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  • 1
    Online Resource
    Online Resource
    A Needs Assessment of Family Physicians to Inform Development of Educational Resources on Antipsychotic Use in Dementia
    SAGE Publications ; 2019
    In:  Journal of Primary Care & Community Health Vol. 10 ( 2019-01), p. 215013271984011-
    Details
    In: Journal of Primary Care & Community Health, SAGE Publications, Vol. 10 ( 2019-01), p. 215013271984011-
    Abstract: Objectives: Objectives of this study were to (1) assess the needs and preferred resources of Iowa physicians to inform the development of educational resources for best practice dementia care and (2) compare the responses of nursing home medical directors with nonmedical directors. Methods: Of 498 physicians, 101 (20%) completed and returned the survey. Family physicians were obtained from a list of family physicians from the Iowa Board of Medical Examiners. Respondent answers were summarized and presented as total numbers and percentages in tables. Significant differences between medical directors and nonmedical directors were evaluated using chi-square tests, Fisher exact tests, and Wilcoxon rank-sum tests. Results: Medical directors and nonmedical directors had similar preferences for resources used and information needs. Online resources, pocket guides, a handbook, consulting pharmacists, and facility in-services were the most commonly preferred sources of new information. Medical directors were significantly more aware of the Food and Drug Administration warning on antipsychotic use in dementia and treated more nursing home patients. No differences were observed between groups related to confidence in and use of nondrug strategies instead of antipsychotics to manage behavioral symptoms of dementia. Conclusion: The results of this survey illustrate physician preferences for information and resources on the management of behavioral and psychological symptoms in dementia. Information was used to inform the development of resources to aid physicians and other health care providers in making decisions about managing these symptoms.
    Type of Medium: Online Resource
    ISSN: 2150-1327 , 2150-1327
    URL: Article
    DOI: 10.1177/2150132719840113
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2550221-9
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  • 2
    Online Resource
    Online Resource
    Validity of the Delirium Observation Screening Scale in Identifying Delirium in Home Hospice Patients
    SAGE Publications ; 2017
    In:  American Journal of Hospice and Palliative Medicine® Vol. 34, No. 8 ( 2017-09), p. 744-747
    Details
    In: American Journal of Hospice and Palliative Medicine®, SAGE Publications, Vol. 34, No. 8 ( 2017-09), p. 744-747
    Abstract: Delirium is common in home hospice patients and conveys significant morbidity to both patients and caregivers. The Delirium Observation Screening Scale (DOS) was developed to improve delirium recognition but has yet to be validated in the home hospice setting. Objective: This pilot study aimed to explore the accuracy of the DOS for identifying delirium in home hospice patients. Design: Prospective delirium evaluation using a convenience sample. Setting/Participants: Community hospice patients were approached for study inclusion. Measurements: Participants were assessed using the Delirium Rating Scale–Revised–98 (DRS-R-98), with results being categorized as “delirium” or “no delirium.” The Delirium Observation Screening Scale scores, completed by hospice nurses during weekly patient assessment visits, were compared to the DRS-R-98 results. Results: Within this population, 30/78 (38%) assessments were categorized as delirious. In the majority of assessments, 69/75 (92%), the DRS-R-98 and DOS provided congruent results. There were 5 false positives and 1 false negative, demonstrating the DOS to be a clinically useful tool with a sensitivity of 0.97 and specificity of 0.89. Conclusion: The DOS appears to be an accurate way to screen for delirium in home hospice patients. Validation of the DOS may help to improve delirium recognition and treatment and has the potential to increase quality of life in this vulnerable population. This input will also be taken into consideration in the development of a systematic screening procedure for delirium diagnosis at our local hospice, which we hope will be generalizable to other hospice agencies.
    Type of Medium: Online Resource
    ISSN: 1049-9091 , 1938-2715
    URL: Article
    DOI: 10.1177/1049909116658468
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2236674-X
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  • 3
    Online Resource
    Online Resource
    Hypomania with Agitation Associated with Varenicline Use in Bipolar II Disorder
    SAGE Publications ; 2008
    In:  Annals of Pharmacotherapy Vol. 42, No. 2 ( 2008-02), p. 288-289
    Details
    In: Annals of Pharmacotherapy, SAGE Publications, Vol. 42, No. 2 ( 2008-02), p. 288-289
    Type of Medium: Online Resource
    ISSN: 1060-0280 , 1542-6270
    URL: Article
    DOI: 10.1345/aph.1K511
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2053518-1
    SSG: 15,3
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  • 4
    Online Resource
    Online Resource
    Antipsychotic Medication Use in the Elderly Patient
    SAGE Publications ; 2007
    In:  Journal of Pharmacy Practice Vol. 20, No. 4 ( 2007-08), p. 318-326
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 20, No. 4 ( 2007-08), p. 318-326
    Abstract: The use of antipsychotic medications in the elderly can be very complex and is ever changing. Consideration must be given to not only the physiologic and functional changes normally associated with age but also to the latest data on safety and adverse outcomes associated with using these agents. Because of new and changing information, this article will review the effects of aging, side effects of antipsychotic medications, and the current issues surrounding their use in elderly patients for those clinicians who are not specialists in this area of practice.
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/0897190007304982
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2131091-9
    SSG: 15,3
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  • 5
    Online Resource
    Online Resource
    Risk of Cognitive Decline Associated With Paroxetine Use in Elderly Nursing Home Patients With Depression
    SAGE Publications ; 2016
    In:  American Journal of Alzheimer's Disease & Other Dementiasr Vol. 31, No. 8 ( 2016-12), p. 678-686
    Details
    In: American Journal of Alzheimer's Disease & Other Dementiasr, SAGE Publications, Vol. 31, No. 8 ( 2016-12), p. 678-686
    Abstract: This study evaluated the risk of cognitive decline associated with paroxetine use in elderly nursing home patients with depression. Methods: A retrospective cohort study was conducted using the 2007 to 2010 Medicare Part D claims and minimum data set (MDS) data involving new users of paroxetine and other selective serotonin reuptake inhibitors (SSRIs). The primary outcome was MDS Cognition Scale. The repeated-measures mixed model was used to examine the effect of paroxetine on cognition after controlling for other factors. Results: The baseline MDS Cognition Scale measures for paroxetine (n = 63) and other SSRI users (n =1018) were 2.02 (±1.85) and 2.50 (±2.39), respectively. The repeated-measures mixed model did not find statistically significant difference in cognition with the use of paroxetine (β = 0.02, 95% CI: −0.16 to 0.21]) when compared to other SSRIs. Conclusions: There was no differential effect of paroxetine on cognition when compared to other SSRIs.
    Type of Medium: Online Resource
    ISSN: 1533-3175 , 1938-2731
    URL: Article
    DOI: 10.1177/1533317516673463
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2235173-5
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  • 6
    Online Resource
    Online Resource
    Older Adults’ Views About “Managing Your Medications” Booklet
    SAGE Publications ; 2013
    In:  Journal of Applied Gerontology Vol. 32, No. 3 ( 2013-04), p. 370-382
    Details
    In: Journal of Applied Gerontology, SAGE Publications, Vol. 32, No. 3 ( 2013-04), p. 370-382
    Abstract: The objectives were to evaluate Managing Your Medications (MYM) booklet to improve medication management. Mailed packets, including MYM booklet and 4-page survey assessing comprehensibility, communicative effectiveness, and usefulness, were sent to a random sample of 250 older adults. The survey included perceptions of booklet, how to disseminate, and respondent’s health history. Descriptive statistics were used, and individuals were stratified by number of prescription medications and whether they reported side effects. A 59.6% response rate was obtained. The readability was Grade 8. Older adults reported it was comprehensible and 17% reported behavioral intentions to change their current actions regarding medications. Overall, 12.7% of respondents agreed that MYM changed their opinion of the topic. The most popular means to disseminate were doctors’ offices and senior citizens’ centers. Most older adults indicated the MYM booklet was readable, comprehensible, and would generate some behavior change regarding medication management.
    Type of Medium: Online Resource
    ISSN: 0733-4648 , 1552-4523
    URL: Article
    DOI: 10.1177/0733464811421910
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2089028-X
    detail.hit.zdb_id: 155897-3
    SSG: 5,2
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  • 7
    Online Resource
    Online Resource
    Dementia and Comorbidities: An Overview of Diagnosis and Management
    SAGE Publications ; 2007
    In:  Journal of Pharmacy Practice Vol. 20, No. 4 ( 2007-08), p. 296-317
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 20, No. 4 ( 2007-08), p. 296-317
    Abstract: The term “dementia” describes various neurodegenerative disorders that effect cognition, including Alzheimer disease, vascular dementia, and others. This article reviews the diagnosis and management of common types of dementia and comorbidities. Dementias are differentiated clinically by history, symptom presentation, and exclusion of other causes through laboratory and imaging studies. Cholinesterase inhibitors are useful but may not be effective for all types of dementia and provide only modest benefits. Certain medical comorbidities may increase the risk of dementia, although genetics are also important in its etiology. Psychiatric comorbidities in dementia include delirium, which is treated primarily by addressing underlying medical disorders, but antipsychotics can be useful for symptom management and patient comfort. Nonpharmacologic interventions are first-line treatments for other psychiatric comorbidities, although drug therapy may be useful in some cases. The management of patients with dementia presents many challenges and will continue to do so unless agents with pronounced disease-modifying capabilities are developed.
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/0897190007308594
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2131091-9
    SSG: 15,3
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  • 8
    Online Resource
    Online Resource
    Editorial
    SAGE Publications ; 2007
    In:  Journal of Pharmacy Practice Vol. 20, No. 5 ( 2007-10), p. 359-359
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 20, No. 5 ( 2007-10), p. 359-359
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/0897190007310778
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2131091-9
    SSG: 15,3
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