National Healthcare Quality and Disparities Report
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- Antibiotics (1)
- Behavioral Health (1)
- Cancer (11)
- Cancer: Breast Cancer (4)
- Cancer: Colorectal Cancer (4)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (2)
- Caregiving (1)
- Care Management (1)
- Case Study (2)
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- Clinical Decision Support (CDS) (4)
- Clinician-Patient Communication (2)
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- Comparative Effectiveness (1)
- (-) Decision Making (44)
- Dementia (2)
- Diabetes (1)
- Dialysis (1)
- Education: Patient and Caregiver (1)
- (-) Elderly (44)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Falls (2)
- Guidelines (1)
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- Health Information Technology (HIT) (5)
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- Heart Disease and Health (1)
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- Hospital Discharge (1)
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- Medication: Safety (2)
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- Nursing Homes (4)
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- Pain (1)
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- Patient-Centered Outcomes Research (2)
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- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (2)
- Risk (3)
- Screening (9)
- Substance Abuse (1)
- Surgery (3)
- Transitions of Care (3)
- Urinary Tract Infection (UTI) (1)
- Web-Based (1)
- Women (4)
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
1 to 25 of 44 Research Studies DisplayedValentine KD, Vo H, Mancini B
Shared decision making for elective surgical procedures in older adults with and without cognitive insufficiencies.
The purpose of this study was to examine surgical decision-making processes of older adults with and without cognitive insufficiencies and to evaluate the psychometric properties of the shared decision making (SDM) Process scale. Participants were eligible patients aged 65 or older who were scheduled for a preoperative appointment before elective surgery; a baseline phone survey was administered a week before the visit and a follow-up survey 3 months later to assess decision regret. Survey responses indicated that patient-reported shared decision making, decisional conflict, and decision regret did not differ significantly for patients with and without cognitive insufficiencies. The authors concluded that the SDM Process scale was an acceptable, reliable, and valid measure of shared decision making.
AHRQ-funded; HS025718.
Citation: Valentine KD, Vo H, Mancini B .
Shared decision making for elective surgical procedures in older adults with and without cognitive insufficiencies.
Med Decis Making 2023 Aug; 43(6):656-66. doi: 10.1177/0272989x231182436..
Keywords: Decision Making, Elderly, Surgery
Dalton AF, Golin CE, Morris C
Effect of a patient decision aid on preferences for colorectal cancer screening among older adults: a secondary analysis of a randomized clinical trial.
This research studied the effects of a patient decision aid on preferences for colorectal cancer (CRC) screening among adults aged 76 to 84 years. Participants were recruited from 14 community-based primary care practices who were not up to date with screening and had an appointment within 6 weeks. They were randomized to receive the intervention or control. Among the 424 participants, mean age was 76.8, 248 were women, and 333 were White. There were no statistically significant differences found in patient preferences between the health groups. Additional studies that are appropriately powered were recommended.
AHRQ-funded; HS021133.
Citation: Dalton AF, Golin CE, Morris C .
Effect of a patient decision aid on preferences for colorectal cancer screening among older adults: a secondary analysis of a randomized clinical trial.
JAMA Netw Open 2022 Dec;5(12):e2244982. doi: 10.1001/jamanetworkopen.2022.44982..
Keywords: Elderly, Decision Making, Screening, Cancer: Colorectal Cancer, Cancer
Ross RL, Rubio K, Rodriguez HP
Mammography and decision aid use for breast cancer screening in older women.
This study examines the association between practice-level decision-aid use and mammography use among older women. Physician practice responses to the 2017/2018 National Survey of Healthcare Organizations and Systems were linked to 2016-17 Medicare fee-for-service beneficiary data from eligible beneficiaries aged 65-74 years. Findings showed that health information technology-enabled automation of mammography reminders and other advanced health information technology functions may support mammography, whereas breast cancer decision aids may reduce patients' propensities to be screened through the alignment of their preferences and screening decision.
AHRQ-funded; HS022241; HS024075.
Citation: Ross RL, Rubio K, Rodriguez HP .
Mammography and decision aid use for breast cancer screening in older women.
Am J Prev Med 2022 Oct;63(4):630-35. doi: 10.1016/j.amepre.2022.04.014..
Keywords: Imaging, Screening, Decision Making, Cancer: Breast Cancer, Women, Prevention, Cancer, Elderly
Kagarmanova A, Sparkman H, Laiteerapong N
Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for i-cope study.
This article describes a protocol for an upcoming study on the planned implementation and evaluation of I-COPE (Improving Chicago Older Adult Opioid and Pain Management through Patient-centered Clinical Decision Support and Project ECHO®) to improve care for older adults with chronic pain, opioid use, and opioid use disorder (OUD). The study will be implemented in 35 clinical sites across the metropolitan Chicago area for patients aged ≥ 65 with chronic pain, opioid use, or OUD who receive primary care at one of the clinics. I-COPE includes the integration of patient-reported data on symptoms and preferences, clinical decision support tools and shared decision making into routine primary care. Primary care providers will be trained on the tools through web-based videos and an optional Project ECHO® course, entitled "Pain Management and OUD in Older Adults." A framework called RE-AIM will be used to assess the I-COPE implementation. Outcomes considered effective include an increased variety of recommended pain treatments, decreased prescriptions of higher-risk pain treatments, and decreased patient pain scores. Outcomes will be evaluated at 6 and 12 months after implementation, and PCPs participating in Project ECHO® will be evaluated on changes in knowledge, attitudes, and self-efficacy using pre- and post-course surveys.
AHRQ-funded; HS027910.
Citation: Kagarmanova A, Sparkman H, Laiteerapong N .
Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for i-cope study.
Trials 2022 Jul 27;23(1):602. doi: 10.1186/s13063-022-06537-w..
Keywords: Elderly, Pain, Chronic Conditions, Opioids, Medication, Substance Abuse, Behavioral Health, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT)
Tsang M, DeBoer RJ, Garrett SB
Decision-making about clinical trial options among older patients with metastatic cancer who have exhausted standard therapies.
The purpose of this study was to examine the potential reasons for and responses to older adults’ under enrollment in phase 1 cancer clinical trials. The researchers conducted 101 in-depth qualitative interviews with 39 adults aged 65 and older with advanced cancer and asked about their experiences with the trials. The data was analyzed to identify the participants’ understanding of clinical research, their perceptions of early phase trials, and their experiences with enrollment in the trials. The study found that participants over the age of 70 were less enthusiastic about participation in clinical trials, although they did not mention age as a limitation to participation. Findings indicated that participation in clinical trials was an interactive, ongoing process, in which older adults relied on their oncologist for guidance and discussion. The researchers concluded that older adults rely on their oncologist to navigate the perceived complexities of phase 1 trial enrollment, and that acknowledgement of those complexities via shared decision-making can help prevent under-enrollment.
AHRQ-funded; HS022241.
Citation: Tsang M, DeBoer RJ, Garrett SB .
Decision-making about clinical trial options among older patients with metastatic cancer who have exhausted standard therapies.
J Geriatr Oncol 2022 Jun;13(5):594-99. doi: 10.1016/j.jgo.2022.01.012..
Keywords: Elderly, Cancer, Decision Making, Quality of Life
Rice H, Garabedian PM, Shear K
Clinical decision support for fall prevention: defining end-user needs.
The purpose of this study was to identify patient and primary care staff needs for development of a tool that will generate clinical decision support (CDS) to prevent falls and injuries in older adults. Community-dwelling patients aged 60 and over and primary care clinic staff were eligible to participate in the study; all were affiliated with the University of Florida Health Archer Family Health Care primary care clinic and the Brigham & Women's Hospital-affiliated primary care clinics. Through qualitative interviews with patients (n=18) and primary care clinic staff (n=24) user needs were identified and then categorized into the following themes: evidence-based safe exercises; expert guidance; individualized resources; in-person assessment of patient condition; motivational tools; patient understanding of fall risk; personal support networks; systematic communication and workload burden. The study concluded that personalized, actionable, and evidence-based clinical decision support may be able to address some of the many gaps that exist in fall prevention management in older adults.
AHRQ-funded; HS027557.
Citation: Rice H, Garabedian PM, Shear K .
Clinical decision support for fall prevention: defining end-user needs.
Appl Clin Inform 2022 May;13(3):647-55. doi: 10.1055/s-0042-1750360..
Keywords: Elderly, Falls, Prevention, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT)
Kurasz AM, Smith GE, Curiel RE
Patient values in healthcare decision making among diverse older adults.
This study investigated the types of values that culturally diverse older adults incorporate in medical decision making. Focus groups were held with 49 individuals, 49% with mild cognitive impairment, and 51% Hispanic. Participants described barriers and facilitators that interfere with or promote value solicitation and incorporation. A wide range of values relating to individual factors, familial/cultural beliefs and expectations, balancing risks and benefits, receiving decisional support, and considering values other than their own were expressed. Participants also emphasized that values are individual-specific, influenced by aging, and change throughout life.
AHRQ-funded; HS024159.
Citation: Kurasz AM, Smith GE, Curiel RE .
Patient values in healthcare decision making among diverse older adults.
Patient Educ Couns 2022 May;105(5):1115-22. doi: 10.1016/j.pec.2021.08.031..
Keywords: Elderly, Decision Making, Racial and Ethnic Minorities
Jacobsohn GC, Leaf M, Liao F
Collaborative design and implementation of a clinical decision support system for automated fall-risk identification and referrals in emergency departments.
The authors used a collaborative and iterative approach to design and implement an automated clinical decision support system (CDS) for Emergency Department (ED) providers to identify and refer older adult ED patients at high risk of future falls. The system was developed using collaborative input from an interdisciplinary design team and integrated seamlessly into existing ED workflows. A key feature of development was the unique combination of patient experience strategies, human-centered design, and implementation science, which allowed for the CDS tool and intervention implementation strategies to be designed simultaneously. Challenges included: usability problems, data inaccessibility, time constraints, low appointment availability, high volume of patients, and others. The study concluded that using the collaborative, iterative approach was successful in achieving all project goals, and could be applied to other cases.
AHRQ-funded; HS024558.
Citation: Jacobsohn GC, Leaf M, Liao F .
Collaborative design and implementation of a clinical decision support system for automated fall-risk identification and referrals in emergency departments.
Healthc 2022 Mar;10(1):100598. doi: 10.1016/j.hjdsi.2021.100598..
Keywords: Elderly, Clinical Decision Support (CDS), Decision Making, Falls, Risk, Emergency Department, Health Information Technology (HIT)
Daley CN, Cornet VP, Toscos TR
Naturalistic decision making in everyday self-care among older adults with heart failure.
The purpose of this study was to explore the role of everyday decision-making on disease outcome in a group of older adults living with heart failure. The researchers describe such decisions as events of naturalistic decision-making which are influenced by factors such as the involvement of others, older adults’ social and physical environments, high stakes of the decision, and shifting goals. The researchers recruited 24 older adults with heart failure and 14 of their support persons from an ambulatory cardiology center, and conducted a qualitative field study. The study utilized a naturalistic decision-making model and critical incident technique to analyze health-related everyday decision making and determine how individuals make everyday health-related decisions. The study found that for various decisions, the decision-making of White, male, older adults aligned with the three phases of a preliminary model of naturalistic decision making: monitoring, interpreting, and acting. The researchers also determined that: health decisions are made in a context of personal variables such as emotions, priorities, and values; other people can play important roles; and the performance of the phases can be affected by barriers and strategies. The study concluded that the findings contribute to an expanded model of naturalistic decision-making with implications for not only future research, but for the design of interventions.
AHRQ-funded; HS025232.
Citation: Daley CN, Cornet VP, Toscos TR .
Naturalistic decision making in everyday self-care among older adults with heart failure.
J Cardiovasc Nurs 2022 Mar-Apr;37(2):167-76. doi: 10.1097/jcn.0000000000000778..
Keywords: Elderly, Patient Self-Management, Decision Making, Heart Disease and Health, Cardiovascular Conditions
Dossett LA, Mott NM, Bredbeck BC
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
The purpose of this study was to examine the role that an individual’s maximizing-minimizing trait, an inherent preference for more or less medical care, may influence the preference for low-value care in the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women 70 years of age or higher with early-stage, hormone-receptor positive invasive breast cancer. The researchers recruited women 70 years of age or higher (n=1600) who were maximizers (515), minimizers (550), or neutral (535), and presented them with a hypothetical breast cancer diagnosis and then randomized exposure to one of three follow-up messages. Messages included: 1) maximizer-tailored, 2) minimizer-tailored, or 3) neutral. The study reported that higher maximizing tendency correlated positively with electing both SLNB and radiotherapy on logistic regression. Any maximizer- or minimizer-tailoring decreased preference for SLNB in maximizing and neutral women but had no effect in minimizing women. Tailoring had no impact on radiotherapy decision, except for an increased probability of minimizers electing radiotherapy when presented with maximizer-tailored messaging. The study concluded that among women facing a hypothetical breast cancer diagnosis, tendencies for maximizing-minimizing are correlated with preferences for treatment.
AHRQ-funded; HS026030.
Citation: Dossett LA, Mott NM, Bredbeck BC .
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
J Surg Res 2022 Feb;270:503-12. doi: 10.1016/j.jss.2021.10.005..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Decision Making, Clinician-Patient Communication, Communication
Rosenthal M, Poling J, Wec A
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
This article investigated health professionals’ experiences with decision-making during changes under the National Partnership to Improve Dementia Care in Nursing Homes and its companion coalitions. These programs were introduced in 2012 for the purpose of encouraging reductions in antipsychotic use and increasing use of nonpharmacological treatments for dementia. Interviews were conducted with 40 nursing home physicians and staff in seven states. The authors found that reducing antipsychotics is more time and resource-intensive than relying on medication. However, respondents supported reductions in antipsychotic use. They indicated that with supported staffing, effective communications, and training, they could create or implement individualized treatments.
AHRQ-funded; HS023464.
Citation: Rosenthal M, Poling J, Wec A .
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
J Appl Gerontol 2022 Jan;41(1):62-72. doi: 10.1177/0733464820958919..
Keywords: Elderly, Medication, Nursing Homes, Dementia, Neurological Disorders, Long-Term Care, Decision Making
Xiong KZ, Shah S, Stone JA
Using a scenario-based hybrid approach to understand participant health behavior.
This study described a scenario-based hybrid approach that included a simulation exercise and a situational interview to understand how older adults first select and then take OTC medication. The authors concluded that the scenario-based hybrid approach not only yielded detailed information about behavior, but also allowed investigators to discern participants' decision-making, influences, and the rationales they used when selecting and taking OTC medications.
AHRQ-funded; HS024490.
Citation: Xiong KZ, Shah S, Stone JA .
Using a scenario-based hybrid approach to understand participant health behavior.
Res Social Adm Pharm 2021 Dec;17(12):2070-74. doi: 10.1016/j.sapharm.2021.02.020..
Keywords: Elderly, Medication, Decision Making
Morris AO, Gilson A, Chui MA
Utilizing a cognitive engineering approach to conduct a hierarchical task analysis to understand complex older adult decision-making during over-the-counter medication selection.
This study characterized older adults' cognitive decision-making process when seeking to self-medicate with over-the-counter (OTC) medications from their community pharmacy, and demonstrated how hierarchical task analysis (HTA) can be used to evaluate a pharmacy intervention's impact on their decision-making. Findings showed that, while selecting an OTC, older adults considered quantity, cost, form, regimen, safety, strength, appropriateness of OTC safety, generic/name-brand, past experiences, and ingredients. The study intervention reduced by half the number of factors considered. Findings suggested that HTA-informed decision profiles may provide pharmacists with critical insights into safety issues that older adults may not be considering so that pharmacists can support their decision-making.
AHRQ-funded; HS024490.
Citation: Morris AO, Gilson A, Chui MA .
Utilizing a cognitive engineering approach to conduct a hierarchical task analysis to understand complex older adult decision-making during over-the-counter medication selection.
Res Social Adm Pharm 2021 Dec;17(12):2116-26. doi: 10.1016/j.sapharm.2021.07.005..
Keywords: Elderly, Decision Making, Medication
De Roo AC, Vitous CA, Rivard SJ
High-risk surgery among older adults: not-quite shared decision-making.
This study explored surgeons’ approaches to decision-making for surgery among adults ≥65 years at high-risk of postoperative complications or death. The authors conducted semistructured in-depth interviews with 46 practicing surgeons across Michigan. They found that although shared decision-making is strongly recommended, surgeons who perform high-risk operations among older adults predominantly focused on assessing risk and setting expectations with patients and families rather than inviting them to actively participate in the decision-making process. Surgeons were also influenced by quality metrics, referrals, and personal experiences.
AHRQ-funded; HS026772; HS000053.
Citation: De Roo AC, Vitous CA, Rivard SJ .
High-risk surgery among older adults: not-quite shared decision-making.
Surgery 2021 Sep;170(3):756-63. doi: 10.1016/j.surg.2021.02.005..
Keywords: Elderly, Surgery, Decision Making, Patient and Family Engagement
Campbell NL, Holden RJ, Tang Q
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
This study tested the effectiveness of a multicomponent behavioral intervention to reduce the use of high-risk anticholinergic medications in primary care older adults. Ten primary care clinics within Eskenazi Health in Indianapolis were selected to test the intervention. The intervention included provider- and patient-focused components. The provider-focused component was a computerized decision support system alerting the presence of a high-risk anticholinergic and offering dose- and indication-specific alternatives; while the patient-focused component was a story-based video providing education and modeling an interaction with a healthcare provider. The intervention occurred from April 2019 through March 2020. A total of 552 older adults had primary care visits during the study period. Only 3 out of 259 provider-focused alerts led to a medication change. Of the 276 staff alerts, 4.7% were confirmed to activate the patient-focused intervention.
AHRQ-funded; P30HS024384.
Citation: Campbell NL, Holden RJ, Tang Q .
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
J Am Geriatr Soc 2021 Jun;69(6):1490-99. doi: 10.1111/jgs.17121..
Keywords: Elderly, Medication, Primary Care, Clinical Decision Support (CDS), Decision Making
Thorsteinsdottir B, Hickson LJ, Giblon R
Validation of prognostic indices for short term mortality in an incident dialysis population of older adults >75.
Prognosis provides critical knowledge for shared decision making between patients and clinicians. While several prognostic indices for mortality in dialysis patients have been developed, their performance among elderly patients initiating dialysis is unknown, despite great need for reliable prognostication in that context. The purpose of this study was to assess the performance of 6 previously validated prognostic indices to predict 3 and/or 6 months mortality in a cohort of elderly incident dialysis patients.
AHRQ-funded; HS025517; HS025164; HS025402.
Citation: Thorsteinsdottir B, Hickson LJ, Giblon R .
Validation of prognostic indices for short term mortality in an incident dialysis population of older adults >75.
PLoS One 2021 Jan 20;16(1):e0244081. doi: 10.1371/journal.pone.0244081..
Keywords: Elderly, Dialysis, Kidney Disease and Health, Mortality, Decision Making
Hanlon JT, Perera S, Schweon S
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
This study evaluated the impact of an educational quality improvement initiative on the appropriateness of antibiotic prescribing restricted to uncomplicated cystitis in older noncatheterized nursing home residents. This 1-year case-control study used 25 participating nursing homes that were randomized to the intervention or usual care group by strata that included state, urban/rural status, bed size, and geographic separation. A total of 75 cases of cystitis were found in the intervention groups and 92 in the control groups. The intervention group had a nonsignificant 21% reduction in the risk of antibiotic prescribing. There was a favorable comparison in appropriateness of duration. However, the intervention group had more problems with drug-drug interactions than the control group (8% vs 1%). There were also more problems with dosage in the intervention group. Both groups had similar rates of problems with choice or effectiveness (44% vs 45%). The most common antibiotic class that was prescribed inappropriately was quinolones.
AHRQ-funded; R18 HS023779.
Citation: Hanlon JT, Perera S, Schweon S .
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
J Am Med Dir Assoc 2021 Jan;22(1):173-77. doi: 10.1016/j.jamda.2020.07.040..
Keywords: Elderly, Nursing Homes, Long-Term Care, Antibiotics, Medication, Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Decision Making
Rutkowski RA, Salwei M, Barton H
Physician perceptions of disposition decision-making for older adults in the emergency department: a preliminary analysis.
Disposition decision-making in the emergency department (ED) is critical to patient safety and quality of care. Disposition decision-making has particularly important implications for older adults who comprise a significant portion of ED visits annually and are vulnerable to suboptimal outcomes throughout ED care transitions. In this study, the investigators conducted a secondary inductive content analysis of interviews with ED physicians to explore their perceptions of who they involve in disposition decision-making and what information they use to make disposition decisions for older adults.
AHRQ-funded; HS026624.
Citation: Rutkowski RA, Salwei M, Barton H .
Physician perceptions of disposition decision-making for older adults in the emergency department: a preliminary analysis.
Proc Hum Factors Ergon Soc Annu Meet 2020 Dec;64(1):648-52. doi: 10.1177/1071181320641148..
Keywords: Elderly, Decision Making, Emergency Department, Provider: Physician
Shah S, Gilson AM, Jacobson N
Understanding the factors influencing older adults' decision-making about their use of over-the-counter medications-a scenario-based approach.
The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of this study was to assess how older adults' knowledge, beliefs, and attitudes informed their decision-making regarding OTC use.
AHRQ-funded; HS024490.
Citation: Shah S, Gilson AM, Jacobson N .
Understanding the factors influencing older adults' decision-making about their use of over-the-counter medications-a scenario-based approach.
Pharmacy 2020 Sep 18;8(3). doi: 10.3390/pharmacy8030175..
Keywords: Elderly, Decision Making, Medication, Medication: Safety, Patient Safety, Health Literacy
Abrahamson K, Hass Z, Arling G
Shall I stay or shall I go? The choice to remain in the nursing home among residents with high potential for discharge.
This study examines why private-pay nursing home (NH) residents who expressed a desire for discharge and had relatively low-care needs chose to remain in the NH. The Minnesota Return to Community Initiative (RTCI) is a program that assists those residents to return to the community. Those who remained were more likely to beolder, more cognitively impaired, unmarried, had behavior problems, or diagnosed with dementia. At a 90-day assessment, residents who remained in the facility had a small decline in cognitive status, their continence improved, and they become more independent in activities of daily living (ADLs). Seventy-four percent of those remaining reported a perception of health barriers to discharge.
AHRQ-funded; HS020224.
Citation: Abrahamson K, Hass Z, Arling G .
Shall I stay or shall I go? The choice to remain in the nursing home among residents with high potential for discharge.
J Appl Gerontol 2020 Aug;39(8):863-70. doi: 10.1177/0733464818807818..
Keywords: Elderly, Nursing Homes, Long-Term Care, Transitions of Care, Decision Making
Killelea BK, Evans SB, Mougalian SS
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
This study examined perceptions of older women with stage I estrogen-receptor-positive breast cancer who underwent lumpectomy and were considering or receiving radiotherapy. Perceptions among 63 older women was that radiotherapy would reduce their 10-year-risk of local recurrent by an average of 18.7% although the literature showed only an 8% risk reduction. Participants who had the perception of a larger benefit were more likely to receive radiotherapy treatment.
AHRQ-funded; HS023900.
Citation: Killelea BK, Evans SB, Mougalian SS .
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
Breast J 2020 Feb;26(2):231-34. doi: 10.1111/tbj.13518..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Patient-Centered Outcomes Research, Decision Making
Goyal P, Anderson TS, Bernacki GM
Physician perspectives on deprescribing cardiovascular medications for older adults.
Investigators sought to characterize and compare clinician perspectives regarding deprescribing cardiovascular medications for older adults across three specialties. Within each specialty, 750 physicians were surveyed. The investigators found that, while barriers to deprescribing cardiovascular medications were shared across specialties, reasons for deprescribing, especially in the setting of limited life expectancy, varied. They concluded that implementing deprescribing will require improved processes for both physician-physician and physician-patient communication.
AHRQ-funded; HS022982.
Citation: Goyal P, Anderson TS, Bernacki GM .
Physician perspectives on deprescribing cardiovascular medications for older adults.
J Am Geriatr Soc 2020 Jan;68(1):78-86. doi: 10.1111/jgs.16157..
Keywords: Elderly, Medication, Cardiovascular Conditions, Decision Making, Provider: Physician, Provider
Holden RJ, Campbell NL, Abebe E
Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults.
Researchers sought to test the usability and feasibility of Brain Buddy, a consumer-facing mobile health technology designed to inform and empower older adults to consider the risks and benefits of anticholinergics. Primary care patients aged 60 years or older who used anticholinergic medications participated in task-based usability testing of Brain Buddy; usability was assessed by the System Usability Scale, and performance-based usability data collected for each task through observation. The researchers found that overall usability was acceptable or better, with 100% of participants completing each Brain Buddy task. Observed usability issues included higher rates of errors, hesitations, and need for assistance on tasks. They conclude that user-centered design and evaluation with demographically heterogeneous clinical samples uncovers correctable usability issues and confirms the value of interventions targeting consumers as agents in shared decision making and behavior change.
AHRQ- funded; HS024384.
Citation: Holden RJ, Campbell NL, Abebe E .
Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults.
Res Social Adm Pharm 2020 Jan;16(1):54-61. doi: 10.1016/j.sapharm.2019.02.011..
Keywords: Elderly, Medication, Patient Safety, Health Information Technology (HIT), Decision Making
Linsky A, Gellad WF, Linder JA
Advancing the science of deprescribing: a novel comprehensive conceptual framework.
Polypharmacy is common in older adults and associated with inappropriate medication use, adverse drug events, medication nonadherence, higher costs, and increased mortality compared with those without polypharmacy. Deprescribing, the clinically supervised process of stopping or reducing the dose of medications when they cause harm or no longer provide benefit, may improve outcomes. This article discusses a novel comprehensive conceptual framework for deprescribing.
AHRQ-funded; 2332015000201; HS026506; HS024930.
Citation: Linsky A, Gellad WF, Linder JA .
Advancing the science of deprescribing: a novel comprehensive conceptual framework.
J Am Geriatr Soc 2019 Oct;67(10):2018-22. doi: 10.1111/jgs.16136..
Keywords: Medication, Elderly, Decision Making
Hong M, Casado BL, Lee SE
The intention to discuss advance care planning in the context of Alzheimer's disease among Korean Americans.
The authors examined the intention to discuss advance care planning (ACP) for a family member with Alzheimer's disease among Korean Americans. Path analyses were conducted on a cross-sectional convenience sample; age, gender, education, and knowledge about Alzheimer's disease and ACP were included as covariates. From their findings, the authors recommended promoting ACP among this population and designing educational interventions to address positive attitudes and subjective norms toward ACP.
AHRQ-funded; HS022947.
Citation: Hong M, Casado BL, Lee SE .
The intention to discuss advance care planning in the context of Alzheimer's disease among Korean Americans.
Gerontologist 2019 Mar 14;59(2):347-55. doi: 10.1093/geront/gnx211..
Keywords: Elderly, Dementia, Neurological Disorders, Decision Making, Racial and Ethnic Minorities