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Antipsychotics for ICU delirium don't work: Podcast with Tim Girard

In this week's GeriPal podcast we talk with Tim Girard, Plumonary Critical Care physician-researcher at the University of Pittsburgh about his study NEJM study of Haloperidol vs. Ziprasidone vs. Placebo for ICU delirium in critically ill patients.

When I was on service last month, the ICU team said to me, "We've just started treating Mr. X's delirium today.  We started him on haloperidol."

Haloperidol and other antipsychotics for ICU delirium are ubiquitous.  When I was on service last month, the ICU team said to me, "We've just started treating Mr. X's delirium today.  We started him on haloperidol."  In this well-done randomized double blind placebo controlled trial, Girard and his co-investigators detected no difference between the 3 drugs.  Nada.  Zip.

Eric solicited questions in advance via twitter and many are incorporated into the podcast.

Some questions we address:
-But wait, might antipsychotics work for agitated hyperactive delirium?
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Identifying what patients care about the most: A Podcast with Aanand Naik

On this weeks podcast we talk with Aanand Naik about his recent JAGS article titled "Development of a Clinically Feasible Process for Identifying Individual Health Priorities".  Aanand's many titles include Investigator, Houston Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center in Houston Texas and Acting Chief, Geriatrics Section and Associate Professor of Medicine, Baylor College of Medicine, Houston, Texas.

Aanand's research is focused on developing and testing decision-making interventions to improve the outcomes of older adults with multiple morbid conditions, or to put it more simply, how do we identify what patients care about the most (i.e their values), and what their healthcare should be about (their health outcome goals).

So take a listen and read his recent JAGS article to learn more about how to move from values to goals and preferences!

Also, check out the Patient Priorities Care website to lea…

Substance Use in Older Adults: A Podcast with Ben Han

We thought it would be an excellent time to talk about substance use in older adults as many of us gather around the Thanksgiving dinner table with our extended families.  We invited Ben Han, a geriatrician and Assistant Professor of Medicine in Geriatrics at NYU, to talk about the research that he has done in this area. 

In particular, we talked with Ben about the recent increase in substance use in older adults with the rising baby boomer generation, including use of alcohol, marijuana, heroin and prescription opiate misuse, and other drugs.    To learn more about the studies he has done in this area, look at these great publications:

Prevention and Screening of Unhealthy Substance Use by Older AdultsMarijuana Use By Middle-Aged and Older Adults in the USDemographic Trends of Adults in NYC Opioid Treatment ProgramsAging, Multimorbidity, and Substance Use Disorders: The Growing Case for Integrating the Principles of Geriatric Care and Harm ReductionDemographic Trends of Binge Alcoh…