bluuebunny/crossref_metadata_2025_split huggingface dataset:
2843 Evaluating dementia pathway services: a Sussex-wide patients and carers’ perspective
Authors: Coleman L , Mensah E , Ali K 
Published: January 2025

Abstract

Introduction
As the prevalence of dementia continues to increase across the UK, understanding the lived experience of patients and carers affected by dementia becomes paramount. There is an established dementia pathway in Sussex for people living with dementia (PLWD) and their carers. To improve care and inform future commissioning priorities, the Brighton and Hove Health Watch (BHHW- a community interest company) surveyed the opinions of a group of PLWD and their carers around initial diagnosis and subsequent support.

Methods
PLWD and their carers receiving social support and willing to provide feedback were included in this survey. Using a topic guide, BHHW volunteers conducted a telephone interview with this group exploring their experience with their general practitioner (GP), and the memory assessment service (MAS) in relation to diagnosis, and post-diagnosis support. Transcribed interviews were analysed using qualitative thematic analysis (inductively and deductively) using Braun and Clarke’s method.

Results
Forty-five participants were interviewed, 37 carers and 6 PLWD (average age 78.2 range 64–95 years) between December 2022 and May 2023. Thirty-nine participants (86%) were of white-British ethnicity. Participants reported a range of different experiences with no consistent pattern by age, gender or location. Participants were generally satisfied with the initial GP care they received. The waiting time to access MAS was six weeks on average, an acceptable timeframe for the group. Some participants reported waiting as long as two years since the initial GP consultation before a dementia diagnosis was eventually made. Participants were generally satisfied by the thorough MAS review. Most participants felt that the information material they immediately received after dementia diagnosis was complex and overwhelming. Social support offered post-diagnosis was commendable.

Conclusion
The lived experience of PLWD and their carers in Sussex was generally positive. However, a tailored approach to post-diagnosis information provision is required.
2826 The effect of age and frailty on outcomes for older adults admitted with acute coronary syndrome: an analysis of MINAP registry
Authors: Chakravorty MK , Sritharan S , Capper I , Nakum S , Chakraborty T , Kaza N , Jethwa N , Shah J 
Published: January 2025

Abstract

Introduction
Frailty, independent of age, is associated with adverse outcomes following admission with Acute Coronary Syndrome (ACS) but is often not accounted for in risk stratification scores. Those identified as frail may not be considered for invasive interventions despite evidenced benefits (1) and are at risk of worsening geriatric syndromes on discharge.

Purpose
We aimed to assess clinical outcomes in older adults admitted with ACS, with or without frailty to suggest if there is a role for geriatrician input in improving healthcare usage and preventing adverse events.

Method
Anonymised data was obtained from an NHS trust’s MINAP registry of patients admitted with ACS between April 2022 to March 2023. Baseline demographics, Clinical Frailty Score (CFS), GRACE and HEART scores, total length of stay (LOS), days as inpatient pre- and post-procedure, adverse events during admission, readmission rates and all-cause mortality rate at 30 days and 1 year were calculated.

Results
288 patients over age 65 admitted with ACS were included in analysis. Median age was 73 [IQR 67–80.75]. Patients over 75 years had higher rates of frailty (38.5% of 75–84 years and 50.0% over 85 years had CFS ≥ 5 versus 14.9% 65–74 years (p &lt; 0.00001)). 253 (87%) patients underwent invasive angiogram during admission. Although age was not a limiting factor, frail patients were less likely to have an angiogram: 24.9% of CFS ≥ 5 versus 57.1% of CFS ≤ 3 (p = 0.00199). Mean LOS was 9.02 days with a median of 7[IQR 4–12]. There was a trend for longer LOS post-angiogram particularly for patients with CFS 4–5 versus CFS ≤ 3 (11.3 days v 8.92 days p = 0.053).

Conclusions
Input from geriatricians and wider multidisciplinary team may help to optimise decision-making and care of patients admitted with ACS with mild to moderate frailty.

Reference
1. Damluji et al. J Am Heart Assoc. 2019;8:e013686.
2603 Optimising the research capacity and capability within a multi-disciplinary (district general hospital) elderly care department
Authors: McColl AJ , Chatterjee A , Joseph M , Sammour M 
Published: January 2025

Abstract

Introduction
Older adults, particularly those with multi-morbidity, frailty or cognitive impairment, are under-represented in clinical research studies. To facilitate inclusive research for this population requires empowerment of all members of the multi-disciplinary team to promote and advocate for this underserved population. However, understanding of the personal and organisational barriers to staff engagement with research within Elderly Care remains limited.

Method
Using an amended version of the research capacity and culture tool an anonymous online survey open to all staff members of an Elderly Care Department (n = 351) in a District General Hospital was undertaken. The survey results were used to inform the departmental 5-year research strategy and launch a multifaceted educational and engagement programme.

Results
107 responses to the survey were received with a wide multi-disciplinary contribution. Despite 89% of respondents stating research was not part of their job, 96% were willing to be more involved in research. Motivators to staff engagement in research included: dedicated time for research (74%), research skills training (73%), mentors (67%), research relevant to elderly care (62%), hearing from researchers within the department (54%) and local promotion of research studies (49%). Barriers to research included: lack of time (78%), unsure of opportunities (65%) and lack of skills (47%). As a result of the survey numerous departmental interventions have been staged: a multi-disciplinary research half day, research opportunity display boards, monthly departmental presentations, promotion of the associate Principal Investigator scheme, Q&A webinars and a section in quarterly newsletter.

Conclusion(s)
Multi-disciplinary staff working within Elderly Care can be motivated to advocate and engage with research opportunities for older adults. Supporting their engagement through the provision of dedicated time, research skills training and promotion of opportunities is key.
2775 Advancing professional development in older People’s healthcare: a survey of BGS and UKCPA pharmacy professionals
Authors: Alićehajić-Bečić Đ , Mitchell A 
Published: January 2025

Abstract

Introduction
The British Geriatrics Society (BGS) highlighted the need for workforce improvement and development of a skilled multidisciplinary team (MDT) in older people’s healthcare in their 2024 roundtable, ‘Transforming care for older people’. This survey aimed to gather views from pharmacy professionals on career progression and how the BGS and UK Clinical Pharmacy Association (UKCPA) can support their advancement in this speciality.

Method
A Google Forms questionnaire was designed to collect data on demographics, education, working practices, and specialisation. Respondents were asked about the need for defined core competencies and an advanced curriculum for the speciality, as well as the support professional groups should provide. The survey was distributed through BGS and UKCPA communication channels.

Results
Thirty-eight pharmacy professionals responded, with pharmacists comprising the majority (n = 37, 97%), working primarily in secondary (n = 21, 55%) and primary care (n = 12, 32%). Most respondents were female (n = 31, 82%) and 61% (n = 23) identified as white British. Over 80% (n = 31) were at a senior level (band 8a or above), with 68% (n = 26) having over 10 years’ experience. Many identified as specialists in care of older people (n = 29, 76%). There was unanimous support for an advanced pharmacist curriculum specific to older people’s care for those seeking to credential at an advanced level, and 90% (n = 34) agreed on the need for core competencies for all pharmacy staff in this area. Key themes to enable progression included structured support, mentorship, clear career pathways, accredited courses, and opportunities to share expertise.

Conclusion
The BGS and UKCPA are well-positioned to develop an advanced curriculum in older people’s healthcare, aligned with existing professional pathways already implemented by the Royal Pharmaceutical Society. Joint initiatives to provide structured development opportunities could enhance the specialist workforce, ensuring high-quality pharmacy services are provided routinely as part of multidisciplinary teams caring for older people.
2820 A survey assessing medical Professional’s confidence and understanding of Iron studies in elderly people
Authors: Freeman N , Ninan S 
Published: January 2025

Abstract

Introduction
Iron deficiency anaemia (IDA) is common in older people, but traditional ferritin cutoffs may not be applicable in older people and iron studies are increasingly being used to diagnose iron deficiency anaemia. We wish to update guidance for diagnosing IDA, but first wished to survey current knowledge.

Method
Clinical staff working with older people were asked to complete a survey. They answered questions relating to confidence in interpreting ferritin and iron studies. Their knowledge of interpreting iron studies was assessed with two multiple choice questions illustrating common scenarios.

Results
When asked on a scale of 1–5 how confident the 126 participants were at interpreting ferritin, the mean was 3.7. For iron studies, it was 3.26. Among consultants, the mean confidence in interpreting ferritin was 4.19, in doctors of other grades this was 3.55, and for other medical professionals (PAs, ACPs and pharmacists) 2.78. Regarding iron studies, the mean confidence in consultants was 3.68, 2.96 in doctors of other grades, and 2.84 in other medical professions. 85.4% of consultants and 72.4% doctors of other grades correctly answered the case on a patient with anaemia of chronic disease. 91.6% consultants and 82.7% doctors of other grades correctly answered the case on a patient with IDA. For both cases, 76.9% of the other medical professionals answered correctly.

Conclusions
The data suggests that clinicians of all grades felt less confident in interpreting iron studies than ferritin. A significant proportion of medical professionals did not correctly interpret iron studies. We have consulted with our colleagues in haematology and gastroenterology and drafted a revised guideline to help interpretation and suggest that IDA guidance should have advice on iron study interpretation. We will also examine IV iron prescription use and provide clear guidance on indications, tracking costs related to this.
2776 Leveraging Technology for Delivery of dementia prevention interventions remotely: through the Participant’s Lens
Authors: Faig K , Steeves A , Gallibois M , McGibbon CA , Handrigan G , Tranchant CC , Bohnsack A , Jarrett P 
Published: January 2025

Abstract

Objectives
The objective of this study was to examine participant’s experience with remote delivery during SYNERGIC@Home/SYNERGIE~Chez soi (NCT04997681), a home-based, double-blind, randomised controlled trial targeting older adults at risk for dementia. Metrics included study adherence, adverse events (AEs), participant’s attitudes towards technology, and protocol deviations (PDs) due to technological difficulties.

Methods
Participants underwent 16 weeks of physical and cognitive interventions (three sessions/week) remotely administered in their homes via Zoom for HealthcareTM. Participants used a laptop, webcam, and required email and internet access. Throughout the trial, adherence, AEs, and PDs were recorded. Post- intervention, survey questions about satisfaction with technology were administered and semi-structured interviews were conducted which underwent thematic analysis.

Results
Sixty participants, mean age 68.9 and 76.7% female, were randomised to one of four intervention arms, with 52 completing the 16-week intervention. Adherence rate was 87.5% with no significant difference between treatment arms (p = 0.656). There were 88 AEs reported in 42 participants. The majority (71.6%) of AEs were unrelated to the intervention, and 69.3% were classified as mild. There was one serious AE, unrelated to the intervention. Most (74.9%) participants reported overall satisfaction with technology, with Zoom being both enjoyable (81.0%) and easy to use (96%). Most enjoyed using the computer (87%), and the majority (87.0%) encountered few difficulties with connectivity. Of the 2496 intervention sessions, 14 (0.56%) were missed due to technical difficulties. Technical difficulties requiring modification to the intervention, such as an unstable internet connection, were reported on 79 occasions (3.0%). Themes from the interviews were: participants built rapport with the research assistants; felt better participating; had fun; and technology helped overcome barriers to participation.

Conclusions
Using technology to deliver dementia prevention interventions remotely was well received by participants Participation occurred safely from the comfort of their own home with few technical difficulties.
2860 Can clinical assessments be administered in a remotely delivered clinical trial targeting older adults at risk for dementia?
Authors: Steeves A , Jarrett P , Faig K , Tranchant CC , Handrigan G , Witkowski L , Haché J , MacMillan K , Gullison A , Omar H , Pauley C , Sexton A , McGibbon CA 
Published: January 2025

Abstract

Introduction
Research suggests that physical and cognitive exercise can have a positive effective on those with dementia, but less is known about such interventions in those at risk for dementia. Understanding the feasibility of administering clinical assessments remotely using Zoom for HealthcareTM in the context of a dementia prevention trial for at risk older adults is not well understood.

Methods
SYNERGIC@Home/SYNERGIE~Chez soi (NCT04997681) is a home-based, remotely delivered clinical trial targeting older adults at risk for dementia. Participants underwent a screening/baseline assessment and were randomised to one of four physical and cognitive exercise intervention arms for 16 weeks (3 times per week). They were reassessed immediately post-intervention and 6-months later. The standardised assessments of cognition, physical activity, mobility, mental health, nutrition, sleep, and quality of life were done at all three points. A research coordinator completed the assessments on a one-on-one basis via Zoom for HealthcareTM. The quality-of-life questionnaire was mailed to the participant.

Results
Forty-eight of 60 participants (80%) (mean age 68.7 ± 5.7 years, 81.3% female) completed the study. Most participants (75.0%) were cognitively intact with at least 2 dementia risk factors. No participants withdrew from the trial because of difficulty with the remote delivery of the assessments. There were no statistically significant changes in any of the assessments of cognition, physical activity, mobility, mental health, nutrition, sleep, or quality of life throughout the study.

Conclusion
This study demonstrates it is possible to administer standardised clinical assessments of cognition, physical activity, mobility, mental health, nutrition, sleep, and quality of life remotely in the context of a clinical trial. The study was not powered to detect meaningful differences in these assessments. Nevertheless, this confirms the feasibility of remotely administering clinical assessments to older adults at risk for dementia.
2663 Estimating the effect of frailty on long term survival following emergency laparotomy
Authors: Price A , Pearce L , Griffiths J , Smith J , Tomkow L , Martin P 
Published: January 2025

Abstract

Introduction
Around 30,000 emergency laparotomies are performed each year across the United Kingdom. Over half are in people aged 65 years or above, with a third of this group living with frailty. The association between frailty and 90-day mortality following surgery is well documented, but longer-term mortality risk has been less extensively studied, despite clear implications for person-centred care. This study aimed to estimate the influence of frailty on longer-term mortality (&gt; 90 days) following emergency laparotomy.

Methods
A retrospective analysis of National Emergency Laparotomy Audit (NELA) data was undertaken, including records entered between 01/12/18 and 30/11/20. Baseline patient characteristics including Clinical Frailty Scale (CFS) are routinely collected within NELA. Data are linked via NHS Digital with Office for National Statistics mortality data. A multivariate analysis was undertaken using a Cox proportional hazards model with hospital-level random effects. Potential confounders were identified via a directed acyclic graph and included in the model as covariates.

Results
23,290 patients remained alive at 90 days post-surgery and were therefore included in the analysis. After adjusting for other covariates, increasing frailty was associated with an increased risk of longer-term mortality. Compared with CFS 1–3, adjusted HR were 1.86 (95% CI 1.68–2.05) for CFS 4, 2.23 (95% CI 2.03–2.45) for CFS 5, 3.26 (95% CI 2.99–3.57) for CFS 6, 4.53 (95% CI 3.97 (95% CI 5.17) for CFS 7, 5.80 (95% CI 4.44–7.57) for CFS 8 and 5.36 (95% CI 4.06–7.08) for CFS 9.

Conclusion
Older people living with frailty remain at increased risk of death beyond 90 days following emergency laparotomy. This information should be incorporated into shared decision-making, enabling patients to make informed choices about their care. Future work must explore how outcomes for this group might be improved through targeted post-operative support.
2786 Defining advanced multimorbidity: a scoping review of research, policy and practice
Authors: Bowers SP , Black P , McCheyne L , Wilson D , Penfold RS , Stapleton L , Channer P , Mills SEE , Williams L , Quirk F , Bowden J 
Published: January 2025

Abstract

Introduction
As people are living for longer with multiple long-term health conditions (MLTCs), there are also more people dying with and from MLTCs. Dying with/from MLTCs can be unpredictable, lead to uncertainty for patients, caregivers and healthcare professionals, and hinder timely conversations around future care planning. There is no universally accepted definition informing the identification of individuals with MLTCs who may be approaching the end of life (advanced multimorbidity). This scoping review synthesised how advanced multimorbidity is defined in research, policy and practice.

Methods
Using the Arksey and O’Malley framework and relevant updates, scoping review methodology was used to search multiple databases and Grey Literature, summarised via the PRISMA-ScR. Two reviewers selected final study texts, which underwent content analysis. Stakeholder consultations with clinicians, academics and public participants ensured context and relevance of findings.

Results
From 10,316 unique publications, 38 final texts were included. Most (33/38) were published in the last decade. Many were quantitative (18/38) though a variety of other study types were included. Participants were mainly elderly—mean age 78.5 years. Only 4/38 studies integrated patient and public involvement. Forty-four different definitions of advanced multimorbidity were identified across the 38 studies, with only 2 definitions used across multiple studies. Definitions varied in the type and number of conditions included. Twenty-six definitions incorporated multiple variables to define advanced multimorbidity, while the remaining 18 used a single variable. Variables were conceptualised as discrete (functional assessments, age, healthcare utilisation etc) or holistic (self-assessment, clinician assessment, assessment tools). Stakeholders preferred definitions that were user-friendly and clinically driven.

Conclusions
The lack of consensus around an advanced multimorbidity definition creates unwarranted heterogeneity and barriers to advancing research in this field. This review highlights the need for a standardised approach that is context-appropriate and meaningful to practice and care, to facilitate proactive realistic conversations and decision-making.
2806 Assessing medication self-Management in Older People at hospital-to-home transition: a systematic review of measures and tools
Authors: Mohamed H , Tomlinson J , Ali E , Badawoud A , Silcock J , Jameson A , Sutherland A , Smith H , Fylan B , Gardner PH 
Published: January 2025

Abstract

Introduction
Adverse drug events from medication-related harm (MRH) can lead to hospital readmissions, compromised quality of life, and even death. After hospital discharge, older people can experience heightened vulnerability and are often unprepared for self-care and medication self-management. Effective medication self-management involves more than adherence; it requires patients to monitor their condition(s), build routines, recognise errors, seek help, understand when to alter medications, and discuss these issues with healthcare professionals. Determining medication self-management capability in older people can guide supportive interventions and improve medication-related outcomes. This systematic review identifies measures which assess medication self-management capability for older people transitioning from hospital-to-home.

Method
A comprehensive search was conducted in electronic databases (Medline, EMBASE, PsychINFO, CINAHL, Cochrane Library of Systematic Reviews, and PROSPERO) for articles from database inception to 2023. Eligible studies included participants aged 65 or older experiencing a hospital-to-home transition, and measures containing at least one medication self-management component. Data extraction was performed using a standardised form. Characteristics of measures were tabulated and summarised descriptively. This review is registered with PROSPERO (CRD42023464325).

Results
14 studies were included, identifying 12 unique measures. These measures predominantly had an adherence-focus, with other medication self-management components included to a lesser degree. Timing of measure administration and the individual administering the measure varied greatly across studies. Medication self-management capability was assessed through physical and cognitive skills. The number and type of skills assessed differed between measures. None of the measures considered all medication self-management components, with self-monitoring and adaptability specifically lacking.

Conclusion
Current measures for medication self-management capability assessment primarily focus on cognitive and physical skills, with significant emphasis on medication adherence. This can lead to other important skills being overlooked. Findings further highlight the importance of comprehensive definitions when considering medication self-management across the hospital-to-home transition, and recommendations are provided for developing future measures.