https://doi.org/10.4081/gc.2022.10384
Challenges in the performance of real-life studies in older patients: focus on long-term care facilities
Submitted: 27 January 2022
Accepted: 8 March 2022
Published: 24 March 2022
Accepted: 8 March 2022
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Research on geriatric conditions and atypical disease presentation in poorly studied patients’ groups is becoming increasingly important. Aim of the present investigation was addressing prevalence and prognostic significance of aortic valve stenosis (AVS) in older residents of long-term care facilities (LTCF). For the planned recruitment of 500 LTCF guests of a German metropolitan area, study investigators were trained and in the performance of a cardiologic examination and of the comprehensive geriatric assessment- based multidimensional prognostic index (MPI). After five attempts to obtain permission to conduct the study in 30 institutions, patients’ recruitment was stopped with 22 participants included from one institution. AVS was suspected in two patients, in agreement with the reported prevalence data. The MPI value correlated with social support (P=0.002) and geriatric syndromes (P=0.004). This structured attempt at investigating presence and prognostic signature of AVS in older LTCF guests was challenged by logistic obstacles strongly hindering diagnosis of potentially treatable conditions which, if undisclosed, negatively impact on survival and quality of life.
Steinbeißer K, Grill E, Holle R, et al. Determinants for utilization and transitions of long-term care in adults 65+ in germany: Results from the longitudinal kora-age study. BMC Geriatr 2018;18.
DOI: https://doi.org/10.1186/s12877-018-0860-x
Schulz M, Czwikla J, Tsiasioti C, et al. Differences in medical specialist utilization among older people in need of long-term care - results from german health claims data. Int J Equity Health 2020;19.
DOI: https://doi.org/10.1186/s12939-020-1130-z
Hofman MR, van den Hanenberg F, Sierevelt IN, et al. Elderly patients with an atypical presentation of illness in the emergency department. Neth J Med 2017;75:241-6.
Bundesamt S. 3,4 millionen pflegebedürftige zum jahresende 2017 2018. Available from: https://www.destatis.de/DE/Presse/Pressemitteilungen/2018/12/PD18_501_224.html
Balzer KBS, Lühmann D. Beschreibung und bewertung der fachärztlichen versorgung von pflegeheimbewohnern in deutschland. Health Technol Assess 2013;125.
Veronese N, Custodero C, Cella A, et al. Prevalence of multidimensional frailty and pre-frailty in older people in different settings: a systematic review and meta-analysis. Ageing Res Rev 2021;72:101498.
DOI: https://doi.org/10.1016/j.arr.2021.101498
Lansbury LE, Brown CS, Nguyen-Van-Tam JS. Influenza in long-term care facilities. Influenza Other Respir Viruses 2017;11:356-66.
DOI: https://doi.org/10.1111/irv.12464
McMichael TM, Currie DW, Clark S, et al. Epidemiology of covid-19 in a long-term care facility in king county, washington. N Engl J Med 2020;382:2005-11.
DOI: https://doi.org/10.1056/NEJMoa2005412
Lindman BR, Patel JN. Multimorbidity in older adults with aortic stenosis. Clin Geriatr Med 2016;32:305-14.
DOI: https://doi.org/10.1016/j.cger.2016.01.006
Généreux P, Stone GW, O'Gara PT, et al. Natural history, diagnostic approaches, and therapeutic strategies for patients with asymptomatic severe aortic stenosis. J Am Coll Cardiol 2016;67:2263-88.
DOI: https://doi.org/10.1016/j.jacc.2016.02.057
Grimard BH, Safford RE, Burns EL. Aortic stenosis: Diagnosis and treatment. Am Fam Physician 2016;93:371-8.
Baumgartner H, Falk V, Bax JJ, et al. 2017 esc/eacts guidelines for the management of valvular heart disease. Eur Heart J 2017;38:2739-91.
DOI: https://doi.org/10.1093/eurheartj/ehx470
Lei X, Wei Z, Liu S, et al. The short-term and long-term outcomes of transcatheter or surgical aortic valve replacement in elderly patients: a protocol for a systematic review. Medicine 2020;99:e19307.
DOI: https://doi.org/10.1097/MD.0000000000019307
Meyer AM, Siri G, Becker I, et al. The multidimensional prognostic index in general practice: One-year follow-up study. Int J Clin Pract 2019:e13403.
DOI: https://doi.org/10.1111/ijcp.13403
Pilotto A, Ferrucci L, Franceschi M, et al. Development and validation of a multidimensional prognostic index for one-year mortality from comprehensive geriatric assessment in hospitalized older patients. Rejuvenation Res 2008;11:151-61.
DOI: https://doi.org/10.1089/rej.2007.0569
Pilotto A, Panza F, Sancarlo D, et al. Usefulness of the multidimensional prognostic index (mpi) in the management of older patients with chronic kidney disease. J Nephrol 2012;25:S79-84.
DOI: https://doi.org/10.5301/jn.5000162
Pilotto A, Sancarlo D, Aucella F, et al. Addition of the multidimensional prognostic index to the estimated glomerular filtration rate improves prediction of long-term all-cause mortality in older patients with chronic kidney disease. Rejuvenation Res 2012;15:82-8.
DOI: https://doi.org/10.1089/rej.2011.1210
Kang Y, Demiris G. Self-report pain assessment tools for cognitively intact older adults: Integrative review. Int J Older People Nurs 2018;13:e12170.
DOI: https://doi.org/10.1111/opn.12170
Pilotto A, Veronese N, Daragjati J, et al. Using the multidimensional prognostic index to predict clinical outcomes of hospitalized older persons: a prospective, multicenter, international study. J Gerontol A Biol Sci Med Sci 2019;74:1643-9.
DOI: https://doi.org/10.1093/gerona/gly239
Veronese N, Koyanagi A, Stangherlin V, et al. Mortality attributable to covid-19 in nursing home residents: A retrospective study. Aging Clin Exp Res 2021;33:1745-51.
DOI: https://doi.org/10.1007/s40520-021-01855-6
Schäfer M, Körber MI, Vimalathasan R, et al. Risk stratification of patients undergoing percutaneous repair of mitral and tricuspid valves using a multidimensional geriatric assessment. Circ Cardiovasc Qual Outcomes 2021;14:e007624.
DOI: https://doi.org/10.1161/CIRCOUTCOMES.120.007624
Chetrit J, Mendis N, Afilalo J. Frailty: as simple as possible, but no simpler. Circ Cardiovasc Qual Outcomes 2021;14:e008227.
DOI: https://doi.org/10.1161/CIRCOUTCOMES.121.008227
Polidori MC, Sies H, Ferrucci L, et al. Covid-19 mortality as a fingerprint of biological age. Ageing Res Rev 2021;67:101308.
DOI: https://doi.org/10.1016/j.arr.2021.101308
Gladman JR, Conroy SP, Ranhoff AH, et al. New horizons in the implementation and research of comprehensive geriatric assessment: knowing, doing and the 'know-do' gap. Age Ageing 2016;45:194-200.
DOI: https://doi.org/10.1093/ageing/afw012
Galas N, Becker I, Ficon T, et al. Prescription rate of anti-atherosclerotic drugs in german nursing homes and its impact on outcome. Vasa 2019;48:158-66.
DOI: https://doi.org/10.1024/0301-1526/a000754
Gul RB, Ali PA. Clinical trials: the challenge of recruitment and retention of participants. J Clin Nurs 2010;19:227-33.
DOI: https://doi.org/10.1111/j.1365-2702.2009.03041.x
Sanders ML, Stuckenschneider T, Devenney KE, et al. Real world recruiting of older subjects with mild cognitive impairment for exercise trials: Community readiness is pivotal. J Alzheimers Dis 2018;62:579-81.
DOI: https://doi.org/10.3233/JAD-171083
Thoma A, Farrokhyar F, McKnight L, et al. Practical tips for surgical research: How to optimize patient recruitment. Can J Surg 2010;53:205-10.
Nuremberg code establishes the principle of informed consent 2019. Available from: https://www.encyclopedia.com/science/medical-magazines/nuremberg-code-establishes-principle-informed-consent
Nathe JM, Krakow EF. The challenges of informed consent in high-stakes, randomized oncology trials: A systematic review. MDM Policy Pract 2019;4:2381468319840322.
DOI: https://doi.org/10.1177/2381468319840322
How to Cite
Christiansen, J. M., Meyer, A. M., Pickert, L., Pfister, R., & Polidori, M. C. . (2022). Challenges in the performance of real-life studies in older patients: focus on long-term care facilities. Geriatric Care, 8(1). https://doi.org/10.4081/gc.2022.10384
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