Posters

Aims This study assesses national trends and, sociodemographic and clinical factors associated with polypharmacy and potentially in appropriate prescribing among people with type 2 diabetes in Scotland from 2012 to 2022. Methods Retrospective cohort study using nationwide data from the Scottish Care Information – Diabetes database. Individuals aged ≥40 years with type 2 diabetes were included. Medication counts were based on unique medications dispensed per calendar year. Potentially inappropriate medications were based on the 2023 Beers criteria and applied to people aged over 65 years. A

Background Randomised controlled trials are often criticised for excluding older people with multiple long-term conditions. This study used individual participant data (IPD) for 25 trials of sodium glucose co-transporter-2 inhibitors (SGLT2i) to compare baseline characteristics, comorbidities, and event rates between trial participants and community SGLT2i-treated people. Methods Trials were identified through a systematic review with subsequent application for IPD. Community SGLT2i-treated people in routine care were identified from SAIL databank. For each trial, we applied the eligibility

Introduction Iron deficiency anaemia (IDA) is one of the most common reasons for referral to day-case settings, reflecting its significant contribution to global morbidity and disease burden. In 2017/2018, over 100,000 treatments were delivered nationally at a cost of £465 million – averaging £449/ case. Locally in South London, a single trust treats 50-60 patients monthly. In the general population , anemia is defined as a haemoglobin <130g/L in men and <120 g/L in non-pregnant women, in association with a serum ferritin<30 mg/L (in the absence of inflammation).The diagnostic criteria differs

Introduction: Anticholinergic medications are widely prescribed to manage pain, urinary incontinence, allergies. Patients with high frailty scores are more susceptible to anticholinergic adverse effects such as falls, cognitive impairment, urinary retention. The Anticholinergic Burden Score (ACB) is a tool used to quantify the cumulative anticholinergic effect of patients' medications. A score of 3 or more is associated with an increased risk of mortality and worse cognitive function. This quality improvement project aims to quantify and reduce ACB scores of patients admitted to the Acute

Introduction: Venous thromboembolism (VTE) is a common complication in post-stroke patients, with an incidence of approximately 17%. Pulmonary embolism accounts for 25–50% of reported VTE-related deaths. Pharmacological prophylaxis with low-molecular-weight heparin (LMWH) is contraindicated within the first 30 days following stroke due to the risk of haemorrhagic transformation and clot instability. As an alternative, mechanical prophylaxis using intermittent pneumatic compression (IPC) has demonstrated efficacy in reducing VTE incidence and improving survival outcomes. Evidence from the CLOTS

Introduction: In October 2023, the electronic patient record system Epic® was introduced across two London NHS Foundation Trusts — King's College Hospital (KCH) and Guy's & St Thomas' (GSTT). This replaced legacy documentation processes, including the Comprehensive Geriatric Assessment (CGA). At KCH, a CGA template widely used by the multidisciplinary team was lost, leading to inconsistent CGA documentation, poor communication of outcomes at discharge, and reduced data usability. This quality improvement project aimed to standardise CGA documentation and communication across care settings

Introduction Older people living in Nursing Homes (NH) are often admitted to Acute Hospitals (AH) toward their end-of-life (EOL) due to the limited capacity to manage exacerbations and symptoms within NHs. The EAGLEcare (Enhancing Advance care planning, Geriatric and End-of-Life care in NHs in the East) Programme was set up to improve in-NH care and to reduce avoidable AH admissions and their unintended consequences. Methods A system of proactive case-finding for residents with specific and general indicators of advanced life-limiting illnesses was developed in collaboration with NH partners

Introduction: Emergency laparotomy is associated with high risk of mortality and morbidity. NELA best practice tariff identifies Geriatrician input as a key performance indicator for all patients over 80 years of age and those who are over 65 and living with frailty. Evidence suggests geriatrician-led comprehensive geriatric assessment (CGA) may improve post-operative outcomes, but only 8% received one between 2019-2020 in our Trust (national average 27%). The aim of this project was to create a standardised referral system between general surgeons and ageing and complex medicine (ACM) team

Introduction Pain is a major concern in cognitively impaired patients. Communication challenges contribute to poor recognition and undertreatment, negatively impacting prognosis and quality of life. The National Dementia Audit highlighted that structured pain assessment for people with dementia admitted to hospitals remains a significant area for improvement. The PAINAD (Pain Assessment in Advanced Dementia) scale aids in structured pain recognition through objective assessment. We implemented a quality improvement project aiming to improve PAINAD utilisation in inpatient geriatric wards

Background The NHS 10 year plan outlines the ambition to shift care from a Hospital centric model, to integrated community based systems, but little is known about how to implement this change. The integrated frailty crisis multidisciplinary team working across acute and community settings were motivated to improve services but lacked the confidence/knowledge to lead quality improvement (QI). A whole pathway QI practitioner development programme was established with projects aligned to the overarching system strategy to embed the change. Methods A structured training and coaching programme was

Introduction Indwelling urinary catheters are commonly used in hospitalised adults. Measuring bags, while necessary for fluid monitoring in specific cases, are often used by default without clear indication. This can restrict mobility, affect dignity, and contribute to functional decline in patients with preserved mobility. This project aimed to evaluate the usage of urine collection systems and their impact on patient well-being and improve the usage of less restrictive leg bags where appropriate. Methods QIP was conducted on medical wards at two hospital sites. Cycle 1 (Jan–Feb 2024)

Introduction Out-of-hours (OOH) services provide emergency primary care outside normal GP hours, serving patients with higher health needs. Delirium affects 25% of hospitalised older adults, causes distress to patients and carers, and leads to poor outcomes. However, little is known about delirium presentations and prevalence in OOH services. We aimed to investigate delirium occurrence and management using case records from an OOH service in South-West England. Methods The OPEN database contains 33,345 consultations of patients ≥65 attending the OOH service between April 2019–March 2020. We

Title: Therapists’ perspectives on a new Structured Tailored approach to Rehabilitation AfTer HIp FragilitY Fracture – the Stratify Feasibility Randomised Controlled Trial. Background: The stratify feasibility randomised controlled trial explored a risk-stratified rehabilitation intervention, where patients with hip fracture were categorised as low, medium, or high risk of poor outcome and received tailored interventions accordingly. This qualitative study aimed to understand therapists’ views on the acceptability of the approach, as well as barriers and facilitators to its implementation, to

Introduction: Delirium is a common and serious presentation in older inpatients, associated with increased risk of mortality and long term cognitive impairment. Drugs with anticholinergic properties (DAPs)have been linked to poorer cognitive outcomes, and anticholinergic burden may contribute to the development of delirium. This study explores whether higher Anticholinergic Burden Scale (ACB) scores are associated with delirium in older inpatients referred to Old Age Liaison Psychiatry (OALP) at Nottingham University Hospitals (NUH). Method: All inpatients aged 65 or older referred to OALP at

Intro: Decompensated heart failure is a common acute presentation to hospital amongst the frail older population where treatment often involves intravenous furosemide. Whilst this is effective in inducing a diuresis, it can be associated with negative effects of hospital stay such as hospital-associated infections and deconditioning. Continuous subcutaneous infusion (CSCI) of furosemide is well-established as a palliative treatment for end-stage heart failure and there is growing evidence that CSCI Furosemide is as safe and effective as intravenous in the management of acute episodes of

Introduction: People with deafness or hearing loss (PDHL) face substantial communication barriers within the UK’s National Health Service (NHS), leading to reduced access to care, lower engagement with services, and poorer health outcomes. Deafness can affect anyone, but acquired hearing loss increases in prevalence and severity with age. A multidisciplinary working group comprising patients, clinicians, researchers, and charity representatives was formed to explore accessibility, communication practices, and deaf awareness across NHS services. Method: A cross-sectional survey assessed the

Effective communication is essential in delivering quality, patient-centred care, yet older inpatients frequently encounter barriers arising from sensory impairment, cognitive decline, and complex co-morbidities1. Evidence suggests inadequate communication contributes to reduced patient satisfaction, delayed discharges and avoidable readmissions2,3. Within local elderly care wards, observations indicated patients often lacked understanding of their diagnoses and were not engaged in decision-making. This project sought to evaluate existing communication practices during ward rounds and

Introduction: This quality improvement project (QIP) was conducted in a busy Emergency Department (ED) in South Wales (Grange University Hospital (GUH)), as part of efforts to improve safety for older patients. Our ultimate goal is to reduce unnecessary re-admissions, as hospital stays can cause rapid deconditioning in older patients. Patients aged over 65 account for 25% of ED attendances (Emergency Care Data Set, 2024). It is well documented for this subset of patients that good handover is crucial to improving overall standards of care, and continuity of care into the community. Standard

Background Frailty is a poor prognostic indicator following cardiopulmonary resuscitation (CPR). Discussions about Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions are often contentious. While existing research focuses on patients’ and relatives’ perspectives, there is a lack of in-depth studies exploring clinicians' experiences of DNACPR discussions. This study aims to explore how clinicians' personal and professional beliefs and experiences influence their approach to DNACPR conversations with frail, older adults. Methods Ninety clinicians from primary and secondary care

Title: Ageing with Confidence; A QI project on Urinary Incontinence Assessment Introduction: UI is a common yet underdiagnosed geriatric problem with a UK prevalence of >20% in individuals aged over 65. Despite its high prevalence, UI often remains untreated negatively impacting the quality of life. Objectives: This project aimed to raise awareness and improve patient outcomes by introducing a standardised urinary incontinence (UI) assessment proforma to aid early recognition and management of UI among elderly patients admitted to the COTE ward in a district general hospital. Methods: A