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01/2022 journal articles

DEFINING LIFE-LIMITING ILLNESS IN THE NURSING HOME POPULATION: IDENTIFYING A POPULATION TO BENEFIT FROM PALLIATIVE CARE SERVICES

D.S. Mack, J. Tjia, K.L. Lapane

Jour Nursing Home Res 2022;8:1-5

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Patients with life-limiting conditions often benefit from palliative care to improve quality of life. There is no consensus definition of the term “life-limiting illness” for the nursing home population. The objective of this paper was to provide a framework to define life-limiting illness in the nursing home population using a narrative review. PubMed and GoogleScholar were searched for terms to define: “life-limiting illness,” “serious illness,” and “end-of-life.” Based on peer-reviewed literature, we operationalized the term “life-limiting illness” in the context of the nursing home population into five domains: (1) prognosis-based definitions (i.e. <6 months), (2) mortality risk-based (i.e. high risk vs low risk), (3) healthcare service-based (i.e. receipt of palliative care consult), (4) comorbidity index-based (e.g. the Veteran’s Health Association Palliative Care Index), and (5) composite definition (i.e. comorbidity and caregiver burden).

CITATION:
D.S. Mack ; J. Tjia ; K.L. Lapane ; (2022): Defining Life-Limiting Illness in the Nursing Home Population: Identifying a Population to Benefit from Palliative Care Services. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2022.1

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EDITORIAL: RESEARCH IN NURSING HOMES IN THE TIME OF COVID

Y. Rolland, P. de Souto Barreto

Jour Nursing Home Res 2022;8:6-7

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CITATION:
Y. Rolland ; P. de Souto Barreto ; (2022): Editorial: Research in nursing homes in the time of COVID. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2022.2

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LETTER TO THE EDITOR: VITAMIN D INTAKE AND FALLS AMONG OLDER NURSING HOME RESIDENTS

K. Salminen, U. Aalto, M. Suominen, H. Kautiainen, K. Pitkälä, H.-M. Roitto

Jour Nursing Home Res 2022;8:8-9

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K. Salminen; U. Aalto; M. Suominen; H. Kautiainen; K. Pitkälä; H.-M. Roitto (2022): Letter to the Editor: Vitamin D intake and falls among older nursing home residents. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2022.3

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ANTIHYPERGLYCEMIC DRUG USE IN LONG-STAY NURSING HOME RESIDENTS WITH DIABETES MELLITUS

A.L. Hume, S. Osundolire, A.K. Mbrah, A.P. Nunes, K.L. Lapane

Jour Nursing Home Res 2022;8:10-19

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Background: About 29.2% of American adults ≥ 65 years of age have diabetes mellitus, but details regarding diabetes management especially among nursing home residents are dated. Objectives: Evaluate the prevalence of antihyperglycemic agents in residents with diabetes mellitus and describe resident characteristics using major drug classes. Design: Cross-sectional study. Setting: Virtually all United States nursing homes. Participants: 141,636 residents with diabetes mellitus. Measurements: Minimum Data Set (2016) and Medicare Part D claims determined use of metformin, sulfonylureas, meglitinide analogs, alpha-glucosidase inhibitors, TZDs, DPP4 inhibitors, SGLT2 inhibitors, GLP1 agonists, as monotherapy and with basal insulin. Results: Seventy-two percent received antihyperglycemic drugs [most common: basal insulins (53.9% total; 46.9% with other non-insulin agents), metformin (35.5% total; 14.2% monotherapy), sulfonylureas (19.6% total; 6.3% monotherapy), and DPP4 inhibitors (12.2% total; 2.2% monotherapy)]. Sixty-three percent of meglitinide monotherapy versus 34.1% of metformin monotherapy users; and 38.3% meglitinide–basal insulin versus 22.2% metformin–basal insulin users were ≥85 years. Obesity was greater among users of GLP1 agonists compared to those receiving other agents (monotherapy: 60.5% versus 33-42%; with basal insulin: 76.2% versus 50-58%). End-stage renal disease was least prevalent among metformin users (monotherapy: 6.6%; with basal insulin: 8.8%) and most common among meglitinide monotherapy (19.6%) and GLP1 agonists with basal insulin (22%) users. Conclusions: There is heterogeneity of diabetes treatment in nursing homes. Use of antihyperglycemic drugs with a higher risk of hypoglycemia, such as insulin with sulfonylureas or meglitinides, continue in nursing home residents.

CITATION:
A.L. Hume ; S. Osundolire ; A.K. Mbrah ; A.P. Nunes ; K.L. Lapane (2022): Antihyperglycemic Drug Use in Long-Stay Nursing Home Residents with Diabetes Mellitus. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2022.4

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