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DESCRIPTION The American College of Physicians and American Academy of Family Physicians developed this guideline to present the available evidence on current pharmacologic treatment of dementia. METHODS The targeted literature search included evidence related to the effectiveness of 5 U.S. Food and Drug Administration-approved pharmacologic therapies for(More)
PURPOSE The purpose of the study was to determine if simply providing nursing facilities with comparative quality performance information and education about quality improvement would improve clinical practices and subsequently improve resident outcomes, or if a stronger intervention, expert clinical consultation with nursing facility staff, is needed. (More)
PURPOSE A focus on palliative care for residents with dementia is much more common in Dutch nursing homes than in the United States. We compared treatment and mortality in U.S. and Dutch nursing home residents with lower respiratory infections (LRI), which are often the immediate cause of death in dementia. DESIGN AND METHODS We studied two prospective(More)
BACKGROUND Currently, 24% of all deaths nationally occur in nursing homes making this an important focus of care. However, many residents are not identified as dying and thus do not receive appropriate care in the last weeks and months of life. The aim of our study was to develop and validate a predictive model of 6-month mortality risk using functional,(More)
PURPOSE This study investigated the effectiveness of interventions to improve medication adherence (MA) in older adults. DESIGN AND METHODS Meta-analysis was used to synthesize results of 33 published and unpublished randomized controlled trials. Random-effects models were used to estimate overall mean effect sizes (ESs) for MA, knowledge, health(More)
BACKGROUND Urinary tract infections (UTIs) are the most commonly treated infection among nursing home residents. Even in the absence of specific (e.g., dysuria) or non-specific (e.g., fever) signs or symptoms, residents frequently receive an antibiotic for a suspected infection. This research investigates factors associated with the use of antibiotics to(More)
PURPOSE Patients are increasingly interested in using Internet-based technologies to communicate with their providers, schedule clinic visits, request medication refills, and view their medical records electronically. However, healthcare organizations face significant challenges in providing such highly personal and sensitive communication in an effective(More)
BACKGROUND Although lower respiratory tract infections (LRI) cause considerable morbidity and mortality among nursing home residents with dementia, the effects of care and treatment are largely unknown. Few large prospective studies have been conducted. METHODS We pooled data from two large prospective cohort studies in 61 Dutch nursing homes and 36(More)
CONTEXT Lower respiratory tract infection (LRI) is a leading cause of mortality and hospitalization in nursing home residents. Treatment decisions may be aided by a clinical prediction rule that identifies residents at low and high risk of mortality. OBJECTIVE To identify patient characteristics predictive of 30-day mortality in nursing home residents(More)
BACKGROUND Accurately defining severe dementia is important for care and prognosis, but is not explicitly included in the Minimum Data Set (MDS). OBJECTIVE To define severe dementia using the MDS, we used data for nursing home residents with moderate to severe dementia. METHODS Two cross-sectional studies enrolled 175 residents; 89 residents from one US(More)