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Journal article

Managing chronic pain in older people

Author:
SCHOFIELD Patricia
Journal article citation:
Nursing Times, 109(30), 2013, pp.26-27.
Publisher:
Nursing Times

This article presents the results of a collaborative project between the British Pain Society and British Geriatric Society to produce guidelines on pain management for older people. The guidelines are the first of their kind in the UK and aim to provide best practice for the management of pain to all health professionals working with older people in any care setting. (Publisher abstract)

Journal article

Twist and gout

Authors:
BEYNON Caryl, BARON Lloyd
Journal article citation:
Druglink, 24(6), November 2009, pp.16-17.
Publisher:
Drugscope
Place of publication:
London

There are a growing population of older drug users in contact with drug treatment services. This article looks at the challenges facing the treatment sector.

Journal article

Reading around...reality orientation

Author:
WOODS Bob
Journal article citation:
Journal of Dementia Care, 2(2), March 1994, pp.24-25.
Publisher:
Hawker

Looks at the history and development of reality orientation (RO) in dementia care.

Journal article

Complementary medicine for treatment of agitation and delirium in older persons: a systematic review and narrative synthesis

Authors:
LEVY Ilana, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 32(5), 2017, p.492–508.
Publisher:
Wiley-Blackwell

Background: Agitation and delirium frequently occur in cognitively impaired older people. The authors conducted a systematic review with narrative synthesis of the literature aiming to assess effectiveness of complementary and alternative medicine (CAM) modalities to address these conditions. Methods: Following preliminary search, the authors included 40 original researches on CAM treatment of delirium and agitation in older persons. Then, the quality of these studies was assessed using the Downs and Black Checklist and Quality Assessment Tool for Studies with Diverse Designs, and the effect sizes were calculated. The authors subsequently conducted a narrative synthesis of the main findings, including theory development, preliminary synthesis, exploration of relationships within and between studies, and assessment of synthesis robustness. Results: Forty articles that met the inclusion criteria were analysed. Sixteen of these were randomised controlled trials. One article specifically addressed CAM treatment of delirium in patients without dementia, and the remaining 39 articles described treatments of agitated older persons with dementia. Thirty-five of the 40 included studies suggested that the investigated CAM therapies may ameliorate the severity of agitation and delirium. The physiological surrogates of agitation assessed in these studies included cortisol level, chromogranin A level, and heart rate variability. Very few of the studies systematically assessed safety issues, although no major adverse effects were reported. Conclusion: Overall, the systematic review of the literature suggests that several CAM modalities are potentially beneficial in the treatment of agitation and delirium among older persons. The authors suggest that promising CAM modalities should be further explored through large-scale randomised controlled trials in different clinical settings. (Edited publisher abstract)

Journal article

A scoping review of treatments for older adults with substance use problems

Authors:
MOWBRAY Orion, QUINN Adam
Journal article citation:
Research on Social Work Practice, 26(1), 2016, pp.74-87.
Publisher:
Sage

Objectives: To identify effective treatment services for older, substance-using adults, an examination of the evidence associated with interventions for this group is presented. Methods: Using explicit, validated criteria to identify effective interventions, 22 publications were included in a review and were subject to a critical appraisal of study methodology. Results: The review identified four types of substance use treatment service settings for older adults, with mixed efficacy. These settings included (1) primary care settings or health clinics, (2) combined individual and group-based settings, (3) individual-based treatment settings, and (4) multiple treatment/multisite settings. Conclusion: Analyses of these publications revealed primary care settings or health clinic settings offered the most evidence of effective interventions, with noticeable gaps in research on interventions within other settings. Implications for social work practice and research are discussed. (Publisher abstract)

Journal article

STOPP/START criteria for potentially inappropriate prescribing in older people: version 2

Authors:
O'MAHONY Denis, et al
Journal article citation:
Age and Ageing, 44(2), 2015, pp.213-218.
Publisher:
Oxford University Press

Purpose: Screening tool of older people's prescriptions (STOPP) and screening tool to alert to right treatment (START) criteria were first published in 2008. Due to an expanding therapeutics evidence base, updating of the criteria was required. Methods: The authors reviewed the 2008 STOPP/START criteria to add new evidence-based criteria and remove any obsolete criteria. A thorough literature review was performed to reassess the evidence base of the 2008 criteria and the proposed new criteria. Nineteen experts from 13 European countries reviewed a new draft of STOPP & START criteria including proposed new criteria. These experts were also asked to propose additional criteria they considered important to include in the revised STOPP & START criteria and to highlight any criteria from the 2008 list they considered less important or lacking an evidence base. The revised list of criteria was then validated using the Delphi consensus methodology. Results: The expert panel agreed a final list of 114 criteria after two Delphi validation rounds, i.e. 80 STOPP criteria and 34 START criteria. This represents an overall 31% increase in STOPP/START criteria compared with version 1. Several new STOPP categories were created in version 2, namely antiplatelet/anticoagulant drugs, drugs affecting, or affected by, renal function and drugs that increase anticholinergic burden; new START categories include urogenital system drugs, analgesics and vaccines. Conclusion: STOPP/START version 2 criteria have been expanded and updated for the purpose of minimising inappropriate prescribing in older people. These criteria are based on an up-to-date literature review and consensus validation among a European panel of experts. (Edited publisher abstract)

Journal article

Older adults in methadone maintenance treatment: a literature review

Author:
DOUKAS Nick
Journal article citation:
Journal of Social Work Practice in the Addictions, 11(3), July 2011, pp.230-244.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Approximately 10% of patients engaged in a methadone programme across the world are 50 years of age or over, and older people present challenges to clinics that prescribe methadone because of their unique biopsychosocial needs. This article reviews the research literature on methadone maintenance treatment or opioid replacement therapy, focusing on studies conducted with adults aged 50 or older who have been prescribed methadone. It describes the methods used and discusses the research identified, covering mortality and causes of death, medical and mental health issues, illegal drug use, social supports, barriers to treatment, and gender differences. It also discusses gaps in the research and makes recommendations for future studies. The article notes that there are a significant number of older adults in methadone maintenance treatment, but that there is limited research available, with few qualitative studies conducted so far.

Book Full text available online for free

Improving the detection of correctable low vision in older people

Authors:
EVANS Bruce, JESSA Zahra
Publisher:
Thomas Pocklington Trust
Publication year:
2008
Pagination:
15p.
Place of publication:
London

What is the optimum test battery for visual screening of older people and what sensitivity and specificity does this have for detecting correctable visual impairment? The study is mainly quantitative. A battery of computerised visual screening tests will be compared with a full eye examination, in two blind studies. The first study will be used to refine the test battery and to develop a flip chart rapid vision screener. The sensitivity and specificity of the refined computerised screener and flip chart rapid screener will be evaluated in a second study. The main target conditions are uncorrected refractive error and cataract, since these are readily correctable. The sensitivity and specificity of the screening tools for detecting these problems will be calculated. The value of different screening venues will also be investigated.

Journal article Full text available online for free

Sex in the middle ages

Author:
GULLARD Anne
Journal article citation:
Community Care, 31.7.08, 2008, pp.24-25.
Publisher:
Reed Business Information

Instances of sexually transmitted infections in over-45s are increasing. Discusses what is causing the trend and what can be done to ensure people receive the treatment they need.

Journal article

The effects of at-risk drinking on the treatment of late life major depression a pilot study to establish effects

Author:
OSLIN David W.
Journal article citation:
Journal of Dual Diagnosis, 2(3), 2006, pp.47-56.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Depression is one of the leading causes of morbidity and mortality worldwide. Comorbidity with alcohol dependence is a significant cause of poor response to treatment for depression and prolonged disability. However, epidemiological evidence demonstrates that at-risk alcohol use (drinking more than one drink/day and not meeting criteria for alcohol dependence) is more common than alcohol dependence among patients with major depression and that this is especially true in mid and late life. In this American study patients with a depressive disorder were enrolled in one of two clinical trials and received standard depression care. Outcomes were compared amongst those patients who drank at or above recommended drinking limits to those who were non-drinkers. Patients from both studies who consumed alcohol at levels considered “at-risk” have had lower rates of remission from standard depression care. While these results were not statistically significant, they provide a framework for conceptualizing a more definitive trial. Conclusion: These data suggest that at-risk drinking may reduce the effectiveness of standard depression care. Therefore, assessment of alcohol use and intervention at lower levels of drinking may be of value in increasing the impact of depression care. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

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