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A study on antipsychotic medication prescription in elderly patients in Royal Gwent Hospital.

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K Dineshkumar , D Duric, EB Peter
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Introduction -The use of anti-psychotics is higher in older people than their younger adult counterparts due to high prevalence of dementia/delirium. Anti-psychotic drugs cause side effects which include cardio vascular, metabolic, extra pyramidal and high risk of falls. So, we set out to do a QIP on antipsychotic medication prescription on our Geriatric wards and compared it with NICE guidelines. Method- We had 2 approaches to use. Firstly, we prepared a check list for anti-psychotic medication monitoring according to NICE guidelines 2021 and we applied this retrospectively to 17 patients who

Application of STOPP/START criteria to reduce polypharmacy among Elderly patients: a Geriatric medicine ward-based clinical audit

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Vipuli Jayendra Kobbegala , David Oliver , Hannah Johnson .
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Introduction: The number of older adults has been constantly growing around the world. Chronic disease occurrence and concurrency increase with age, and medication use rises correspondingly. The World Health Organisation (WHO) defines multi-morbidity as the “ co-occurrence of two or more chronic medical conditions in one patient.” The most commonly used definition of Polypharmacy is “taking co-currently five or more medications daily by an individual.” Polypharmacy is associated with increased mortality, falls, adverse drug reactions, hospital stay, readmission, and medication costs. STOPP

Enhancing Heart Failure Management in Geriatric Patients: A Tertiary Hospital Study and the Growing Significance of SGLT2 Inhibitors

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P Jeganathan, A Sanz-Cepero
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The 2022 national heart failure audit noted, "Older patients are less likely to access diagnostics, lifesaving drugs, and specialist care.” Additionally, there is evidence suggesting that they are less frequently initiated on disease-modifying drugs (DMD). The National Institute for Health and Care Excellence (NICE) supports the use of SGLT2 inhibitors for those with heart failure with reduced ejection fraction (HFrEF). However, this has recently expanded to those with preserved ejection fraction (HFpEF). This is significant for elderly heart failure patients as SGLT2 inhibitors offer a

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ReSPECT form completion - A quality improvement project reviewing the accuracy and completeness of ReSPECT form documentation and DNACPR decisions

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Jennifer Tucker
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Background: Clear and accurate documentation of a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision is vital to ensure patients receive appropriate care and autonomy regarding their end-of-life management. Inaccuracies or omissions allow potential for unnecessary or harmful interventions to occur. Aims/Objectives: To produce ≥20% improvement in accuracy and overall completion of all sections of respiratory inpatient ReSPECT forms, with particular focus on DNACPR decisions, during a four-month respiratory

The future of research: Participant perspectives on remote trial delivery

Authors' names
W Milczanowska1; RCE Bowyer2,3; MP García2; S Wadge2; AF Baleanu2; A Nessa2; A Sheedy2; G Akdag2; D Hart2; K Whelan4; CJ Steves2; M Ni Lochlainn2
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Introduction The PROMOTe trial was conducted entirely remotely, which aimed to enable a wider recruitment of participants, minimise risk of Covid-19 exposure and adhere to former travel restrictions. Participant experiences with remote clinical trials are not well understood. This work aimed to characterise participant perspectives on the remote delivery of the PROMOTe trial. Methods The trial involved remote measurement of short physical performance battery and grip strength, and remote collection of stool, urine, saliva, and capillary blood. Equipment including a dynamometer was posted to

Effect of Early Intervention By Physiotherapy And Occupational Therapy On Older Inpatient Population

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S. Kotak, Physiotherapist; C. Miller, Consultant Geriatrician
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Effect of Early Intervention By Physiotherapy And Occupational Therapy On Older Inpatient Population S Kotak 1, C Miller 2 1 Senior Physiotherapist, University Hospitals of Leicester NHS Trust 2Consultant Geriatrician, University Hospitals of Leicester NHS Trust Background: Currently, on inpatient medical wards at University Hospitals of Leicester NHS Trust, the first contact by therapy teams (physiotherapy and occupational therapy) is made when patients become medically optimised for discharge. This is due to a number of reasons such as staffing and resource shortages. Aim: Analyse the

Development of a Frailty memory service - improving access to dementia diagnosis with focus on admission avoidance.

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M McCarthy; C O'Donnell
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Introduction: The Community Geriatrician team based at the Countess of Chester Hospital is a multidisciplinary team offering comprehensive assessments at home to older patients with frailty. The team review frail patients identified as being at risk of hospital admission. Cognitive impairment and dementia are increasingly common concerns in our patient group and significant risk factors for admission. Frail patients often struggle to access traditional memory clinics for a variety of reasons and can therefore remain undiagnosed. They often require a more holistic approach in their home

Increasing number of deaths related to Parkinson’s disease (PD) and Parkinsonism

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V Adhiyaman, P Hobson
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Introduction The burden of PD has exponentially risen from 2.5 million in 1990, to 6.1 million in 2016 (PD Collaborators. Lancet Neurol. 2018; 17(11):939-53). This is due to ageing population, increased longevity, increased duration of the disease and improved diagnosis. The aim of our study was to identify the trend on deaths related to PD and Parkinsonism over the last decade. Methods We collected our data from the Office of the National Statistics, using codes G20 (PD), G21 (Secondary Parkinsonism) and G22 (Parkinsonism classified elsewhere), to extract the number of deaths coded under

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'Three sides to every story'- Living the patient, carer and staff experience of COVID

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Sarah Ramsey1; Helen Hurst2; Michelle Briggs3; Lauren Wentworth1
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Introduction When COVID-19 first entered our world in March 2020 and the country went into lock down the NHS braced itself for one of its biggest challenges of this century. Older, frail patients were in the highest risk group, with those in care homes not only at higher risk of death, but higher risk of contracting COVID-19, often suffering more psychological disturbances (Hewitt et al., 2020; Numbers & Brodaty, 2021). This study was conceived by two nurse researchers working throughout the pandemic on a COVID ward for predominantly older people, aiming to capture the experiences of patients

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Dogs and Bones

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L Williams, N Nyunt, R Davies, V Adhiyaman
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Introduction The health benefits of owning dogs include improved physical activity, mental well-being, companionship, and so forth. However, musculoskeletal injuries caused by dog-related activities might negate the aforementioned benefits. The aim of this study was to estimate the number of femoral fractures directly linked to dog-related activities in people above the age of 60. Methods In this observational study, we included all patients above the age of 60 with femoral fractures caused by dog-related activities, over a one-year period (June 2022 to May 2023). We chose to include people

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Working as a Multidisciplinary Team to Reduce Weight Loss - a Quality Improvement Project to Improve Nutrition In Older Patients

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Dr Charlotte Newman, Dr Lucy Wright
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Introduction Weight loss is common during acute hospital admissions, and can be devastating to the older patient where weight loss is associated with an increase in mortality over a 12 month period. Patients who lack the ability to communicate their food preferences are at risk of receiving food they do not like, especially as food orders are often taken when family/carers are not present. Methods While working on a Department of Medicine for Older People and Stroke (DMOPS) ward, we worked with the Multidisciplinary team (MDT) with the aim of reducing weight loss. We implemented two

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Improving Delirium Awareness and Screening

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Aaron Lau, Musaab Ahmed
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The 4AT Score is a simple tool recommended by NICE to help detect Delirium in everyday practice. In QEH Gateshead, clerking sheets include this score however it is frequently missed by admission doctors. Our QIP standard was that all patients >65 should be screened for Delirium in accordance with NICE Guidance and to improve this. Clerking sheets were audited to assess completion of 4AT scores. Improvement Methodology included prompt cards on working computers, posters in handover rooms, verbal reminders and quick teaching after morning handover. Run charts shows improvement in patients >65

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MULTIFACTORIAL ANALYSIS IN A COHORT OF LATIN AMERICAN GERIATRIC PATIENTS WITH SARSCOV2 INFECTION AND SUBSEQUENT DEVELOPMENT OF HEART FAILURE

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Estévez M1;Dulcey L1;Castillo S1;Acevedo D1;Gutierrez E1;Lizcano A1; Arias A1
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Introduction: Infection caused by the SARS-CoV-2 has been found to have serious consequences for the cardiovascular system. Among these, the development of heart failure (HF) has been stipulated; however, its causality has not yet been established. Therefore, the purpose of this study is to evaluate the role of clinical and laboratory parameters in determining the risk of developing HF in patients infected with SARS-CoV-2. Methodology: 151 electronic medical records were taken from hospitalized patients with confirmed SARS-CoV-2 infection and pneumonia, from 03/11/20 to 10/02/21. HF was

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Results of a pilot comprehensive rehabilitation program in geriatric patients from a South American hospital

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Dulcey L1; Theran J2; Caltagirone R3; Gomez J1; Pineda J1; Amaya M1; Quintero A4; Ciliberti M1; Blanco C1; Lizcano A1; Gutierrez E1; Estevez M1; Acevedo D1; Castillo S1; Vargas J1; Esparza S2; Hernandez C1; Mateus D1; Lara J1; Velasco M1; Rueda N1
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Introduction: COVID-19 disease can cause a wide variety of long-term health problems, such as impaired lung function, reduced exercise performance, and decreased quality of life. Our study aimed to investigate the efficacy, feasibility, and safety of pulmonary rehabilitation in patients with COVID-19 and to compare the results between patients with a mild/moderate and severe/critical course of the disease. Materials and Methods: Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive pulmonary rehabilitation program were included in this

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Barriers percieved by medical students when considering a career in geriatric medicine

Authors' names
Grace Fisher (1), Sarah True (2)
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Introduction Despite the UK’s increasing life expectancy, and increase in the elderly population, there is an overwhelming lack of Geriatricians in the UK; as of 2022, there is only 1 consultant Geriatrician per 8,031 individuals over the age of 65 (BGS, 2023). To meet the complex care needs of this population, there must be a focus on increasing the interest that doctors have towards Geriatric Medicine, with the overall aim being to recruit more doctors into the speciality. Method The aim of this review was to investigate what factors medical students perceive as barriers to pursuing a career

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Related risk factors for the development of dysphagia in geriatric patients in a South American cohort with COVID-19 infection

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Ciliberti M1; Blanco C1; Dulcey L1; Theran J2; Caltagirone R3; Gomez J1; Pineda J1; Amaya M1; Quintero A4; Lizcano A1; Gutierrez E1; Estevez M1; Acevedo D1; Castillo1; Vargas J1; Esparza S2; Hernandez C1; Mateus D1; Lara J1; Velasco M1; Rueda N1, Ramos V1
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Introduction: The appearance of dysphagia after intubation in COVID 19 patients is very frequent, however there are few studies carried out in this regard. Methods: Retrospective study of 306 adults infected by SARSCOV2 by antigenic or molecular test. The main objective was to evaluate the risk factors involved in the appearance of dysphagia after intubation. Results: There was a higher frequency of COVID 19 in the Male gender 78% in relation to the Female 22%, the time of mechanical ventilation greater than 14 days was a factor with a high association, as well as the appearance of pneumonia

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Role of oximetry in the CURB65 in geriatric patients with pneumonia from a Latin American hospital.

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Ciliberti M1; Blanco C1; Dulcey L1; Theran J2; Caltagirone R3; Gomez J1; Pineda J1; Amaya M1; Quintero A4; Lizcano A1; Gutierrez E1; Estevez M1; Acevedo D1; Castillo1; Vargas J1; Esparza S2; Hernandez C1; Mateus D1; Lara J1; Velasco M1; Rueda N1, Ramos V1
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Introduction: The use of pneumonia scores to stratify the prognosis is very useful in general terms, since it allows objectively evaluating the risks in these patients. Methods: mixed type open study, first cross-sectional phase Test vs. Test, second phase follow-up at 8 and 30 days. Carried out between November 2017 and April 2018. The main objective was to determine the usefulness of pulse oximetry as a substitute for urea of the CURB 65 score in the evaluation of the severity of pneumonia in geriatric patients. Results: 65 patients, gender distribution was comparable, the main age group was

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Factors involved in morbidity and mortality due to hip osteoporotic fracture in a South American geriatric cohort.

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Lizcano A1; Ciliberti M1; Blanco C1; Dulcey L1; Theran J2; Caltagirone R3; Gomez J1; Pineda J1; Amaya M1; Quintero A4; Gutierrez E1; Estevez M1; Acevedo D1; Castillo1; Vargas J1; Esparza S2; Hernandez C1; Mateus D1; Lara J1; Velasco M1; Rueda N1; Ramos V.
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Introduction: Mortality after a hip fracture increases compared to the general population. The main objective of this study is to examine the incidence, trends, and factors associated with mortality in patients with osteoporotic hip fractures. Methods: This is a retrospective cohort study from a South American hospital. Patients older than 65 years with osteoporotic hip fracture between 2015 and 2018 were identified. Demographic data and comorbidities were obtained. The incidence rate, standardized mortality rate, trend (Poisson regression), and risk (hazard ratio) were calculated. Results: A

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Establishing a national network of trainee representatives in geriatric medicine higher specialty training

Authors' names
1.Dr Sarah True; 2.Dr Victoria O'Brien
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Introduction : This study demonstrates how a network of geriatric medicine trainee representatives was established across the UK. The intention of the network was threefold: accurately represent the interests of trainees by gathering national feedback, develop a job description of deanery trainee representatives and create a community of practice between representatives. Method: Deanery trainee representatives were identified through TPDs then contacted to participate in an online questionnaire which also consented for whatsapp group invitation. Results: Deanery representatives were identified

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Risk predictors during 90 days of follow-up in geriatric patients with asthma and SARSCOV2 infection

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Gutierrez E1; Dulcey L1; Theran J2; Caltagirone R3; Gomez J1; Pineda J1; Martinez J1; Amaya M1; Quintero A4; Ciliberti M1; Blanco C1; Lizcano A1; Gutierrez E1; Estevez M1; Acevedo D1; Castillo1; Vargas J1; Esparza S2; Hernandez C1; Mateus D1; Lara J1.
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Introduction: Since the first wave of COVID-19, caused by SARS-CoV-2 virus, we have sought to identify possible short- and long-term complications, the so-called "post-discharge syndrome", especially in patients at higher risk, after prolonged hospitalization and intensive care. Objective: The aim of the study was to study the outcomes, possible adverse consequences after severe COVID-19 illness and its predictors in the 90-day post-hospitalization stage in elderly patients with asthma. Methodology and Results: We conducted a longitudinal observational study including 131 patients older than

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