Browsing by Subject "aged"
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Item An In-Home Advanced Robotic System to Manage Elderly Home-Care Patients’ Medications: A Pilot Safety and Usability Study(Clinical Therapeutics, 2017-05) Rantanen, Pekka; Parkkari, Timo; Leikola, Saija; Airaksinen, Marja; Lyles, AlanABSTRACT Purpose: We examined the safety profile and usability of an integrated advanced robotic device and telecare system to promote medication adherence for elderly home-car e-patients. Methods: There were two phases. Phase I aimed to verify under controlled conditions in a single nursing home (n ¼ 17 patients) that no robotic malfunctions would hinder the device’s safe use. Phase II involved home-care patients from 3 sites (n ¼ 27) who were on long-term medication. On-time dispensing and missed doses were recorded by the robotic system. Patients’ and nurses’ experiences were assessed with structured interviews. Findings: The 17 nursing home patients had 457 total days using the device (Phase I; mean, 26.9 per patient). On-time sachet retrieval occurred with 97.7% of the alerts, and no medication doses were missed. Atbaseline, PhaseII home-dwelling patients reported difficulty remembering to take their medicines (23%), and 18% missed at least 2 doses per week. Most Phase II patients (78%) lived alone. The device delivered and patients retrieved medicine sachets for 99% of the alerts. All patients and 96% of nurses reported the device was easy to use. Implications: This trial demonstrated the safety profile and usability of an in-home advanced robotic device and telecare system and its acceptability to patients and nurses. It supports individualized patient dosing schedules, patient–provider communications, and on-time, in-home medication delivery to promote adherence. Real time dose-by-dose monitoring and communication with providers if a dose is missed provide oversight generally not seen in homecare.Item Symptoms Associated with Long-term Benzodiazepine Use in Elderly Individuals Aged 65 Years and Older: A Longitudinal Descriptive Study(International Journal of Gerontology, 2015) Vaapio, Sari; Puustinen, Juha; Salminen, Marika J.; Vahlberg, Tero; Salonoja, Maritta; Lyles, Alan; Kivela, Sirkka-LiisaBackground: Recent epidemiologic studies have shown that the use of psychotropics is associated with many symptoms and may result in dependence and tolerance among elderly individuals. The aim of this study was to describe the symptoms related to withdrawal or dose reduction of long-term benzodiazepine (BZD) or BZD-related drugs (RDs) use and to compare them with nonuse of these drugs in community-dwelling individuals aged 65 and older. Methods: The study was a post hoc analysis embedded in a 12-month randomized, controlled fallprevention trial that included withdrawal of BZDs and RDs. The participants (n ¼ 248) in the intervention group were divided into the following four groups according to their use of BZDs/RDs at baseline and follow-up: (1) withdrawal (WG), (2) reduction (RG), (3) unchanged (UG), and (4) nonusers (NUG). Differences in symptom changes were compared between and within these four groups. Results: Using BZD/RD was associated with numerous symptoms at baseline and during the intervention. At follow-up, those symptoms reduced significantly among all participants. However, there were no significant differences between the groups in the changes of symptoms during the follow-up. Selfperceived health improved in only NUG (p < 0.001), but not in the other groups (WG, RG, and UG). Conclusion: Withdrawal or reduction of BZD/RD produced positive effects on physical, psychological, or cognitive symptoms among all participants, but no differences between the groups were detected. We recommend that clinical goals should be carefully assessed against the risks of long-term BZD/RD use, and that withdrawal interventions should be initiated for community-dwelling users aged 65 and older, especially those long-term users who may already be experiencing adverse drug effects.