Robert L. Kane, M.D. (1940-2017) - American Geriatric Society

Abstract

It is difficult to pay proper tribute to Bob, whose life touched so many others and whose work reflected a deep commitment to leave this world a better place, especially for the vulnerable and the downtrodden. He was a complex person. One's initial encounter with Bob often produced a first impression of exactitude, criticism, and intellectual intimidation. But through repeated and lasting interaction, another more personal side of Bob emerged, one of compassion, respect, and tenderness.

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Off-Label Prescribing of Second-Generation Antipsychotics to Elderly Veterans with Posttraumatic Stress Disorder and Dementia - American Geriatric Society

Objectives

To determine whether elderly veterans with posttraumatic stress disorder (PTSD) and dementia are more likely to be prescribed second-generation antipsychotics (SGAs) than those with PTSD alone.

Design

National serial cross-sectional study.

Setting

Veterans Health Affairs inpatient and outpatient settings.

Participants

Veterans aged 65 and older with PTSD (excluding schizophrenia or bipolar disorder) with or without concomitant dementia who received care from the Veterans Health Administration between 2003 and 2010 were identified using International Classification of Diseases, Ninth Revision, codes (N = 93,068; 11.1% with dementia).

Measurements

Trends in SGA prescribing and odds of being prescribed an SGA were determined using a multivariable logistic regression model adjusted for clinical, sociodemographic, and geographic covariates.

Results

Between 2004 and 2009, SGA prescribing declined annually from 7.0% to 5.1% of elderly veterans with PTSD without dementia and 13.2% to 8.9% in those with dementia; findings over time consistently indicated that veterans with PTSD and dementia had at least twice the odds of being prescribed an SGA as those without PTSD (odds ratios 2.03 (95% confidence interval (CI) = 1.82–2.26) to 2.33 (95% CI = 2.10–2.58).

Conclusion

Although the prescribing of SGAs to elderly veterans with PTSD has decreased, prescribing an SGA to those with dementia remained consistently higher than for those with PTSD alone and is problematic given the high prevalence of medical comorbidities in this aging population coupled with the lack of compelling evidence for effectiveness of SGAs in individuals with dementia.

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Components of Comprehensive and Effective Transitional Care - American Geriatric Society

Transitional care (TC) has received widespread attention from researchers, health system leaders, clinicians, and policy makers as they attempt to improve health outcomes and reduce preventable hospital readmissions, yet little is known about the critical elements of effective TC and how they relate to patients’ and caregivers’ needs and experiences. To address this gap, the Patient-Centered Outcomes Research Institute (PCORI) funded a national study, Achieving patient-centered Care and optimized Health In care transitions by Evaluating the Value of Evidence (Project ACHIEVE). A primary aim of the study is the identification of TC components that yield desired patient and caregiver outcomes. Project ACHIEVE established a multistakeholder workgroup to recommend essential TC components for vulnerable Medicare beneficiaries. Guided by a review of published evidence, the workgroup identified and defined a preliminary set of components and then analyzed how well the set aligned with real-world patients' and caregivers' experiences. Through this process, the workgroup identified eight TC components: patient engagement, caregiver engagement, complexity and medication management, patient education, caregiver education, patients' and caregivers' well-being, care continuity, and accountability. Although the degree of attention given to each component will vary based on the specific needs of patients and caregivers, workgroup members agree that health systems need to address all components to ensure optimal TC for all Medicare beneficiaries.

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Caregiver Integration During Discharge Planning for Older Adults to Reduce Resource Use: A Metaanalysis - American Geriatric Society

Objectives

To determine the effect of integrating informal caregivers into discharge planning on postdischarge cost and resource use in older adults.

Design

A systematic review and metaanalysis of randomized controlled trials that examine the effect of discharge planning with caregiver integration begun before discharge on healthcare cost and resource use outcomes. MEDLINE, EMBASE, and the Cochrane Library databases were searched for all English-language articles published between 1990 and April 2016.

Setting

Hospital or skilled nursing facility.

Participants

Older adults with informal caregivers discharged to a community setting.

Measurements

Readmission rates, length of and time to post-discharge rehospitalizations, costs of postdischarge care.

Results

Of 10,715 abstracts identified, 15 studies met the inclusion criteria. Eleven studies provided sufficient detail to calculate readmission rates for treatment and control participants. Discharge planning interventions with caregiver integration were associated with a 25% fewer readmissions at 90 days (relative risk (RR) = 0.75, 95% confidence interval (CI) = 0.62–0.91) and 24% fewer readmissions at 180 days (RR = 0.76, 95% CI = 0.64–0.90). The majority of studies reported statistically significant shorter time to readmission, shorter rehospitalization, and lower costs of postdischarge care among discharge planning interventions with caregiver integration.

Conclusion

For older adults discharged to a community setting, the integration of caregivers into the discharge planning process reduces the risk of hospital readmission.

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Conagra Brands Recalls Hunt’s Chili Kits Due To Potential Presence Of Salmonella In Spice Packet - FDA Safety Alerts & Drug Recalls

Conagra Brands, Inc., announced today it is voluntarily recalling a limited amount of Hunt’s Chili Kits due to the potential presence of Salmonella in the chili seasoning packet contained in the kit. The chili seasoning used in the packet originated from a supplier who informed the company of the potential presence of Salmonella in a raw material used in the chili seasoning.

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Frozen Burritos Recalled Due To Possible Health Risk, Menu Del Sol Recalls Burritos in California and Nevada - FDA Safety Alerts & Drug Recalls

Sigma Alimentos Congelados, which produces burritos under the Menu Del Sol brand name, is voluntarily recalling 201 cases of frozen beans and cheese burritos because they have the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women. The recalled product was distributed in and sold via retail outlets in California and Nevada.

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FDA alerts consumers of nationwide voluntary recall of EpiPen and EpiPen Jr - FDA Press Releases

The U.S. Food and Drug Administration is alerting consumers to Meridian Medical Technologies’ voluntary recall of 13 lots of Mylan’s EpiPen and EpiPen Jr (epinephrine injection) Auto-Injector products used for emergency treatment of severe allergic reactions. This recall is due to the potential that these devices may contain a defective part that may result in the devices’ failure to activate. The recalled product was manufactured by Meridian Medical Technologies and distributed by Mylan Specialty.

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