Age and ageing
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Multicenter Study Comparative Study
Access to stroke care in England, Wales and Northern Ireland: the effect of age, gender and weekend admission.
To determine whether access to high-quality stroke care is affected by the age or gender of the patient or by weekend admission. ⋯ There is clear evidence of an age effect on the delivery of stroke care in England, Wales, and Northern Ireland, with older patients being less likely to receive care in line with current clinical guidelines. Quality of acute care is also less good for patients admitted at weekends. No systematic evidence for sexism was identified.
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Randomized Controlled Trial
Home-based medication review in a high risk elderly population in primary care--the POLYMED randomised controlled trial.
To assess whether home-based medication review by a pharmacist for at-risk older patients in a primary care setting can reduce hospital admissions. ⋯ No positive impact on clinical outcomes or quality of life was demonstrated, however, this intervention did appear to reduce prescribing. This is in line with other evidence and suggests that this form of intervention may not have a clear health gain, but may lead to modest savings in terms of reduced prescribing. Future research should focus on whether such a prescribing effect would make this type of intervention cost effective.
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Multicenter Study Comparative Study
National audit of continence care for older people: management of faecal incontinence.
Faecal incontinence in older people is associated with considerable morbidity but is amenable to successful management. Quality standards in this area were previously subject to a pilot audit in primary, secondary care and care homes to allow providers to compare the care delivered by their service to others and to monitor the development of integrated continence services as set out in the National Service Framework for Older People. This study reports the results of the national audit. ⋯ The results of this audit indicate that the requirement for integrated continence services contained within the National Service Framework for Older People has not yet been met. Basic assessment and care by the professionals directly looking after older persons is often lacking. There is an urgent need to re-establish the fundamentals of continence care into the daily practice of medical and nursing staff, and undoubtedly, action needs to be taken with regard to the establishment of truly integrated, quality services in this neglected area of practice.
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Editorial Comment
Why stroke patients don't like Mondays (or Saturdays or Sundays).