Asunto(s)
Disfunción Cognitiva/diagnóstico , Demencia/diagnóstico , Revelación , Médicos/estadística & datos numéricos , Especialización/estadística & datos numéricos , Adulto , Demencia/clasificación , Dinamarca , Femenino , Humanos , Internet , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
INTRODUCTION: The aim of the present study was to describe the occurrence of antidepressant treatment in geriatric departments in Denmark and assess the notes of the patient records in connection with prescription. MATERIAL AND METHODS: Patient records for consecutively referred patients in seven geriatric departments were examined and basic information was noted. For users of antidepressants further information about the treatment was noted. RESULTS: A total of 1211 patients records were examined and out of these 338 patients were in treatment with antidepressants (29.7%). The users of antidepressants used more drugs on their discharge from the hospital. For 61.8% (209/338) of the users the treatment had started before the admission and in more than three-fourths the treatment remained unchanged at their discharge, in 9% the treatment was discontinued. 38.2% (129/338) started their treatment during the admission. Depression was stated as being the main reason in 54% of those who continued an ongoing treatment, and in 78% of those who started their treatment during admission. In 98.4%, the beginning of treatment with antidepressants was based upon the file notes. In 34.8% of the records of ongoing treatment no file notes were given. DISCUSSION: Treatment with antidepressants is common in geriatric departments and most often it is a question of continuation of a treatment that had started before the admission. The study shows that there is a need for an optimization of the file notes.
Asunto(s)
Antidepresivos/administración & dosificación , Depresión/tratamiento farmacológico , Utilización de Medicamentos/estadística & datos numéricos , Control de Formularios y Registros/organización & administración , Geriatría/organización & administración , Departamentos de Hospitales/organización & administración , Anciano , Dinamarca , Prescripciones de Medicamentos/estadística & datos numéricos , Enfermería Geriátrica/organización & administración , Enfermería Geriátrica/estadística & datos numéricos , Humanos , Registros Médicos , Persona de Mediana EdadRESUMEN
INTRODUCTION: This randomised study evaluates the effect of intensive physical therapy on the duration of rehabilitation after hip fracture. MATERIALS AND METHODS: The study comprised 88 patients transferred for rehabilitation after operative treatment for hip fracture. After randomisation, 44 patients received physical therapy 3.6 hours (median) a week, whereas the 44 control patients received physical therapy 1.9 hours a week. The outcome was defined as the duration of physical rehabilitation until the patient was able to 1) walk 50 metres in less than two minutes; 2) manage to climb stairs to the first floor; 3) manage the sit-to-stand transfer; 4) get in and out of bed; 5) manage bathing, dressing, and lavatory visits. RESULTS: In the group randomised to intensive physical therapy, 24 patients dropped out after 15 days (median) whereas 13 patients dropped out of the control group after 22 days. Drop outs were caused by orthopaedic complications, general weakness, and poor co-operation. No difference was found in the duration of physical rehabilitation by analysis per protocol of the patients who completed the trial. DISCUSSION: The considerable number of drop outs suggests that intensive physical therapy may be of limited value in the attempt to reduce the duration of rehabilitation after hip fracture. An altered objective, including enhanced outpatient rehabilitation, may be necessary in order to reduce the length of hospital stay after hip fracture.
Asunto(s)
Fracturas del Fémur/rehabilitación , Fracturas de Cadera/rehabilitación , Modalidades de Fisioterapia/métodos , Anciano , Femenino , Fracturas del Fémur/fisiopatología , Fracturas del Fémur/cirugía , Fracturas de Cadera/fisiopatología , Fracturas de Cadera/cirugía , Humanos , Persona de Mediana Edad , Pacientes Desistentes del Tratamiento , Recuperación de la FunciónRESUMEN
INTRODUCTION: This randomised study evaluates the effect of intensive physical therapy on the duration of rehabilitation following hip fracture. METHODS: Eighty-eight patients transferred for rehabilitation after surgical treatment for hip fracture were included in the trial. Forty-four patients were randomised to physical therapy 3.6 hours (median) a week, while the 44 control patients received physical therapy 1.9 hours a week. Outcome was defined as duration of physical rehabilitation until the patient was able to (1) walk 50 metres in less than 2 minutes, (2) manage stair climbing to the first floor, (3) manage sit-to-stand transfer, (4) move in and out of bed, (5) manage bathing, dressing and lavatory visits. RESULTS: In the group randomised to intensive physical therapy 24 patients withdrew after 15 days while 13 patients withdrew from the control group after 22 days (median values). Early withdrawal was due to orthopaedic complications, general weakness and poor co-operation. No difference between the two groups was demonstrated in the duration of physical rehabilitation by a per protocol analysis of the patients who completed the trial. DISCUSSION: The considerable drop-out rate suggests that intensive physical therapy may be of limited value when attempting to reduce the duration of rehabilitation following hip fracture. An altered objective including enhanced out-patient rehabilitation may be necessary in order to reduce the length of hospital stay after hip fracture.