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Factors impacting retention in rehab RCTs with community dwelling older people with frailty: systematic review and meta analysis

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M Prescott1; JA Adamson2; CE Hewitt2.
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Introduction: The UK and global life expectancy is increasing, but life years lived in ill health is also increasing. Disease burden, and health and social care service use is highest in older age. Prevention, treatment and management of conditions of older age (e.g. frailty and multi-morbidity) is a research priority. Efficient trials need to better recruit and retain older participants to produce robust and generalisable evidence for our aging population. Synthesised qualitative and quantitative evidence regarding trial retention does not generally include the oldest and frail in society
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The Case for Space:  Does a dedicated Frailty Same Day Emergency Care (F-SDEC) unit improve the impact of an acute frailty team? 

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Catrin Kunemund-Hughes1, Emily Tridimas2, Grace Walker3
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Background: National and local standards in acute frailty recommend a seven-day service, with front-door assessment and a dedicated frailty area. Many acute frailty teams struggle to maintain a dedicated space as they are vulnerable to becoming inpatient areas when bed pressures increase. The Acute Older Persons Unit (AOPU) at Guys and St Thomas' has faced similar challenges and is based on the Acute Admissions Ward and the Emergency Department. This project assessed whether a dedicated Acute Frailty SDEC (F-SDEC) space increased the number of patients seen and the number of same-day

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Intersectional Risks and Adverse Drug Events in Older Adults: A Scoping Review

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Fatima Sabir1,2; Alishba Z. Hussain2,6; Jenni Murray2; Oliver Todd5,6; Muhammad Faisal2,3,4; David P. Alldred1,2
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Introduction Adverse drug events (ADEs) in older adults contribute to preventable harm, hospitalisation, and health inequalities. While age-related physiological changes affecting drug safety are recognised, less attention is given to how sociodemographic and structural factors such as ethnicity and deprivation jointly shape vulnerability to ADEs. This limits the development of equitable medication safety strategies. This review examines how intersectional risks are conceptualised and analysed in ADE research to inform more inclusive approaches to medication safety. Method A scoping review was

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Digital CGA: Innovation, Implementation, and Audit-Driven Evaluation

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Emma Hibbs
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Introduction The Comprehensive Geriatric Assessment (CGA) is the gold standard for managing frailty in older adults, with strong support in the literature. However, gaps remain in the evaluation of electronic CGA's (eCGA's) and standardised implementation. The Frailty Intervention Team at Sandwell and West Birmingham delivers multidisciplinary care via CGA, but prior to intervention, assessments were often incomplete, with baseline compliance at just 23%. This was largely due to the absence of a user-friendly, embedded electronic solution. Method A root cause analysis identified key barriers

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Preventing future fractures; Increasing compliance to National Osteoporosis Guidelines in a Surrey General Practice

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Amy Forrest1 Narmina Chamedova2
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Introduction Osteoporosis is systematic skeletal disorder causing low bone mass, which increases pre-disposition to fractures. In older adults, fragility fractures are usually the first presentation of this. National Osteoporosis Guidelines Group (NOGG) have published evidenced-based guidelines for identifying and managing bone health in the over 50’s, however compliance can be variable. Methods An EMIS search was conducted of patients at the Surrey practice which identified 46 patients over 50 years old (25 of which were over 70 years old) who had been coded as having had a fragility fracture
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Building better bones, a quality improvement project to enhance bone health in the older person’s unit

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A Sweeney1; A Sowah1; A Arora1; S Rehman1,2; M NiLochlainn1,3;
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Introduction: Fragility fractures can have a profound impact on older adults’ quality of life. Optimising bone health by checking vitamin D level, FRAX score, and actioning outcomes provides a cost-effective strategy for reducing the incidence of these fractures. Our aim therefore is to promote awareness and undertaking of bone health assessments in the Older Persons Unit (OPU) Methods: This was a pre-post cross-sectional study. Data was collected from 212 patient records over two separate days, one month apart. Patients admitted to the OPU at St Thomas’ Hospital were included and data was
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Understanding patient experience on the Older Person's Acute Medical Unit (OPAMU) and the acute frailty pathway at UHW.

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T Parkin1; S Lewis2
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Introduction: The older population are more likely to suffer from chronic diseases, requiring more frequent hospital admissions, therefore, in University Hospital of Wales there is a dedicated Older Persons Acute Medical Unit (OPAMU). The OPAMU, opened in 2023, admits frail patients directly from the Emergency (ED) and Acute Medicine (AM) Departments for comprehensive geriatric assessment before discharge or onward hospital stay. Main objective: To understand how our patients felt throughout different steps of their journey to the OPAMU. Secondary objective: To assess how the patient

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Improving the Weekend Handover Process on Older Adults Medicine Wards at Leeds Teaching Hospitals

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E Brew1, R Ambar1, J Burnham1, K Russell1, A Hussain1, F Bennett1, E Ball1, P Khan1, S Ninan1
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Introduction Clinicians covering six older people’s medicine wards reported feeling burdened by requests for weekend review of patients without clear indications, reducing time for patient care. We aimed to standardise the process to streamline reviews, freeing up clinicians to deliver optimal care. Methods We developed a new electronic weekend handover process using existing capabilities within our electronic patient record. The COM-B behaviour change method was used with a focus group of clinicians including PAs, residents and consultants to identify targets to change behaviour. Fifteen

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Satisfaction with Shared Decision Making and Decision Regret in Older Adults Undergoing Elective Colorectal Cancer Surgery

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Dr C Whitear 1, Dr M Sun Wai 1, Dr M Kaneshamoorthy 1, Dr J Jegard 1
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Introduction: Involvement of Geriatricians in peri-operative assessment acknowledges the altered physiology of frail patients and helps to evaluate realistic outcomes as part of patient-centred shared decision making. This is with the aim of addressing modifiable risk factors, preventing complications, preparing for a realistic recovery and ensuring that treatment options are aligned to what is important to the patient. There is data suggesting improved survival following geriatric peri-operative assessment but little analysis from the patient’s perspective; their thoughts about the shared

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Setting the Research Agenda for Co-existing Dementia and Hearing Conditions: A James Lind Alliance Priority Setting Partnership

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Eithne Heffernan1,2,3; Sian Calvert2,3; Tom Dening3; Emma Broome2,3; Ruth V Spriggs2,3; Nahid Ahmad4; Natalie Lerigo-Smith2,3; Helen Henshaw2,3
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Introduction: Dementia and hearing conditions are both major public health concerns. Most people living with dementia also live with hearing conditions (e.g., hearing loss, vestibular disorders, hyperacusis). Furthermore, evidence suggests that hearing loss is a risk factor for the development of dementia. There is a critical need for research to explain the association between dementia and hearing conditions and to optimise assessments and interventions for this co-morbidity. This James Lind Alliance Priority Setting Partnership (JLA PSP) aimed to identify unanswered research questions about
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Standing Up to Deconditioning: A Multidisciplinary Approach to Enhancing Patient Mobilization

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MOE MOE SAN1; SHWE ZIN MYAT SAN2; SIDAK HANSPAL3; HIND ABDELRAHMAN4
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Introduction: Deconditioning, the progressive loss of physical and functional capacity during hospital admission, is a well-recognized but often under-addressed risk factor for poor patient outcomes. It can lead to increased dependency, delayed discharge, and higher rates of hospital-associated complications. Despite its importance, barriers such as invasive lines, limited staff awareness, and entrenched ward routines often prevent patients from engaging in early mobilization. Objective: Our quality improvement project sought to evaluate whether small and simple, multidisciplinary
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Improving outcomes in fragility fractures: integrating bone health into the acute medical unit

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H Donnelly1; S McDonald1; C Henderson1; A Joseph1; F O'Kane1
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Introduction Fragility fractures are a frequent presentation to the acute medical take. Defined as a fracture following a fall from standing height or less[1], they represent up to 10% of acute admissions. Despite this, we identified no standardised protocol for commencing bone protection in our unit. Our project aimed to improve the management of bone health in this cohort. Methods Data was collected across an 18-week audit cycle, with 6 weeks of baseline data collected prior to any interventions. Patients with radiologically proven fractures sustained from standing height or less were
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Implementing Frax based Osteoporosis Risk stratification across Geriatric wards in St Cross Hospital Rugby

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J Odia1 ; M Siddiqui1; J Boylan1; S Gurijala1 ;H Unnikrishnan1
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Introduction: Osteoporosis affects approximately 3.5 million individuals in the UK, with prevalence increasing with age—particularly among women over 75. Hip fractures carry a one-year mortality rate of nearly 33%, underscoring the importance of primary prevention over reactive treatment. However, many elderly patients do not proactively engage with their GP regarding bone health. Objective: This audit aimed to Identify elderly inpatients at elevated risk of osteoporotic fragility fractures using the FRAX tool Communicate these findings to their GPs to support early intervention. Methodology
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Enhancing Delirium Documentation at the Hospital-Community Interface

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C Wong1; H Freeman1; S Rizwan1; S Reddy1
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Introduction Delirium is common in older inpatients and associated with cognitive decline, underlying dementia, and mortality. NICE recommends that current or resolved delirium diagnosis is communicated to general practitioners (GPs) upon discharge. A 2021–22 quality improvement project at Lister Hospital improved the delirium assessments consistently to over 95% across the Trust. However, this study found that only 25% of delirium cases were documented in discharge letters. This gap poses significant risks to patient safety, as unresolved delirium may be overlooked, and underlying dementia

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Enhancing Delirium Documentation at the Hospital-Community Interface

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C Wong1; H Freeman1; S Rizwan1; S Reddy1
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Introduction Delirium is common in older inpatients and associated with cognitive decline, underlying dementia, and mortality. NICE recommends that current or resolved delirium diagnoses are communicated to general practitioners (GPs) upon discharge. A 2021–22 quality improvement project at Lister Hospital improved the delirium assessments consistently to over 95% across the Trust. However, this study found that only 25% of delirium cases were documented in discharge letters. This gap poses significant risks to patient safety, as unresolved delirium may be overlooked, and underlying dementia

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Improving the appropriateness of polypharmacy reviews during hospital admissions: A three-stage retrospective quality improvement project 

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Emily George 1, Alisha Maini 2, Đula Alićehajić-Bečić 3
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Introduction: Inappropriate polypharmacy is the use of medications with no evidence-based indication, unmet treatment goals, high risk of adverse drug reactions, or when the patient is unwilling / unable to take treatment as intended. This is particularly concerning in geriatric care, due to increased risk of hospital admissions, adverse drug reactions and significant healthcare costs. To address these risks, clinicians should conduct patient-focused medication reviews. This project aimed to assess and improve polypharmacy reviews at Royal Albert Edward Infirmary (RAEI), with a focus on

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Feasibility of a culturally adapted picture description task as a measure of cognition within the older adult population of Hai

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R F Strasenburgh1; L Wright1; J Boshe2; J C Bews1; A Kisoli2; G Saria3; B Mbwele4 5; L Fotheringham1; T Young1; B G Mwahi4 5; Z Zakayo4 5; F Ilaza4 5; B Doligo4 5; R Kalaria1; R W Walker1; S-M Paddick1
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Introduction Dementia is an increasing global health problem. Picture description tasks are a useful tool to assess semantic-based language deficits, which can occur during later stages of dementia. There is a paucity of research regarding culturally appropriate picture description tasks within sub-Saharan Africa. Aim Develop a culturally adapted picture description task and scoring method and evaluate its feasibility as a cognitive measure in two rural communities in the Hai district of Kilimanjaro, Tanzania. Methods An adaptation of a widely used picture description task was developed using
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Polypharmacy, Severe Mental Illness And Impaired Mobility In Multiple Long-term Health Conditions: A Scoping Review

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Lucas Mannion1, Kate Best2, Linda Birt1, Firoza Davies3, Helen Dawes4, Emma L. Giles5, Matthew Jones6, Suzy Ker7, Naomi Launders8, Thomas Payne9, Emma Proctor5, Sion Scott1, Thomas Woodcock10, Bethan Hickey1, Sian Jenkins1, Jasmine Mankoo6, Lucy Beishon1
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Introduction Multiple long-term health conditions and multimorbidity (MLTC-M) disproportionally impact older people. Literature highlights associations between polypharmacy, mobility issues, and severe mental illness and MLTC-M. Co-existence of polypharmacy, mobility issues, and severe mental illness with MLTC-M may impact on older people’s health outcomes, however the extent to which these have been explored is unclear. Aim This scoping review aimed to describe the evidence regarding interventions and outcomes associated with the intersection of polypharmacy, mobility issues, and severe
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Utilising Epic to develop a dashboard to drive improvement in care of the older person undergoing vascular surgery in Manchester

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E Robertson, S Mather, J Alldred , N Tollemache
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Introduction: Manchester Vascular Centre (MVC) is one of the largest Arterial Centres in the UK. It serves approximately 2 million people. Older people who are living with frailty are at increased risk of perioperative complications. Perioperative care for Older People undergoing Surgery (POPS) can reduce incidence of these complications by providing Comprehensive Geriatric Assessments (CGA) (Partridge et al 2017). In Manchester Royal Infirmary, the Older Person Assessment and Liaison (OPAL) team have been providing CGAs for older people living with frailty undergoing surgery. Manchester

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Improving the Safety and Continuity of Care for Patients on Apomorphine: A Three-Cycle Quality Improvement Project3712

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Cheng Khuang Lim1; Roberta Dewar1; Fern Gibbon2;Carol Miller2
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Improving the Safety and Continuity of Care for Patients on Apomorphine: A Three-Cycle Quality Improvement Project Cheng Khuang Lim1; Roberta Dewar1; Fern Gibbon2;Carol Miller2 Salford Care Organisation, Northern Care Alliance Background: Delays in the administration of dopamine agonists in patients with Parkinson’s disease can lead to serious patient safety incidents, and transitions of care are a critical period during which medication errors are especially likely to occur. Introduction: Apomorphine is a potent dopamine agonist used as an adjunct therapy in the management of advanced
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