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Showing posts from November, 2020

Time to Benefit of Statins for Primary Prevention: A Podcast with Lindsey Yourman and Sei Lee

How long does it take to see a benefit of statin therapy for primary prevention of cardiovascular events in adults aged 50 to 75 years?  That's the question we try to answer with our two guests today, Drs Lindsey Yourman and Sei Lee, the lead and senior author of a JAMA IM study that tried to answer this question . In the podcast Drs. Yourman and Lee define what time to benefit is, why it is important in regards to decision making for older adults, and common lag time to benefits for common preventative interventions.  We then take a deep dive into the JAMA IM meta-analysis of 8 trials , which showed 2.5 years were needed to avoid 1 cardiovascular event for 100 patients aged 50 to 75 years of age treated with a statin.   So give it a listen and tell us what you think on either our Twitter or Facebook posts about this podcast.

Age Friendly Health Systems: Podcast with Julia Adler-Milstein and Stephanie Rogers

An age friendly health system is one in which everyone, from the doctors to the nurses to the people cleaning the rooms are aware of the unique needs of older adults.  These needs are categorized around the 4 M’s - Medication, Mentation, Mobility, and What Matters Most.   But we cannot achieve the ideal of an age friendly health system without, well, changing systems.  In this week’s podcast, we talk with Julia Adler- Milstein about the ways in which the electronic health records in hospitals and skilled nursing facilities are set up (or not set up) to document and track the 4 M’s.  We also talk with Stephanie Rogers about her work toward creating an age friendly health system at UCSF. Enjoy! -@AlexSmithMD

A void: advanced financial planning?

Many GeriPal readers may be familiar with Eric's 2011 JAMA article " Finances in the older patient with cognitive impairment. " But many of you may not be. Despite Eric and co-authors' groundbreaking JAMA piece, there is a surprising absence of literature on health care providers' role in assessing their patients' ability to manage their finances and non-health affairs. There is a parallel void on how (and whether) health care providers should counsel patients about planning for incapacity to manage financial affairs. We are conducting an informal survey of health care providers to glean preliminary information about whether providers engage with patients about financial planning. We would greatly appreciate your interest and time to answer this brief (6 question) anonymous survey. The survey should take less than one minute to complete. The survey will be open until November 20th. https://uchastings.co1.qualtrics.com/jfe/form/SV_bl5Fm0CauFxLk6V Thank you very

Crisis Communication and Grief in the Emergency Department: A Podcast with Naomi George and Kai Romero

  The Emergency Department (ED) is a hard place to have serious illness discussions, whether it be goals of care or code status discussions, or whether or not to consider intubation for a seriously ill patient.  Emergency physicians often don't have the time for in-depth discussions, nor have been trained on how to do so.  There often is limited information about the patient, their functional status, or their prognosis.  These are some of the most challenging and some of the most important conversations in medicine, as 75% of older adults visit the ED during the last 6 months of life ( data thanks to this Alex Smith publication in Health Affairs! )  So how do we have these urgent conversations in a time of crisis to ensure that patients receive care that aligns with their goals?  We have Naomi George, researcher and ED physician extraordinaire from the University of New Mexico, and Kai Romero from UCSF and Hospice by the Bay to help answer this question. Naomi discuss her practical