Unplanned nursing home admission among discharged polymedicated older inpatients: a single-centre, registry-based study in Switzerland.

OBJECTIVE To investigate patient characteristics and the available health and drug data associated with unplanned nursing home admission following an acute hospital admission or readmission. DESIGN A population-based hospital registry study. SETTING A public hospital in southern Switzerland (Valais Hospital). PARTICIPANTS We explored a population-based longitudinal dataset of 14 705 hospital admissions from 2015 to 2018. OUTCOME MEASURES Sociodemographic, health and drug data, and their interactions predicting the risk of unplanned nursing home admission. RESULTS The mean prevalence of unplanned nursing home admission after hospital discharge was 6.1% (n=903/N=14 705). Our predictive analysis revealed that the oldest adults (OR=1.07 for each additional year of age; 95% CI 1.05 to 1.08) presenting with impaired functional mobility (OR=3.22; 95% CI 2.67 to 3.87), dependency in the activities of daily living (OR=4.62; 95% CI 3.76 to 5.67), cognitive impairment (OR=3.75; 95% CI 3.06 to 4.59) and traumatic injuries (OR=1.58; 95% CI 1.25 to 2.01) had a higher probability of unplanned nursing home admission. The number of International Classification of Diseases, 10th version diagnoses had no significant impact on nursing home admissions, contrarily to the number of prescribed drugs (OR=1.17; 95% CI 1.15 to 1.19). Antiemetics/antinauseants (OR=2.53; 95% CI 1.21 to 5.30), digestives (OR=1.78; 95% CI 1.09 to 2.90), psycholeptics (OR=1.76; 95% CI 1.60 to 1.93), antiepileptics (OR=1.49; 95% CI 1.25 to 1.79) and anti-Parkinson's drugs (OR=1.40; 95% CI 1.12 to 1.75) were strongly linked to unplanned nursing home admission. CONCLUSIONS Numerous risk factors for unplanned nursing home admission were identified. To prevent the adverse health outcomes that precipitate acute hospitalisations and unplanned nursing home admissions, ambulatory care providers should consider these risk factors in their care planning for older adults before they reach a state requiring hospitalisation

Les objets connectés et applications de santé : étude exploratoire des perceptions, usages (ou non) et contextes d’usage

tIn a contemporary context of major health challenges, the market of digital technologies has increasingly developed in past years. This article aims to explore main profiles of use in relation to connected objects and health apps, as well as attitudes related to uses, non-uses and contexts of use. Therefore, our objective is to contribute to the scientific debate by proposing an empirical study in psychology that focusses on the perspectives of consumers and non-consumers of these technologies in the French-speaking part of Switzerland. Todo this, a survey was conducted among participants of a large publich ealth exhibition (n = 760). According to our results, the majority of respondents declare not having a connected object/health app and a third of non-users does not intend to acquire such techno-logies. Also, there is a trend among younger generations to have a connected object/health app. Concerning the contexts of use, such technologies are employed to self-track physical activity and eating practices. The degree of satisfaction of such use is rather high. Given these results, our analyses point out a divide within our sample, between individuals who seem resistant and declare not willing to have this kind of technology and those who use it in the long run.These results cast new light upon concrete uses and contexts of use among consumers and non-consumers of connected objects/healthapps beyond techno-scientific promises that prevail today in ours societies

Safe Medication Management for Polymedicated Home-Dwelling Older Adults after Hospital Discharge: A Qualitative Study of Older Adults, Informal Caregivers and Healthcare Professionals' Perspectives

Safe medication management is particularly challenging among polymedicated home- dwelling older adults after hospital discharge. This study aimed to identify and categorise the stressors experienced and reconstitution strategies adopted by older adults, their informal caregivers, and healthcare professionals as they manage older adults’ medications after hospital discharge. A primary study collected the perspectives of 28 older adults, 17 informal caregivers, and 13 healthcare professionals using a qualitative descriptive design. The Neuman Systems Model was used as the basis for a secondary deductive content analysis. Findings revealed that post-discharge medication management at home involved numerous stressors, often including dysfunctions in communication, collaboration, and coordination between the multiple stakeholders involved. Reconstitution strategies for safe medication management were not always successful or satisfactory and were sometimes identified as stressors themselves. Older adults, informal caregivers, and healthcare professionals’ perspectives highlighted several potential opportunities for improving safe medication management through nurse-led, interprofessional, patient-centred practices