| Title |
Impact of a nurse-based intervention on medication outcomes in vulnerable older adults
|
|---|---|
| Published in |
BMC Geriatrics, September 2018
|
| DOI | 10.1186/s12877-018-0905-1 |
| Pubmed ID | |
| Authors |
Michael A. Steinman, Marcelo Low, Ran D. Balicer, Efrat Shadmi |
| Abstract |
Medication-related problems are common in older adults with multiple chronic conditions. We evaluated the impact of a nurse-based primary care intervention, based on the Guided Care model of care, on patient-centered aspects of medication use. Controlled clinical trial of the Comprehensive Care for Multimorbid Adults Project (CC-MAP), conducted among 1218 participants in 7 intervention clinics and 6 control (usual care) clinics. Inclusion criteria included age 45-94, presence of ≥3 chronic conditions, and Adjusted Clinical Groups (ACG) score > 0.19. The co-primary outcomes were number of changes to the medication regimen between baseline and 9 month followup, and number of changes to symptom-focused medications, markers of attentiveness to medication-related issues. Mean age in the intervention group was 72 years, 59% were women, and participants used a mean of 6.6 medications at baseline. The control group was slightly older (73 years) and used more medications (mean 7.1). Between baseline and 9 months, intervention subjects had more changes to their medication regimen than control subjects (mean 4.04 vs. 3.62 medication changes; adjusted difference 0.55, p = 0.001). Similarly, intervention subjects had more changes to their symptomatic medications (mean 1.38 vs. 1.26 changes, adjusted difference 0.20, p = 0.003). The total number of medications in use remained stable between baseline and follow-up in both groups (p > 0.18). This nurse-based, primary care intervention resulted in substantially more changes to patients' medication regimens than usual care, without increasing the total number of medications used. This enhanced rate of change likely reflects greater attentiveness to the medication-related needs of patients. This trial is registered at https://clinicaltrials.gov , trial number NCT01811173 . |
X Demographics
The data shown below were collected from the profiles of 12 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 7 | 58% |
| Canada | 1 | 8% |
| United Kingdom | 1 | 8% |
| Unknown | 3 | 25% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 6 | 50% |
| Members of the public | 4 | 33% |
| Practitioners (doctors, other healthcare professionals) | 1 | 8% |
| Science communicators (journalists, bloggers, editors) | 1 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 99 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 99 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 14 | 14% |
| Student > Bachelor | 11 | 11% |
| Student > Ph. D. Student | 6 | 6% |
| Student > Doctoral Student | 4 | 4% |
| Other | 4 | 4% |
| Other | 14 | 14% |
| Unknown | 46 | 46% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 24 | 24% |
| Medicine and Dentistry | 11 | 11% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 5% |
| Social Sciences | 4 | 4% |
| Unspecified | 3 | 3% |
| Other | 11 | 11% |
| Unknown | 41 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 14. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 September 2018.
All research outputs
#2,390,649
of 24,372,222 outputs
Outputs from BMC Geriatrics
#608
of 3,381 outputs
Outputs of similar age
#49,035
of 339,799 outputs
Outputs of similar age from BMC Geriatrics
#20
of 76 outputs
Altmetric has tracked 24,372,222 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,381 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.2. This one has done well, scoring higher than 82% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 339,799 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 76 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 75% of its contemporaries.