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Article ; Online: Exploring what matters to residents of Australian aged care facilities with the Happy Life Index: comparison of qualitative responses between pre- and mid-Covid-19 pandemic time points.

Murray, Carolyn M / Milanese, Steve / Guerin, Michelle / Bilton, Rebecca / Baldock, Katherine L / Parfitt, Gaynor

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation

2023 Volume 32, Issue 8, Page(s) 2247–2257

Abstract: Purpose: This study analysed data from a national survey of people living in Australian Residential Aged Care Facilities (RACFs) reporting on what is the best thing about where they live and suggestions for improvement. Data from prior to the Covid-19 ... ...

Abstract	Purpose: This study analysed data from a national survey of people living in Australian Residential Aged Care Facilities (RACFs) reporting on what is the best thing about where they live and suggestions for improvement. Data from prior to the Covid-19 pandemic were compared with data during the Covid-19 pandemic. Methods: Qualitative data from the Happy Life Index Survey were analysed using summative content analysis to code the responses in the data sets and then organise them into categories. Once categorised, the pre-Covid-19 and mid-Covid-19 data sets were compared using descriptive statistics. Results: A total of 4745 residents, from over 100 RACFs, provided 8512 open-text responses to at least one of the two survey questions. Pre-Covid-19 responses were compared with mid-Covid-19 responses and those trending towards relevance (5-10% change) were identified. There were both positive and negative relevant percent changes for staff number, food (general comments), and friendliness. A trending positive percentage change was observed for staff quality and the internal environment. There was a trending negative relevant percentage change for lifestyle activities, staff generally, level of contentedness, the general environment, general choice, and general views about the service. Conclusion: People living in RACFs notice the changes in staffing levels and visitors during restrictions imposed during infectious outbreaks. During these times, they appreciate the quality of the staff attending to their needs and the quality of their food. Further exploration is needed of the value of lifestyle activities and strategies to promote feelings of contentedness and general wellbeing during times of restriction.
MeSH term(s)	Aged ; Humans ; Australia/epidemiology ; COVID-19/epidemiology ; Pandemics ; Quality of Life/psychology ; Homes for the Aged
Language	English
Publishing date	2023-03-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1161148-0
ISSN	1573-2649 ; 0962-9343
ISSN (online)	1573-2649
ISSN	0962-9343
DOI	10.1007/s11136-023-03387-0
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Article ; Online: The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study).

Hibbert, Peter D / Molloy, Charlotte J / Cameron, Ian D / Gray, Leonard C / Reed, Richard L / Wiles, Louise K / Westbrook, Johanna / Arnolda, Gaston / Bilton, Rebecca / Ash, Ruby / Georgiou, Andrew / Kitson, Alison / Hughes, Clifford F / Gordon, Susan J / Mitchell, Rebecca J / Rapport, Frances / Estabrooks, Carole / Alexander, Gregory L / Vincent, Charles /

Edwards, Adrian / Carson-Stevens, Andrew / Wagner, Cordula / McCormack, Brendan / Braithwaite, Jeffrey

BMC medicine

2024 Volume 22, Issue 1, Page(s) 22

Abstract: Background: This study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) ... ...

Abstract	Background: This study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) recommendations. Methods: Sixteen conditions/processes of care amendable to estimating evidence-based care at a population level were identified from prevalence data and CPGs. Candidate recommendations (n = 5609) were extracted from 139 CPGs which were converted to indicators. National experts in each condition rated the indicators via the RAND-UCLA Delphi process. For the 16 conditions, 236 evidence-based care indicators were ratified. A multi-stage sampling of LTC facilities and residents was undertaken. Trained aged-care nurses then undertook manual structured record reviews of care delivered between 1 March and 31 May 2021 (our record review period) to assess adherence with the indicators. Results: Care received by 294 residents with 27,585 care encounters in 25 LTC facilities was evaluated. Residents received care for one to thirteen separate clinical conditions/processes of care (median = 10, mean = 9.7). Adherence to evidence-based care indicators was estimated at 53.2% (95% CI: 48.6, 57.7) ranging from a high of 81.3% (95% CI: 75.6, 86.3) for Bladder and Bowel to a low of 12.2% (95% CI: 1.6, 36.8) for Depression. Six conditions (skin integrity, end-of-life care, infection, sleep, medication, and depression) had less than 50% adherence with indicators. Conclusions: This is the first study of adherence to evidence-based care for people in LTC using multiple conditions and a standardised method. Vulnerable older people are not receiving evidence-based care for many physical problems, nor care to support their mental health nor for end-of-life care. The six conditions in which adherence with indicators was less than 50% could be the focus of improvement efforts.
MeSH term(s)	Humans ; Aged ; Long-Term Care ; Australia/epidemiology ; Terminal Care ; Health Facilities ; Quality of Health Care
Language	English
Publishing date	2024-01-23
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-023-03224-8
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Article: Frailty trajectory over one year among residential aged care (nursing home) residents.

Lim, Renly / Kelly, Thu-Lan / Andrade, Andre Q / Kalisch Ellett, Lisa M / Bilton, Rebecca / Dorj, Gereltuya / Pratt, Nicole L / Roughead, Elizabeth E

Frontiers in medicine

2022 Volume 9, Page(s) 1010444

Abstract: Objectives: Large population-based studies examining frailty trajectory found a linear increase in frailty over time. The pattern in which frailty changes over time for an individual person is less well-described. We examined the frailty trajectory of ... ...

Abstract	Objectives: Large population-based studies examining frailty trajectory found a linear increase in frailty over time. The pattern in which frailty changes over time for an individual person is less well-described. We examined the frailty trajectory of older adults living in aged-care in Australia. Materials and methods: This secondary study used data from a randomised controlled trial involving 39 aged-care facilities in Australia. The trial intervention was an on-going pharmacist-led intervention occurring every 8 weeks over 12 months aimed at preventing medicine-induced deterioration and adverse reactions. Frailty was assessed using the Frailty Index. Participants were categorised as non-frail, pre-frail and frail. Individual frailty trajectory over 12 months was visualised using the alluvial plot. Case notes were examined to explore reasons for any rapid transitions in frailty status. Results: A total of 248 participants was included. At baseline, 40.3% were non-frail and 59.7% were pre-frail. The proportion of participants who were non-frail and pre-frail decreased over time; 15.7% were frail at 6 months and 23.4% were frail at 12 months. Overall, twenty different combinations of frailty transitions were identified over 12 months. Retrospective analysis of case notes suggest that death or transition from non-frail to frail was often preceded by hospitalisation, falls, medication change or clinically significant deterioration in grip strength or cognition. Conclusion: The degree of frailty increased over time, but there were variations in the individual trajectories. Regular monitoring of events that precede changes in frailty status is needed to identify strategies to prevent further deterioration in residents' conditions.
Language	English
Publishing date	2022-11-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.1010444
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Article ; Online: Prevalence and Preventability of Adverse Medicine Events in a Sample of Australian Aged-Care Residents: A Secondary Analysis of Data from the ReMInDAR Trial.

Kalisch Ellett, Lisa M / Dorj, Gerel / Andrade, Andre Q / Bilton, Rebecca L / Rowett, Debra / Whitehouse, Joseph / Lim, Renly / Pratt, Nicole L / Kelly, Thu-Lan / Parameswaran Nair, Nibu / Bereznicki, Luke / Widagdo, Imaina / Roughead, Elizabeth E

Drug safety

2023 Volume 46, Issue 5, Page(s) 493–500

Abstract: Background: Aged care residents are vulnerable to the harmful effects of medicines; however, data on the prevalence and preventability of adverse medicine events in aged care residents are scarce.: Aim: To determine the prevalence and preventability ... ...

Abstract	Background: Aged care residents are vulnerable to the harmful effects of medicines; however, data on the prevalence and preventability of adverse medicine events in aged care residents are scarce. Aim: To determine the prevalence and preventability of adverse medicine events in Australian aged care residents. Methods: A secondary analysis of data from the Reducing Medicine-Induced Deterioration and Adverse Reactions (ReMInDAR) trial was conducted. Potential adverse medicine events were identified and independently screened by two research pharmacists to produce a short-list of potential adverse medicine events. An expert clinical panel reviewed each potential adverse medicine to determine the likelihood that the event was medicine related (based on the Naranjo Probability Scale criteria). The clinical panel assessed preventability of medicine-related events using Schumock-Thornton criteria. Results: There were 583 adverse events due to medicines, involving 154 residents (62% of the 248 study participants). There was a median of three medication-related adverse events (interquartile range [IQR] 1-5) per resident over the 12-month follow-up period. The most common medication-related adverse events were falls (56%), bleeding (18%) and bruising (9%). There were 482 (83%) medication-related adverse events that were preventable, most commonly falls (66% of preventable adverse medicine events), bleeding (12%) and dizziness (8%). Of the 248 residents, 133 (54% of the cohort) had at least one preventable adverse medicine event, with a median of 2 (IQR 1-4) preventable adverse medicine events per resident. Conclusion: In total, 62% of aged care residents in our study had an adverse medicine event and 54% had a preventable adverse medicine event in a 12-month period.
MeSH term(s)	Humans ; Aged ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Drug-Related Side Effects and Adverse Reactions/prevention & control ; Prevalence ; Australia/epidemiology ; Hemorrhage/chemically induced
Language	English
Publishing date	2023-04-19
Publishing country	New Zealand
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1018059-x
ISSN	1179-1942 ; 0114-5916
ISSN (online)	1179-1942
ISSN	0114-5916
DOI	10.1007/s40264-023-01299-z
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Article ; Online: Correction to: Risk factors predictive of adverse drug events and drug-related falls in aged care residents: secondary analysis from the ReMInDAR trial.

Dorj, Gereltuya / Nair, Nibu Parameswaran / Bereznicki, Luke / Kelly, Thu-Lan / Pratt, Nicole / Kalisch-Ellett, Lisa / Andrade, Andre / Rowett, Debra / Whitehouse, Joseph / Widagdo, Imaina / Bilton, Rebecca L / Lim, Renly / Roughead, Elizabeth

Drugs & aging

2022 Volume 40, Issue 1, Page(s) 89

Language	English
Publishing date	2022-12-19
Publishing country	New Zealand
Document type	Published Erratum
ZDB-ID	1075770-3
ISSN	1179-1969 ; 1170-229X
ISSN (online)	1179-1969
ISSN	1170-229X
DOI	10.1007/s40266-022-00996-1
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Article ; Online: Pharmacists as patient advocates: A series of case studies illustrating the impacts of a regular pharmacist service in residential aged care (nursing homes).

Lim, Renly / Bilton, Rebecca / Dorj, Gereltuya / Bereznicki, Luke / Rowett, Debra / Ho, Jun Ni / Freeman, Anthea / Roughead, Elizabeth E

Exploratory research in clinical and social pharmacy

2023 Volume 10, Page(s) 100268

Abstract: Background: Medicine-related problems are common in older people living in residential aged care facilities (RACFs). Recognising the significant medicine-related problems, the Australian government has announced a $345 million funding package to employ ... ...

Abstract	Background: Medicine-related problems are common in older people living in residential aged care facilities (RACFs). Recognising the significant medicine-related problems, the Australian government has announced a $345 million funding package to employ on-site pharmacists in RACFs starting in 2023. The new on-site pharmacists are to provide a range of clinical services to reduce medicine-related adverse events, promote quality use of medicines, and improve clinical governance and education. Underpinning these services, the authors argue that pharmacists play the critical role as resident advocates. Objective: This study aims to demonstrate how pharmacists can enhance their advocacy responsibility within and beyond the clinical environment to not only reduce medicine-related adverse events but also improve residents' overall health and quality of life. Methods: This study uses a case series methodology to demonstrate pharmacists' diverse roles in advocating for residents and their families. The case studies were based on participants enrolled in the Reducing Medicine-Induced Deterioration and Adverse Reactions (ReMInDAR) trial, a randomised controlled trial testing the effects of a regular pharmacist service across the Australian RACFs. Results: Pharmacists' advocacy ranged from persistence in follow-up with a resident's general practitioner (GP) to ensure the GP was aware that a patient was experiencing bleeding and bruising while on an anticoagulant, to advocating for a new bed for a resident with peripheral oedema who had been sleeping in his chair due to fear of falling out of his current bed. Conclusions: Our trial focussed on pharmacists serving as the residents' advocate to improve their overall health and quality of life, rather than just addressing a list of medicine-related problems. The pharmacist model used in the ReMInDAR trial supports pharmacists to work to their full scope of practice, helps guide the Australian government's new on-site pharmacist program, and serves as an exemplar pharmacist in aged care model internationally.
Language	English
Publishing date	2023-04-14
Publishing country	United States
Document type	Case Reports
ISSN	2667-2766
ISSN (online)	2667-2766
DOI	10.1016/j.rcsop.2023.100268
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Article ; Online: Risk factors predictive of adverse drug events and drug-related falls in aged care residents: secondary analysis from the ReMInDAR trial.

Drugs & aging

2022 Volume 40, Issue 1, Page(s) 49–58

Abstract: Background: Residents of aged-care facilities have high rates of adverse drug events. This study aimed to identify risk factors for adverse drug events in aged-care residents.: Method: This was a secondary study using data from a multicentre ... ...

Abstract	Background: Residents of aged-care facilities have high rates of adverse drug events. This study aimed to identify risk factors for adverse drug events in aged-care residents. Method: This was a secondary study using data from a multicentre randomised controlled trial. Data from 224 residents for whom there was 6 months of baseline information were analysed. We assessed the risk of adverse drug events and falls (post hoc) in the subsequent 6 months. Adverse events were identified via a key word search of the resident care record and adjudicated by a multidisciplinary panel using a modified version of the Naranjo criteria. Covariates identified through univariable logistic regression, including age, sex, medicines, physical activity, cognition (Montreal Cognitive Assessment), previous adverse events and health service use were included in multivariable models. Results: Overall, 224 residents were included, with a mean age of 86 years; 70% were female. 107 (48%) residents had an adverse drug event during the 6-month follow-up. Falls and bleeding were experienced by 73 (33%) and 28 (13%) residents, respectively. Age (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.01-1.10), weight (OR 1.02, 95% CI 1.002-1.04), previous fall (OR 2.58, 95% CI 1.34-4.98) and sedative or hypnotic medicine use (OR 1.98, 95% CI 1.52-2.60) were associated with increased risk of adverse drug events. Increased cognition (OR 0.89, 95% CI 0.83-0.95) was protective. Risk factors for falls were previous fall (OR 3.27, 95% CI 1.68-6.35) and sedative or hypnotic medicines (OR 3.05, 95% CI 1.14-8.16). Increased cognition (OR 0.88, 95% CI 0.83-0.95) was protective. Conclusion: Our results suggest residents with a previous fall, reduced cognition, and prescription of sedative or hypnotic medicines were at higher risk of adverse drug events and should be considered for proactive prevention.
MeSH term(s)	Humans ; Female ; Aged ; Aged, 80 and over ; Male ; Risk Factors ; Exercise ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Hypnotics and Sedatives/adverse effects
Chemical Substances	Hypnotics and Sedatives
Language	English
Publishing date	2022-11-23
Publishing country	New Zealand
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1075770-3
ISSN	1179-1969 ; 1170-229X
ISSN (online)	1179-1969
ISSN	1170-229X
DOI	10.1007/s40266-022-00983-6
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Article ; Online: Author Correction: Novel multimodal molecular imaging of Vitamin H (Biotin) transporter activity in the murine placenta.

Ben-Eliezer, Noam / Lysenko, Marina / Bilton, Inbal E / Golani, Ofra / Bartels, Jennifer L / Fernandez, Solana R / Aweda, Tolulope A / Clanton, Nicholas A / Beacham, Rebecca / Lapi, Suzanne E / Garbow, Joel R / Neeman, Michal

Scientific reports

2021 Volume 11, Issue 1, Page(s) 5880

Language	English
Publishing date	2021-03-15
Publishing country	England
Document type	Published Erratum
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-85422-z
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Article ; Online: Frailty trajectory over one year among residential aged care (nursing home) residents

Renly Lim / Thu-Lan Kelly / Andre Q. Andrade / Lisa M. Kalisch Ellett / Rebecca Bilton / Gereltuya Dorj / Nicole L. Pratt / Elizabeth E. Roughead

Frontiers in Medicine, Vol

2022 Volume 9

Abstract: ObjectivesLarge population-based studies examining frailty trajectory found a linear increase in frailty over time. The pattern in which frailty changes over time for an individual person is less well-described. We examined the frailty trajectory of ... ...

Abstract	ObjectivesLarge population-based studies examining frailty trajectory found a linear increase in frailty over time. The pattern in which frailty changes over time for an individual person is less well-described. We examined the frailty trajectory of older adults living in aged-care in Australia.Materials and methodsThis secondary study used data from a randomised controlled trial involving 39 aged-care facilities in Australia. The trial intervention was an on-going pharmacist-led intervention occurring every 8 weeks over 12 months aimed at preventing medicine-induced deterioration and adverse reactions. Frailty was assessed using the Frailty Index. Participants were categorised as non-frail, pre-frail and frail. Individual frailty trajectory over 12 months was visualised using the alluvial plot. Case notes were examined to explore reasons for any rapid transitions in frailty status.ResultsA total of 248 participants was included. At baseline, 40.3% were non-frail and 59.7% were pre-frail. The proportion of participants who were non-frail and pre-frail decreased over time; 15.7% were frail at 6 months and 23.4% were frail at 12 months. Overall, twenty different combinations of frailty transitions were identified over 12 months. Retrospective analysis of case notes suggest that death or transition from non-frail to frail was often preceded by hospitalisation, falls, medication change or clinically significant deterioration in grip strength or cognition.ConclusionThe degree of frailty increased over time, but there were variations in the individual trajectories. Regular monitoring of events that precede changes in frailty status is needed to identify strategies to prevent further deterioration in residents’ conditions.
Keywords	cognition ; frail older adult ; mortality ; physical activity ; nursing home ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article ; Online: Author Correction

Noam Ben-Eliezer / Marina Lysenko / Inbal E. Bilton / Ofra Golani / Jennifer L. Bartels / Solana R. Fernandez / Tolulope A. Aweda / Nicholas A. Clanton / Rebecca Beacham / Suzanne E. Lapi / Joel R. Garbow / Michal Neeman

Scientific Reports, Vol 11, Iss 1, Pp 1-

Novel multimodal molecular imaging of Vitamin H (Biotin) transporter activity in the murine placenta

2021 Volume 1

Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper. ...

Abstract	An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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