Enhancing Care for Hospitalized Older Adults with Cognitive Impairment: A Randomized Controlled Trial View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2012-05

AUTHORS

Malaz A. Boustani, Noll L. Campbell, Babar A. Khan, Greg Abernathy, Mohammed Zawahiri, Tiffany Campbell, Jason Tricker, Siu L. Hui, John D. Buckley, Anthony J. Perkins, Mark O. Farber, Christopher M. Callahan

ABSTRACT

BACKGROUND: Approximately 40% of hospitalized older adults have cognitive impairment (CI) and are more prone to hospital-acquired complications. The Institute of Medicine suggests using health information technology to improve the overall safety and quality of the health care system. OBJECTIVE: Evaluate the efficacy of a clinical decision support system (CDSS) to improve the quality of care for hospitalized older adults with CI. DESIGN: A randomized controlled clinical trial. SETTING: A public hospital in Indianapolis. POPULATION: A total of 998 hospitalized older adults were screened for CI, and 424 patients (225 intervention, 199 control) with CI were enrolled in the trial with a mean age of 74.8, 59% African Americans, and 68% female. INTERVENTION: A CDSS alerts the physicians of the presence of CI, recommends early referral into a geriatric consult, and suggests discontinuation of the use of Foley catheterization, physical restraints, and anticholinergic drugs. MEASUREMENTS: Orders of a geriatric consult and discontinuation orders of Foley catheterization, physical restraints, or anticholinergic drugs. RESULTS: Using intent-to-treat analyses, there were no differences between the intervention and the control groups in geriatric consult orders (56% vs 49%, P = 0.21); discontinuation orders for Foley catheterization (61.7% vs 64.6%, P = 0.86); physical restraints (4.8% vs 0%, P = 0.86), or anticholinergic drugs (48.9% vs 31.2%, P = 0.11). CONCLUSION: A simple screening program for CI followed by a CDSS did not change physician prescribing behaviors or improve the process of care for hospitalized older adults with CI. More... »

PAGES

561-567

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11606-012-1994-8

DOI

http://dx.doi.org/10.1007/s11606-012-1994-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1004142386

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22302355


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