UNASSIGNED: Older persons are frequently prescribed several medications; therefore, inappropriate medication prescriptions are common. Prescribing potentially inappropriate medications (PIMs) poses a serious risk and hence, we aimed to assess the PIMs in older patients in Tabuk, using the 2023 Beers criteria.
UNASSIGNED: A retrospective cross-sectional study was carried out, including older persons ≥65 years of age admitted in two government hospitals from June 2022 to May 2023, and prescribed with five or more medications. PIMs were assessed using the 2023 Beers criteria. Descriptive analysis was performed for the categorical and continuous variables. Logistic regression was used to assess the influence of age, gender, number of medications and comorbidities on PIMs using SPSS version 27.
UNASSIGNED: The study included 420 patients. The mean age of the participants was 75.52 ± 8.70 years (range, 65-105 years). There was a slightly higher proportion of females (52%). The prevalence of PIMs was 81.43%, where 35.41% were prescribed one PIM, 26.48% were prescribed two PIMs, and 17.32% were prescribed three PIMs. The proportion of medications considered potentially inappropriate among older patients was 70.11%, and proton pump inhibitors were the most commonly prescribed medication (52.99%). The proportion of medications to be used with caution was 19.55%, with diuretics being the most frequently administered medication (91.43%). Gender and comorbidity did not influence PIMs, but age and number of medications significantly influenced the likelihood of PIMs.
UNASSIGNED: PIMs are prevalent among older people and are significantly associated with age and multiple medications. Caution should be exercised while prescribing medications to older persons. Frequent audits should be performed to assess PIMs, and clinicians should be informed of the same to avoid serious outcomes associated with PIMs. Interventions designed to reduce PIM need to be initiated.

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The Health Resources and Services Administration created the Geriatric Workforce Enhancement Program (GWEP) in 2015 to address future geriatric workforce challenges and redefine the delivery of care to older adults. The John A. Hartford Foundation subsequently funded the GWEP Coordinating Center (GWEP-CC) to offer centralized, strategic support to these 44 diverse GWEP sites. This article outlines the last 3 years of GWEP work done at the national and local levels to transform geriatric care. Dissemination of the innovative Geriatric Interprofessional Team Transformation in Primary Care program, created by the Dartmouth GWEP, demonstrates how the GWEP-CC can benefit local initiatives and inform national perspectives. The GWEP-CC is a change agent in this way, scaling and distributing information and implementation support across the country. The GWEP-CC also serves as an essential repository of data, continuously determining what is working and what could be improved. This informs activity of the GWEP-CC, funders and other stakeholders, and provides the most up-to-date resources to GWEP sites and their partners. The GWEP-CC achieves its objectives through several key pillars: networking opportunities, education and training, advocacy, and evaluation. Although many advances have been made, opportunities to continue paving the way are plenty, especially with regards to mental health. This article discusses the work accomplished to date and presents some future considerations for mental health and overall healthcare transformation.

Delirium is a pervasive and dangerous syndrome for older adults in the perianesthesia setting, occurring in up to 60% of surgical cases. The American Geriatrics Society performed a systematic review to develop recommendations for the prevention and management of postoperative delirium in older adults. The recommendations emphasize nonpharmacologic interventions with a strong focus on reducing the use of psychoactive medication. Perianesthesia nurses can serve as leaders in translating these recommendations into evidence-based practice at the bedside for older adults.

The American board of internal medicine (ABIM) establishes standards for physicians. The American geriatrics society (AGS) is a not-for-profit membership organization of nearly 6,000 health professionals devoted to improving the health, independence, and quality of life of all older people. Beginning in 2013, ABIM redesigned its governance structure, including the role of the specialty boards. Specialty boards are charged with responsibilities for oversight in four main areas: (1) the assessments used in initial certification and maintenance of certification (MOC); (2) medical knowledge self-assessment and practice assessment in the specialty; (3) building relationships with relevant professional societies and other organizational stakeholders; and (4) issues related to training requirements for initial certification eligibility within the specialty. The aim of this paper is to inform the geriatrics community regarding the function of geriatric medicine board (GMB) of the ABIM, and to invite the geriatrics community to fully engage with and leverage the GMB as a partner to: (1) develop better certification examinations and processes, identifying better knowledge and practice assessments, and in establishing appropriate training and MOC requirements for geriatric medicine; (2) leverage ABIM assets to conduct applied research to guide the field in the areas of training and certification and workforce development in geriatric medicine; (3) make MOC relevant for practicing geriatricians. Active engagement of the geriatrics community with ABIM and the GMB will ensure that certification in geriatric medicine provides the greatest possible value and meaning to physicians, patients, and the public.

The typical older patient with cancer presents with several other chronic conditions. The coexistence of multiple chronic conditions in one patient is best termed multimorbidity, and it affects a growing percentage of the population each year. In cancer care, as in much sub-specialty care, \"other diseases\" have been approached from a research and clinical standpoint as \"comorbidities\"--other age-associated diseases that are of secondary importance to cancer care. This is not the same as the newer concept of \"multimorbidity\", a situation in which several overlapping chronic conditions are managed as equally-important to patient quality of life and outcomes. In the absence of a substantial evidence base or clinical practice guidelines that are tailored for multimorbid patients, clinicians need practical guidance for a rational approach to care for these complex patients. We adapt the American Geriatrics Society\'s Guiding Principles as an excellent starting point for clinical decision-making and management. These Guiding Principles include: 1) assessing patient preferences, 2) interpreting the available evidence, 3) estimating prognosis, 4) considering treatment feasibility, and 5) optimizing therapies and care plans. We apply them to older patients with cancer. As the population of older adults with cancer and multimorbidity grows, understanding the impact of multimorbidity on the care of patients with cancer and developing a management approach for these vulnerable patients will be vital for oncology care.

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