engaging students and trainees. To understand how and why the arts affect attitudes about and engagement with PWD, we examined a service‐learning general education undergraduate course centering on music, filmmaking, and dementia.

METHODS

The undergraduate course curriculum brought students to meet with PWD in dementia care settings, build personalized music playlists, coproduce short films about PWD, and write reflective essays. Two researchers independently completed inductive thematic analysis of the films, essays, and course evaluations. Differences were reconciled by consensus.

RESULTS

A total of 52 students from three classes completed the course; 24 (46%) were majoring in health sciences. Three key themes emerged: (1) Music helps students connect with people living with dementia in meaningful ways; (2) filmmaking offers students the opportunity to share unique, person‐centered stories about dementia and music that empower the voices of PWD; and (3) reflective writing enables students to process new experiences and lessons learned. Unexpectedly, 29 students (56%) reported continued engagement with PWD in their careers, families, and communities after course completion.

CONCLUSION

This study identifies reproducible ways in which undergraduate arts courses thematically focused on dementia not only transform student perceptions about dementia but change the ways in which those students choose to engage with PWD following course completion. Arts and music departments may represent an untapped resource for building a geriatrics workforce.

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Coronavirus (COVID-19) Update: Daily Roundup May 5, 2020 - FDA Press Releases

Coronavirus (COVID-19) Update: Daily Roundup

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FDA approves new treatment for a type of heart failure - FDA Press Releases

FDA approves treatment for heart failure with reduced ejection fraction

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Staying in a Burning House: Perks and Perils of a Hotline in the Times of COVID‐19 - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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Coronavirus (COVID-19) Update: Daily Roundup May 4, 2020 - FDA Press Releases

Coronavirus (COVID-19) Update: Daily Roundup

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Less Really Is More in Inappropriate Medication Use in Older Adults: How Can We Improve Prescribing and Deprescribing in Older Adults? - American Geriatric Society

Journal of the American Geriatrics Society, EarlyView.

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COVID‐19: Use of the Clinical Frailty Scale for critical care decisions. - American Geriatric Society

Journal of the American Geriatrics Society, Accepted Article.

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During COVID‐19, Outpatient Advance Care Planning is Imperative: We need All Hands on Deck - American Geriatric Society

Journal of the American Geriatrics Society, Accepted Article.

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“Social distancing” amidst a crisis in social isolation and loneliness - American Geriatric Society

Journal of the American Geriatrics Society, Accepted Article.

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