TY - JOUR
AU - K. Tanguay
AU - A. Nadeau
AU - A. A. Brousseau
AU - P. M. Archambault
AU - P. H. Carmichael
AU - M. Emond
AU - J. F. Deshaies
AU - M. J. Sirois
AU - F. I. Mowbray
AU - P. G. Blanchard
AU - E. Mercier
A1 - 
AB - BACKGROUND: Data on the predictors of nonmedical problems (NMP) in older adults attending the emergency department (ED) for low acuity conditions is lacking and could help rapid identification of patients with NMP and integration of these needs into care planning. OBJECTIVES: To determine the prevalence and predictors of NMP among older adults attending EDs for low acuity conditions. METHODS: Prospective cohort study in eight EDs (May-August 2021). We included cognitively intact ≥65 years old adults assigned a low triage acuity (3-5) using the CTAS. A questionnaire focusing on 11 NMP was administered. We used multiple logistic regression to identify predictors of NMP. RESULTS: Among the 1,061 participants included, the mean age was 77.1 ± 7.6, majority were female, and 41.6 % lived alone. At least one NMP was reported by 704 persons. Prevalence of each NMP: outdoor (41.1 %) and indoor (30.2 %) mobility issues, difficult access to dental care (35.1 %), transportation (4.1 %) and medication (5.4 %), loneliness (29.5 %), food insecurity (10.3 %), financial difficulties (9.5 %), unsafe living situation (4.1 %), physical/psychological violence (3.4 %), and abuse/neglect (3.3 %). Predictors of NMP were: age (OR 1.04 for each additional year), living alone (OR 2.20), pre-existing mental health conditions (OR 3.12), heart failure (OR 1.42), recent surgery/admission (OR 1.75), memory decline (OR 2.76), no family physician (OR 1.74) and consulting for a fall/functional decline (OR 2.48). CONCLUSIONS: Nonmedical problems are frequent among older adults. We need to implement holistic ED processes that integrate these problems into care planning.
AD - Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, QC, Canada.; Centre de recherche du CHU de Québec - Université Laval, Axe santé des populations et pratiques optimales en santé, Québec, Canada.; VITAM - Centre de recherche en santé durable, Québec, QC, Canada.; Département de médecine de famille et de médecine d'urgence, Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada.; Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada.; Centre de recherche du CHU de Québec - Université Laval, Axe de recherche en vieillissement, Québec, QC, Canada.; College of Nursing, Michigan State University, East Lansing, MI, USA.
AN - 39170452
BT - Heliyon
C5 - Healthcare Disparities
CP - 15
DA - Aug 15
DO - 10.1016/j.heliyon.2024.e35352
DP - NLM
ET - 20240803
IS - 15
JF - Heliyon
LA - eng
N2 - BACKGROUND: Data on the predictors of nonmedical problems (NMP) in older adults attending the emergency department (ED) for low acuity conditions is lacking and could help rapid identification of patients with NMP and integration of these needs into care planning. OBJECTIVES: To determine the prevalence and predictors of NMP among older adults attending EDs for low acuity conditions. METHODS: Prospective cohort study in eight EDs (May-August 2021). We included cognitively intact ≥65 years old adults assigned a low triage acuity (3-5) using the CTAS. A questionnaire focusing on 11 NMP was administered. We used multiple logistic regression to identify predictors of NMP. RESULTS: Among the 1,061 participants included, the mean age was 77.1 ± 7.6, majority were female, and 41.6 % lived alone. At least one NMP was reported by 704 persons. Prevalence of each NMP: outdoor (41.1 %) and indoor (30.2 %) mobility issues, difficult access to dental care (35.1 %), transportation (4.1 %) and medication (5.4 %), loneliness (29.5 %), food insecurity (10.3 %), financial difficulties (9.5 %), unsafe living situation (4.1 %), physical/psychological violence (3.4 %), and abuse/neglect (3.3 %). Predictors of NMP were: age (OR 1.04 for each additional year), living alone (OR 2.20), pre-existing mental health conditions (OR 3.12), heart failure (OR 1.42), recent surgery/admission (OR 1.75), memory decline (OR 2.76), no family physician (OR 1.74) and consulting for a fall/functional decline (OR 2.48). CONCLUSIONS: Nonmedical problems are frequent among older adults. We need to implement holistic ED processes that integrate these problems into care planning.
PY - 2024
SN - 2405-8440 (Print); 2405-8440
SP - e35352
ST - Nonmedical problems among older adults visiting the emergency department for low acuity conditions: A prospective multicentre cohort study
T1 - Nonmedical problems among older adults visiting the emergency department for low acuity conditions: A prospective multicentre cohort study
T2 - Heliyon
TI - Nonmedical problems among older adults visiting the emergency department for low acuity conditions: A prospective multicentre cohort study
U1 - Healthcare Disparities
U3 - 10.1016/j.heliyon.2024.e35352
VL - 10
VO - 2405-8440 (Print); 2405-8440
Y1 - 2024
ER -