National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
76 to 100 of 173 Research Studies DisplayedMcCreedy E, Ogarek JA, Thomas KS
The minimum data set agitated and reactive behavior scale: measuring behaviors in nursing home residents with dementia.
Researchers in this study test the internal consistency and construct validity of the Agitated and Reactive Behavior Scale (ARBS), a measure created to measure agitated and aggressive behaviors in dementia residents at nursing homes (NHs). This cross-sectional study used data from the 2016 national sample of 15,326 Centers for Medicare and Medicaid Services-certified NHs. The sample included 489,854 new admissions and 765,367 long-stay residents (defined as 90 days or more) all diagnosed with dementia. The ARBS is a composite measure of physical and verbal agitation or aggressiveness towards other people; other behavioral symptoms not directed at other people; and rejection of care. The study found that 1) the ARBS score has borderline-adequate internal consistency in the national population of NH residents with dementia; 2) only 18% of new admissions, and 21% of long-stay residents with dementia displayed any aggressive or agitated behaviors in the previous week; and 3) the ARBS demonstrated good construct validity. Conclusions were that nationally available MDS data may significantly underestimate the prevalence of agitated and aggressive behaviors among NH dementia patients.
AHRQ-funded; HS000011.
Citation: McCreedy E, Ogarek JA, Thomas KS .
The minimum data set agitated and reactive behavior scale: measuring behaviors in nursing home residents with dementia.
J Am Med Dir Assoc 2019 Dec;20(12):1548-52. doi: 10.1016/j.jamda.2019.08.030..
Keywords: Elderly, Dementia, Neurological Disorders, Nursing Homes, Long-Term Care, Behavioral Health
Palmer JA, Parker VA, Barre LR
Understanding implementation fidelity in a pragmatic randomized clinical trial in the nursing home setting:a mixed-methods examination.
This randomized clinical trial called Pragmatic Trial of Video Education in Nursing Homes (PROVEN) was one of the largest trials to be conducted in nursing homes on education of residents in Advanced Care Planning (ACP). The trial used videos with champions promoting ACP education across two large health-care systems. The trial length was 18 months, with champions offering video education to the residents every six months. At the end of the study 28 interviews involving 33 champions were analyzed. The researchers found different patterns between high- and low-adherence nursing homes. High-adherence nursing homes had more family and patient willingness to engage in the program and champions were better at recruitment. Champions also supplemented the video with ACP conversations.
AHRQ-funded; HS000011.
Citation: Palmer JA, Parker VA, Barre LR .
Understanding implementation fidelity in a pragmatic randomized clinical trial in the nursing home setting:a mixed-methods examination.
Trials 2019 Nov 28;20(1):656. doi: 10.1186/s13063-019-3725-5..
Keywords: Nursing Homes, Long-Term Care, Education: Patient and Caregiver, Health Literacy, Patient and Family Engagement, Elderly
Kapoor A, Field T, Handler S
Characteristics of long-term care residents that predict adverse events after hospitalization.
This study examined the characteristics of long-term care (LTC) residents that predict adverse events (AEs) after discharge from recent hospitalization. This cohort study looked at AEs that occurred at 32 nursing homes from six New England states. AE incidents involving a total of 555 LTC residents with 762 transitions from the hospital back to LTC were reviewed. The association between all AEs and preventable AEs developing in the 45 days following discharge back to LTC was measured. There were 283 discharges with one or more AEs and 212 with preventable AEs. Characteristics independently associated with higher risk of AEs included hospital length of stay (LOS) 9 or more days, 18 or more regularly scheduled medications, and 19 and above on the dependency in activities of daily living (ADL) scale.
AHRQ-funded; HS024422.
Citation: Kapoor A, Field T, Handler S .
Characteristics of long-term care residents that predict adverse events after hospitalization.
J Am Geriatr Soc 2020 Nov;68(11):2551-57. doi: 10.1111/jgs.16770..
Keywords: Elderly, Long-Term Care, Nursing Homes, Hospitalization, Adverse Events, Transitions of Care, Hospital Discharge, Risk
Hua CL, Thomas KS
Coronavirus Disease 19 (COVID-19) restrictions and loneliness among residents in long-term care communities: data from the National Health and Aging Trends Study.
Loneliness has been associated with increased morbidity and mortality among older adults, especially among residents of long-term care (LTC) facilities. COVID-19 disproportionately contributed to deaths in LTC communities during pandemic, especially before the introduction of vaccines. Restrictive measures were instituted in many LTC facilities to try to slow the spread of COVID-19. This report examines whether these restrictive measures were associated with increased loneliness among older adults in LTC communities during the pandemic. Data from the 2020 National Health and Aging Trends Study (NHATS) COVID-19 supplement, a representative sample of Medicare beneficiaries (age 65 and older) was used, with 234 residents participating. Surveys completed by proxies were excluded because loneliness measures were not available. Approximately 28.7% of residents in LTC communities were lonelier during the pandemic than pre-pandemic. Residents who could not leave their rooms appeared to show increased loneliness.
AHRQ-funded; HS000011.
Citation: Hua CL, Thomas KS .
Coronavirus Disease 19 (COVID-19) restrictions and loneliness among residents in long-term care communities: data from the National Health and Aging Trends Study.
J Am Med Dir Assoc 2021 Sep;22(9):1860-61. doi: 10.1016/j.jamda.2021.06.029..
Keywords: COVID-19, Elderly, Long-Term Care, Nursing Homes
Berry SD, Zullo AR, Zhang T
Validation of the FRAiL model to predict non-vertebral and hip fractures in nursing home residents.
This study created a tool to assess non-vertebral and hip fracture risk in long-term nursing home (NH) residents called FRAiL (Fracture Risk Assessment in Long term care). The objective of this retrospective cohort study was to assess the performance of the model to predict 2-year risk of fractures in a separate large cohort of NH residents. The study included most long-stay NH residents in the United States (n = 896,840). Fractures were identified using Medicare claims. The mean age of NH residents was 83.8 years and 70.7% were women. Over the 2-year follow-up period 4.6% were hospitalized with non-vertebral fractures, the majority being hip fractures. In the fully adjusted model, 14 out of 15 model characteristics remained significant predictors of non-vertebral fractures. Female sex, wandering, and falls were strongly associated with non-vertebral fractures.
AHRQ-funded; HS022998.
Citation: Berry SD, Zullo AR, Zhang T .
Validation of the FRAiL model to predict non-vertebral and hip fractures in nursing home residents.
Bone 2019 Nov;128:115050. doi: 10.1016/j.bone.2019.115050..
Keywords: Elderly, Nursing Homes, Long-Term Care, Injuries and Wounds
Paredes AZ, Malik AT, Cluse M
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Emergency general surgery can have a profound impact on the functional status of even previously independent patients. In this study, the investigators examined the role and influence of discharging a patient to a skilled nursing facility. They concluded that after accounting for patient severity and perioperative course, discharge to a skilled nursing facility was an independent risk factor for death, readmission, and postdischarge complications.
AHRQ-funded; HS022694.
Citation: Paredes AZ, Malik AT, Cluse M .
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Surgery 2019 Oct;166(4):489-95. doi: 10.1016/j.surg.2019.04.034..
Keywords: Nursing Homes, Hospital Discharge, Elderly, Ambulatory Care and Surgery, Emergency Department, Outcomes, Hospital Readmissions, Outcomes, Risk
Kapoor A, Field T, Handler S
Adverse events in long-term care residents transitioning from hospital back to nursing home.
This study looked at adverse event rates of long-term care residents transitioning back to their nursing home after hospitalization. A prospective cohort study of LTC residents discharged from hospital back to LTC from March 1, 2016, to December 31, 2017 was conducted, and residents were followed up for 45 days. A random sample of 32 nursing homes located in 6 New England states was used, and 555 LTC residents were selected, contributing 762 transitions from hospital back to the same LTC facility. Most of the cohort were female (65.5%) and non-Hispanic white (93.7%). The study used trained nurse abstractors to review nursing home records to determine if an adverse event occurred. Out of 762 discharges there were 379 adverse events. The most common adverse events were pressure ulcers, skin tears, and falls followed by health care-acquired infections. 145 adverse events were considered less serious, with 28 life-threatening, and 8 were fatal. Most of the adverse events were considered preventable or ameliorable.
AHRQ-funded; HS024596.
Citation: Kapoor A, Field T, Handler S .
Adverse events in long-term care residents transitioning from hospital back to nursing home.
JAMA Intern Med 2019 Sep;179(9):1254-61. doi: 10.1001/jamainternmed.2019.2005..
Keywords: Adverse Events, Long-Term Care, Nursing Homes, Transitions of Care, Elderly, Patient Safety, Hospital Discharge, Hospitalization
Zhang T, Lary CW, Zullo AR
Post-hip fracture mortality in nursing home residents by obesity status.
This research letter discusses a study that examined whether obesity status affected mortality in post-hip fracture patients who were nursing home residents. A national cohort of nursing home (NH) residents was examined from national Medicare fee-for-service claims linked to the Minimum Data Set (MDS) from January 2008 through the end of 2009. A total of 33, 622 long-stay residents were identified who had been hospitalized for a hip fracture. They excluded 6918 patients due to a number of factors. They classified residents based on their BMI: normal BMI, overweight, mild obesity, or moderate/severe obesity. They found that being moderate/severely obese did not increase mortality.
AHRQ-funded; HS022998.
Citation: Zhang T, Lary CW, Zullo AR .
Post-hip fracture mortality in nursing home residents by obesity status.
J Am Geriatr Soc 2019 Sep;67(9):1983-85. doi: 10.1111/jgs.16028..
Keywords: Injuries and Wounds, Surgery, Nursing Homes, Obesity, Mortality, Elderly, Long-Term Care, Patient-Centered Outcomes Research
Libertucci J, Bassis CM, Cassone M
Bacteria detected in both urine and open wounds in nursing home residents: a pilot study.
Researchers sought to determine if bacterial species colonizing open wounds are also found in the urine. Their pilot study of nursing home residents provided evidence that bacterial species identified within the urine can also be identified in open wounds in the same patient at one point in time. They recommended further studies to investigate if these species are of the same lineage and if the urinary microbiota are able to seed colonization of open wounds below the umbilicus.
AHRQ-funded; HS019767.
Citation: Libertucci J, Bassis CM, Cassone M .
Bacteria detected in both urine and open wounds in nursing home residents: a pilot study.
mSphere 2019 Aug 28;4(4). doi: 10.1128/mSphere.00463-19..
Keywords: Elderly, Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Patient Safety
Orth J, Li Y, Simning A
Providing behavioral health services in nursing homes is difficult: findings from a national survey.
This study evaluated access to behavioral health services in nursing homes (NHs). A random sample of 2996 NHs in the United States was identified. Two structured surveys were developed with questions on service availability, quality, satisfaction, staffing, staff education, turnover and service barriers. The surveys were mailed to administrators and directors of nursing in NHs between July and December 2017. The results showed that over 30% reported having inadequate coordination of care between NHs and community providers, and 26.2% had inadequate infrastructure for resident referrals or transport. Staff education was the most important factor associated with subpar provision of behavioral health services in nursing homes.
AHRQ-funded; HS024923.
Citation: Orth J, Li Y, Simning A .
Providing behavioral health services in nursing homes is difficult: findings from a national survey.
J Am Geriatr Soc 2019 Aug;67(8):1713-17. doi: 10.1111/jgs.16017..
Keywords: Elderly, Nursing Homes, Behavioral Health, Access to Care, Long-Term Care, Healthcare Delivery
Palmer JA, Parker VA, Mor V
Barriers and facilitators to implementing a pragmatic trial to improve advance care planning in the nursing home setting.
This research describes the issues encountered while implementing a trial to improve advance care planning (ACP) in nursing homes. The trial, called Pragmatic trial Of Video Education in Nursing homes (PROVEN) was implemented in 119 nursing homes. Semi-structured interviews were conducted at 4 and 15 months of the 18-month implementation period. Forty interviewed were conducted and analyzed using a hybrid deductive/inductive approach. Barriers identified included mandated protocol-driven aspects of the program, time limitations, and lack of perceived relevance and emotional readiness for ACP among stakeholders.
AHRQ-funded; HS000011.
Citation: Palmer JA, Parker VA, Mor V .
Barriers and facilitators to implementing a pragmatic trial to improve advance care planning in the nursing home setting.
BMC Health Serv Res 2019 Jul 29;19(1):527. doi: 10.1186/s12913-019-4309-5..
Keywords: Elderly, Nursing Homes
Tandan M, Sloane PD, Ward K
Antimicrobial resistance patterns of urine culture specimens from 27 nursing homes: impact of a two-year antimicrobial stewardship intervention.
This study evaluated the impact of a two-year antimicrobial stewardship intervention program at 27 nursing homes. The objective was to identify changes in the prevalence and antimicrobial resistance patterns of potentially pathogenic bacteria in urine cultures. All urine cultures were audited during the time period, and out of 6,718 total urine cultures collected, 68% were positive for potentially antimicrobial resistant bacteria. Most of the bacteria identified were E. coli, Proteus spp, and Klebsiella pneumonia. During the 2-year program there was a significant decrease in nitrofurantoin resistance among E. coli and ciprofloxacin resistant among Proteus spp, but carbanepem resistance increased for Proteus spp. Overall, while there was some reduction in antibiotic resistance, the reductions were too small and scattered to conclude the intervention made a big impact.
AHRQ-funded; HS022846.
Citation: Tandan M, Sloane PD, Ward K .
Antimicrobial resistance patterns of urine culture specimens from 27 nursing homes: impact of a two-year antimicrobial stewardship intervention.
Infect Control Hosp Epidemiol 2019 Jul;40(7):780-86. doi: 10.1017/ice.2019.108..
Keywords: Antibiotics, Antimicrobial Stewardship, Elderly, Long-Term Care, Medication, Nursing Homes
Davidson C, Loganathan S, Bishop L
AHRQ Author: Bergofsky L, Spector W
Scalability of an IT intervention to prevent pressure ulcers in nursing homes.
Researchers assessed the scalability of the On-Time Pressure Ulcer Prevention intervention strategy in nursing homes nationwide. They found that the overall decline in pressure ulcer rates for treatment relative to matched comparison homes was statistically insignificant.
AHRQ-authored; AHRQ-funded; 2332010500023I.
Citation: Davidson C, Loganathan S, Bishop L .
Scalability of an IT intervention to prevent pressure ulcers in nursing homes.
J Am Med Dir Assoc 2019 Jul;20(7):816-21.e2. doi: 10.1016/j.jamda.2019.02.008..
Keywords: Elderly, Health Information Technology (HIT), Nursing Homes, Patient-Centered Outcomes Research, Prevention, Pressure Ulcers
Bain AM, Werner RM, Yuan Y
Do hospitals participating in accountable care organizations discharge patients to higher quality nursing homes?
This study examined whether hospitals participating in Medicare's Shared Saving Program increased use of highly rated skilled nursing facilities (SNFs) or decreased the use of low-rated SNFs after initiation of accountable care organization (ACO) contracts, compared with non-ACO hospitals. The findings indicate that, after joining an ACO, the percentage of hospital discharges going to a high-quality SNF increased slightly; the probability of discharge from ACO-participating hospitals to low-quality SNFs did not change significantly in comparison with non-ACO hospitals.
AHRQ-funded; HS024266.
Citation: Bain AM, Werner RM, Yuan Y .
Do hospitals participating in accountable care organizations discharge patients to higher quality nursing homes?
J Hosp Med 2019 May;14(5):288-89. doi: 10.12788/jhm.3147..
Keywords: Elderly, Hospital Discharge, Hospitals, Medicare, Nursing Homes, Quality of Care
Fabius CD, Robison J
Differences in living arrangements among older adults transitioning into the community: examining the impact of race and choice.
The federal Money Follows the Person Rebalancing Demonstration program allows nursing home residents to use Medicaid funds for home and community-based services rather than institutional care. Race, choice in housing, and challenges faced prior to transitioning may impact living arrangements following a discharge into the community. This study examined the influence of these factors on living arrangements for 659 program participants age 65 or older.
AHRQ-funded; HS000011.
Citation: Fabius CD, Robison J .
Differences in living arrangements among older adults transitioning into the community: examining the impact of race and choice.
J Appl Gerontol 2019 Apr;38(4):454-78. doi: 10.1177/0733464816687496..
Keywords: Elderly, Transitions of Care, Racial and Ethnic Minorities, Medicaid, Nursing Homes, Home Healthcare, Healthcare Delivery
Zullo AR, Mogul A, Corsi K
Association between secondary prevention medication use and outcomes in frail older adults after acute myocardial infarction.
In order to examine the effect of using more guideline-recommended medications after myocardial infarction on mortality, rehospitalization, and functional decline in the frailest and oldest segment of long-stay nursing home residents, researchers conducted a retrospective cohort study of U.S. nursing home residents aged 65 years or older. Exposure was the number of secondary prevention medications initiated after myocardial infarction; outcomes were 90-day death, rehospitalization, or functional decline. The results of the study indicate that the use of more guideline-recommended medications after myocardial infarction was associated with decreased mortality in older, predominantly frail adults, but there was no difference in rehospitalization. Functional decline outcomes were discordant and the researchers note that this does not rule out an increased risk associated with more medication use.
AHRQ-funded; HS022998.
Citation: Zullo AR, Mogul A, Corsi K .
Association between secondary prevention medication use and outcomes in frail older adults after acute myocardial infarction.
Circ Cardiovasc Qual Outcomes 2019 Apr;12(4):e004942. doi: 10.1161/circoutcomes.118.004942..
Keywords: Cardiovascular Conditions, Elderly, Heart Disease and Health, Medication, Nursing Homes, Outcomes, Patient-Centered Outcomes Research, Prevention
Baughman KR, Ludwick R, Jarjoura D
Advance care planning in skilled nursing facilities: a multisite examination of professional judgments.
Lack of advance care planning (ACP) may increase hospitalizations and impact the quality of life for skilled nursing facility (SNF) residents, especially African American residents who may be less likely to receive ACP discussions. In this study, the investigators examined the professional judgments of skilled nursing facility providers to see if race of SNF residents and providers, and risk for hospitalization for residents influenced professional judgments as to when ACP was needed.
AHRQ-funded; HS022162.
Citation: Baughman KR, Ludwick R, Jarjoura D .
Advance care planning in skilled nursing facilities: a multisite examination of professional judgments.
Gerontologist 2019 Mar 14;59(2):338-46. doi: 10.1093/geront/gnx129..
Keywords: Elderly, Hospitalization, Nursing Homes, Quality of Life, Racial and Ethnic Minorities
Powell KR, Alexander GL, Madsen R
A national assessment of access to technology among nursing home residents: a secondary analysis.
The purpose of this study was to report findings from a secondary analysis of data from a national nursing home study of information technology (IT) adoption, called IT sophistication. The investigators found that resident access to technology was a significant predictor of the nursing home IT sophistication (P<.001). The inclusion of covariates-nursing home location, bed size, and ownership-with their interactions produced a nonsignificant effect in the model.
AHRQ-funded; HS022497.
Citation: Powell KR, Alexander GL, Madsen R .
A national assessment of access to technology among nursing home residents: a secondary analysis.
JMIR Aging 2019 Mar 5;2(1):e11449. doi: 10.2196/11449..
Keywords: Elderly, Health Information Technology (HIT), Nursing Homes, Patient and Family Engagement, Patient-Centered Healthcare
Hanlon JT, Perera S, Drinka PJ
The IOU consensus recommendations for empirical therapy of cystitis in nursing home residents.
A 19-member panel of clinical pharmacists was convened for the Improving Outcomes of UTI Management in Long-Term Care Project (IOU) funded by the Agency for Healthcare Research and Quality. The objective is to reach consensus on a set of recommendations for the empirical treatment of cystitis in older nursing home residents with oral anti-infective medications. A comprehensive literature search was conducted and out of that 31 recommendations were created. There were two Delphi Survey rounds conducted and those recommendations were rated on a 5-point Likert scale. In the first round three recommendations reached consensus and in the second round an additional eight recommendations were agreed on.
AHRQ-funded; HS023779.
Citation: Hanlon JT, Perera S, Drinka PJ .
The IOU consensus recommendations for empirical therapy of cystitis in nursing home residents.
J Am Geriatr Soc 2019 Mar;67(3):539-45. doi: 10.1111/jgs.15726..
Keywords: Elderly, Nursing Homes, Long-Term Care, Medication, Quality Improvement, Quality of Care, Evidence-Based Practice
Olivieri-Mui B, McGuire J, Cahill S
People living with HIV in U.S. nursing homes in the fourth decade of the epidemic.
This study described the sociodemographic characteristics as well as the antiretroviral therapy treatment and physical and mental health among Medicare-eligible persons living with HIV (PLWH) in nursing homes (NHs). Of the newer admissions, results showed that they were older, had higher prevalence of viral hepatitis and anemia, but had less pneumonia and dementia. NH nurses can better anticipate health care needs of PLWH using these health profiles, understanding that there have been changes in the health of PLWH at admission over time.
AHRQ-funded; HS025662.
Citation: Olivieri-Mui B, McGuire J, Cahill S .
People living with HIV in U.S. nursing homes in the fourth decade of the epidemic.
J Assoc Nurses AIDS Care 2019 Jan-Feb;30(1):20-34. doi: 10.1097/jnc.0000000000000033..
Keywords: Human Immunodeficiency Virus (HIV), Nursing Homes, Long-Term Care, Elderly, Infectious Diseases, Medicare
Zuckerman RB, Wu S, Chen LM
The five-star skilled nursing facility rating system and care of disadvantaged populations.
AHRQ-funded; HS000029.
Citation: Zuckerman RB, Wu S, Chen LM .
The five-star skilled nursing facility rating system and care of disadvantaged populations.
J Am Geriatr Soc 2019 Jan;67(1):108-14. doi: 10.1111/jgs.15629..
Keywords: Nursing Homes, Vulnerable Populations, Medicare, Elderly, Provider Performance, Quality of Care, Hospital Discharge, Disparities
Aspinall SL, Springer SP, Zhao X
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
This study investigated the association between taking central nervous system (CNS) medications with the risk of serious falls and hip fractures. Study participants were residents at a Veterans Health Administration (VHA) Community Living Center (CLC) between July 1, 2005 and June 30, 2009. This was a nested case-control study. The investigators concluded that there was a higher risk in those residents receiving 3.0 or more daily CNS medications.
AHRQ-funded; HS023779.
Citation: Aspinall SL, Springer SP, Zhao X .
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
J Am Geriatr Soc 2019 Jan;67(1):74-80. doi: 10.1111/jgs.15603..
Keywords: Elderly, Falls, Injuries and Wounds, Long-Term Care, Medication, Nursing Homes, Patient Safety, Risk
Jackson SS, Lydecker AD, Magder LS
Development and validation of a clinical prediction rule to predict transmission of methicillin-resistant Staphylococcus aureus in nursing homes.
This study’s goal was to develop and validate a clinical prediction rule that can predict transmission of methicillin-resistant Staphylococcus aureus (MRSA) in nursing homes. The researchers wanted to identify residents who were most likely to transmit MRSA to health-care workers (HCWs) on their hands or clothing during clinical care. Demographic and clinical characteristic data was used from residents of community nursing homes in Maryland and Michigan from 2012 to 2014. The clinical prediction rule that was developed was then externally validated in a cohort of Department of Veterans Affairs nursing home residents from 7 states between 2012 and 2016. Variables in the prediction model included sex, race, resident dependency on care, the presence of any medical device, diabetes mellitus, and chronic skin breakdown. The prediction model showed good performance although it showed less utility in the validation cohort.
AHRQ-funded; HS019979.
Citation: Jackson SS, Lydecker AD, Magder LS .
Development and validation of a clinical prediction rule to predict transmission of methicillin-resistant Staphylococcus aureus in nursing homes.
Am J Epidemiol 2019 Jan;188(1):214-21. doi: 10.1093/aje/kwy220..
Keywords: Elderly, Healthcare-Associated Infections (HAIs), Infectious Diseases, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Nursing Homes, Patient Safety
Weintraub JA, Zimmerman S, Ward K
Improving nursing home residents' oral hygiene: results of a cluster randomized intervention trial.
This paper describes a 2-year cluster randomized trial of Mouth Care Without a Battle (MCWB) that was conducted in nursing homes (NHs) to determine if recommended mouth care practices provided by NH staff could improve residents' oral hygiene and denture outcomes. The investigators found that training NH staff to attend to residents' oral hygiene and denture care had a sustained, favorable impact on residents' oral and denture hygiene after 24 months compared with usual care.
AHRQ-funded; HS022298.
Citation: Weintraub JA, Zimmerman S, Ward K .
Improving nursing home residents' oral hygiene: results of a cluster randomized intervention trial.
J Am Med Dir Assoc 2018 Dec;19(12):1086-91. doi: 10.1016/j.jamda.2018.09.036.
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Keywords: Dental and Oral Health, Elderly, Nursing Homes
Zullo AR, Hersey M, Lee Y
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
This study analyzed outcomes of using beta-blockers that are considered “diabetes-friendly” vs “diabetes-unfriendly” in older nursing home residents with diabetes after acute myocardial infarction (AMI). Primary outcomes included hospitalizations for hypoglycemia and hyperglycemia in the 90 days after AMI and secondary outcomes functional decline, death, all-cause re-hospitalization and fracture hospitalization. Out of 2855 nursing home residents with type-2 diabetes (T2D), 29% were prescribed a diabetes-friendly beta-blocker vs. 24% without. T2D medicine showed a reduction in hospitalization for hyperglycemia but was unassociated with hypoglycemia. For secondary outcomes T2D-friendly beta-blocks were associated with a greater rate of re-hospitalization but not death, functional decline, or fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Hersey M, Lee Y .
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
Diabetes Obes Metab 2018 Dec;20(12):2724-32. doi: 10.1111/dom.13451..
Keywords: Cardiovascular Conditions, Diabetes, Elderly, Heart Disease and Health, Hospitalization, Medication, Nursing Homes, Outcomes, Patient-Centered Outcomes Research