Frailty Nexus: Community of practice for frailty researchers and healthcare professionals.

Background: There has been success in implementing frailty education for healthcare professionals, but there remains a need to improve the knowledge and skills of researchers and healthcare professionals to develop, implement and evaluate frailty-focused research.

Objectives: This paper describes how the Australian Frailty Network developed and evaluated a virtual community of practice (VCOP), a proven model for fostering knowledge mobilisation, to support researchers and healthcare professionals in advancing frailty research and practice in Australia.

Design: Mixed methods.

Scoping review of the measurement of care environment factors that impact sleep in the rehabilitation, subacute, and aged care settings.

Study Objectives: Unfamiliar environments are often poorly conducive to quality sleep, especially for patients within health and aged care settings. This scoping review aims to map available evidence regarding the sleep environment in rehabilitation, subacute, and aged care settings. It examines how these factors are measured and seeks to identify any reported standard metrics, guidelines, or methodologies.

Describing the outcomes of frail patients undergoing treatment with systemic therapies for acute myeloid leukaemia: A systematic review.

Introduction: Acute myeloid leukaemia (AML) is a disease of the older person. Due to the demands of intensive chemotherapy, there is a significant risk of over or undertreatment, leading to either iatrogenic harm or missed windows of opportunity for remission or cure. Better tools to aid clinical decision making and risk stratify patients are needed.

Frailty knowledge, training and barriers to frailty management: A national cross-sectional survey of health professionals in Australia.

Objective(s): To understand Australian health professionals' perceptions of their knowledge and previous training about frailty, as well as barriers to frailty assessment and management in their practice.

Methods: A cross-sectional online survey was developed and distributed to health professionals (medical, nursing and allied health) engaged in clinical practice in Australia through convenience and snowball sampling techniques from March to May 2022. The survey consisted of five sections: frailty training and knowledge; confidence in recognising and managing adults with frailty; the importance and relevance of frailty; barriers to assessing and managing frailty in practice; and interest in further frailty training.

Navigating the machine learning pipeline: a scoping review of inpatient delirium prediction models.

Objectives: Early identification of inpatients at risk of developing delirium and implementing preventive measures could avoid up to 40% of delirium cases. Machine learning (ML)-based prediction models may enable risk stratification and targeted intervention, but establishing their current evolutionary status requires a scoping review of recent literature.

Methods: We searched ten databases up to June 2022 for studies of ML-based delirium prediction models.

Frailty and solid-organ transplant candidates: a scoping review.

Background: There is currently no consensus as to a standardized tool for frailty measurement in any patient population. In the solid-organ transplantation population, routinely identifying and quantifying frailty in potential transplant candidates would support patients and the multidisciplinary team to make well-informed, individualized, management decisions. The aim of this scoping review was to synthesise the literature regarding frailty measurement in solid-organ transplant (SOT) candidates.

A systematic review of frailty education programs for health care professionals.

Objectives: To identify and examine the reported effectiveness of education programs for health professionals on frailty.

Methods: A systematic review was conducted of articles published up to June 2021, examining the evaluation of frailty training or education programs targeting health professionals/students. The participant demographics, program content and structure, effectiveness assessment methodology and outcomes, as well as participant feedback, were recorded with narrative synthesis of results.

Sex-specific interventions to prevent and manage frailty.

There is growing interest in interventions that delay, slow, and even reverse frailty. In this narrative review, we explore the evidence on exercise, nutrition, medication optimisation and social support interventions for frailty and consider how these relate to underlying frailty pathophysiology. We also consider pathophysiological mechanisms underpinning sex differences in frailty before evaluating the limited evidence for sex-specific frailty interventions that is currently available.

A multimodal intervention to optimise antimicrobial use in residential aged care facilities (ENGAGEMENT): protocol for a stepped-wedge cluster randomised trial.

Background: Inappropriate antibiotic use can cause harm and promote antimicrobial resistance, which has been declared a major health challenge by the World Health Organization. In Australian residential aged care facilities (RACFs), the most common indications for antibiotic prescribing are for infections of the urinary tract, respiratory tract and skin and soft tissue. Studies indicate that a high proportion of these prescriptions are non-compliant with best prescribing guidelines.

Scoping Review of Studies Evaluating Frailty and Its Association with Medication Harm.

Introduction: Frailty is associated with an increased risk of death and morbid events. Frail individuals are known to have multiple comorbidities which are often associated with polypharmacy. Whilst a relationship between polypharmacy and frailty has been demonstrated, it is not clear if there is an independent relationship between frailty and medication harm.

Polypharmacy in Australian Veterans with Post-traumatic Stress Disorder upon Admission to a Mental Health Facility: A Retrospective Chart Review.

Objective: Polypharmacy increases the risk of adverse drug events and drug-drug interactions, and contributes to falls, hospital admissions, morbidity and mortality. Veterans with post-traumatic stress disorder often have psychological and physical comorbidities, increasing the likelihood of general and psychotropic polypharmacy. This study investigates the prevalence of general and psychotropic polypharmacy in inpatient veterans with post-traumatic stress disorder, and illustrates potential risks associated with polypharmacy in this population.

Cervical Cancer Screening Among Immigrant Women Residing in Australia: A Systematic Review.

Since the introduction of systematic population-based cervical cancer screening in Australia in 1991, age-standardized incidence of cervical cancer has halved. Given recent advances in human papillomavirus (HPV) vaccination and screening, cervical cancer may be eliminated nationally within 20 years. However, immigrant women are not equitably reached by screening efforts.

Undertaking medication review by telehealth.

Background: Medication review can be delivered using telehealth during the COVID-19 pandemic to ensure ongoing provision of care to vulnerable patient populations and to minimise risk of infection for both patients and health professionals.

Objective: The aim of this article is to discuss the evidence related to telehealth medication reviews and provide practical considerations for conducting successful medication reviews by telehealth.

Discussion: Leading up to the COVID-19 pandemic, telehealth technologies had been increasingly used to deliver medication review services, mainly to patients in rural and remote areas, and were accepted by patients.

Drug related problems in older adults living with dementia.

Background: Compared with those without dementia, older patients with dementia admitted to acute care settings are at higher risk for triad combination of polypharmacy (PP), potentially inappropriate medication (PIM), and drug-drug interaction (DDI), which may consequently result in detrimental health. The aims of this research were to assess risk factors associated with triad combination of PP, PIM and DDI among hospitalized older patients with dementia, and to assess prevalence and characteristics of PP, PIM and DDI in this population.

Methods: In this retrospective cross-sectional study, 416 older inpatients diagnosed with dementia and referred for specialist geriatric consultation at a tertiary hospital in Brisbane, Australia during 2006-2016 were enrolled.

The Changes in Medication Prescribing Among the Older People with Cognitive Impairment in the Acute Care Setting.

Purpose: Most older people with cognitive impairment usually have multiple comorbidities. In the last decade, the guidelines for the management of chronic diseases have been changed, leading to changes in the patterns of medication prescribing and in the prevalence of drug-related problems (DRPs). The main objectives were to explore the changes in medication use and in the prevalence of polypharmacy (PP), the use of potentially inappropriate medications (PIMs) and drug-drug interactions (DDIs) among older hospitalized adults with cognitive impairment in a 5-year period.

Medication use and cognitive impairment among residents of aged care facilities.

Background: Potentially inappropriate polypharmacy is common in residential aged care facilities (RACF). This is of particular concern among people with cognitive impairment who, compared with cognitively intact residents, are potentially more sensitive to the adverse effects of medications.

Aim: To compare the patterns of medication prescribing of RACF residents based on cognitive status.

A scoping review of the use and impact of telehealth medication reviews.

Background: Telehealth has been proposed as a mechanism to overcome the practical difficulties associated with conducting timely and efficient medication reviews particularly in rural and remote settings.

Objective: The aim was to examine the literature on the use and impact of telehealth-facilitated medication reviews.

Methods: A scoping review of the literature was conducted.

Using telehealth to enable collaboration of pharmacists and geriatricians in residential medication management reviews.

Background Practical issues impede optimum collaboration between pharmacists and other clinical specialists in the current Australian residential medication review services which potentially affect efficiency, timeliness and quality of outcomes. Objective This mixed methods study aimed to explore the potential value of an existing telehealth platform to enable collaboration of pharmacists and geriatricians in residential medication reviews. Setting Long term care facilities in Australia.

Interventions to Optimise Prescribing in Older People with Dementia: A Systematic Review.

Background: Older adults living with dementia may have a higher risk of medication toxicity than those without dementia. Optimising prescribing in this group of people is a critically important yet challenging process.

Objective: Our aim was to systematically review the evidence for the effectiveness of interventions for optimising prescribing in older people with dementia.