Ten Things Physicians and Patients Should Question

Medication review identifies high-risk medications, interactions with other medicinal products and those on your display. In patients who take megestrol acetate, in 12 will be an increase in weight and one in 23 is an unwanted event that leads to death. No studies have investigated the benefits of the cleared up over a year, the risks and benefits of long-term therapy. Nursing educational initiatives and innovative models of practice have been shown to be effective in the implementation of a restraint-free approach for patients with delirium. Prescribe or discontinuation of sedative-hypnotics in the hospital a significant impact on the long-term use. Eicosapentaenoic acid (EPA, an omega-3 fatty acid from fish oils) for the treatment of cancer cachexia. Screening for and treatment of asymptomatic bacteriuria is recommended before urological procedures for which mucosal bleeding is expected. The use of these drugs in patients with dementia should be limited to cases where non-pharmacologic measures have failed and patients pose a threat to themselves or others.. In such cases, antipsychotic medications are often prescribed, but they provide limited benefit and can cause serious damage, including premature death. The use of these drugs should be limited to cases where non-pharmacologic measures have failed and patients pose a threat to themselves or others

American Geriatrics Society Choosing Wisely

What Does it Mean When Patients Choose Wisely?

American Geriatrics Society Choosing Wisely

American Geriatrics Society Choosing Wisely

Choosing Wisely in Older Adults: Five Situations to

2012 Jan 8;346:e8441. Although high-calorie supplements increase weight in older people, there is no evidence that they affect other important clinical endpoints, such as quality of life, mood, functional status or survival. To reach among non-older adults, except for long-term reduction of myocardial infarction and mortality with metformin, using medications glycated hemoglobin less than 7% is associated with harms, including higher mortality. Sedative hypnotics in older people with insomnia: meta-analysis of the risks and benefits. Mirtazapine is likely to lead to weight gain or increased appetite, when used to treat depression, but there is little evidence to support its use for the promotion of appetite and weight gain, in the absence of depression. Polypharmacy may lead to decreased adherence, side effects and the increased risk of cognitive impairment, falls and functional decline. The number needed to treat with a sedative-hypnotic for improved sleep is 13, whereas the number needed to harm is only 6. It is unclear whether these drugs can delay institutionalization, improve the quality of life or to reduce caregiver burden. After the first review by the CGS executive, each theme was examined in detail, the selected Canadian geriatricians and other specialists, the relevant research and clinical expertise. JAMA. Use of megestrol acetate results in minimal improvements in appetite and weight gain, no improvement in the quality of life or survival, and the increased risk of thrombotic events, fluid retention, and death. BMJ. Doctors, patients and their carers should discuss the treatment goals, the practical value that can be easily assessed and the type and likelihood of adverse effects prior to the start of the study of cholinesterase inhibitors.. Systematic reviews of cannabinoids, dietary polyunsaturated fatty acids (DHA and EPA), thalidomide, and anabolic steroids, have not identified adequate evidence for the efficacy and safety of these medications for weight gain. 2005 Nov 19;331(7526):1169. Our geriatric health professional-members work together in an interdisciplinary, patient – and family-centered team care to older adults. Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, the United Kingdom and Denmark. BMJ. Artificial feeding in patients with advanced dementia: A review of the evidence. 1999;282(14):1365-1370. AGS members were asked for feedback and recommendations on what they thought should be included in the list via an electronic survey

Choosing Wisely British Geriatrics Society

Choosing Wisely – Consumer Health Choices

Suitable environment to patients with delirium: lessons learned from the delirium room, a restraint-free environment for older hospitalized adults with delirium. Work group members were drawn, the Committee, as well as the ethics, ethno-geriatrics, and quality and Performance measurement (QPMC) committees. Consensus criteria for the specific clinical symptoms that, when associated with bacteriuria, define urinary tract infection was developed to characterize.. To reach, given the long time-frame, micro-theorized vascular benefits of tight control of the glycemic targets reflect patient goals, health status and life expectancy. In such cases, antipsychotic medications are often prescribed, but they offer limited and inconsistent benefits, while posing risks, including sedation, cognitive deterioration, and increased likelihood of falls, stroke, and mortality. Risk of fractures requiring hospitalization after an initial prescription of zolpidem, alprazolam, lorazepam, or diazepam in older adults. Effective alternatives include strategies to prevent and treat delirium, identification and management of conditions, the discomfort of the patients, environmental modifications to promote orientation and effective sleep-Wake cycles, frequent family contact and supportive interaction with the staff. If the desired effects (including stabilization of cognition) is not perceived to have be discontinued within 12 weeks or so, the inhibitors

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