OCTOBER 2010 Health Care of the Elderly FAMILY MEDICINE FORUM Nov 3 - 5, 2011
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O C T O B E R 2 0 1 0
Health Care of the Elderly FAMILY MEDICINE FORUM Nov 3 - 5, 2011
Health Care of the Elderly: Agenda
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Visit and practice with Health Care of the Elderly (HCOE) information in these areas:
1. CFPC & other associations & organizations
2. Guidelines
3. Keeping up to date
4. Clinical practice tools
5. Patient & health information
Questions/Answers Wrap-up
1. CFPC & other associations
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CFPC Health Care of the Elderly Program –in CFPC Section of Family Physicians with Special Interests or Focused Practices (SIFP) | Section des médecins de famille avec intérêts particuliers ou pratiques ciblées (IPPC)
The Health Care of the Elderly Program Committee is the executive body for the program On committee web pages: What’s new, Who we are,
Resources
To get to committee pages, use search box or Directories pulldown > Committees or >Sections
Information on CFPC Website
3 tabs- What’s New, Who We Are,
Resources
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Breadcrumb trail
Pull down DIRECTORIES > Committees or > Sections
Examples
"Priorities for the Health Care of the Elderly" The Role of the Family Physician CFPC;2007. [PDF]
Evidence-Based Care of the Elderly Health-Guide CFPC;2002. [PDF]
These are listed on HCOE Program Committee page on Resources tab
Reports & Resources
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HCOE Associations/Organizations
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Find various types of information on these websites - Clinical Tools, Discussion, Guidelines, Patient Information, News & Events
American Geriatrics Society Canadian Association on Gerontology Canadian Coalition for Seniors’ Mental Health Canadian Geriatrics Society Centre de recherche de l'Institut universitaire de gériatrie de Montréal Long Term Care Medical Directors of Canada National Initiative for the Care of the Elderly Ontario Long Term Care Physicians Société québécoise de gériatrie Regional Geriatric Programs of Ontario La Société française de gériatrie et gérontologie
Information on CFPC Website - Training
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Program Directors: Directories pulldown > University Programs > online Directory of Departments, select Care of Elderly Program Directors from the pulldown menu or click here
Standards for Accreditation PDF (Appendix A for HCOE standards) | Critères pour l’agrément des programmes de résidence PDF (Annexe A)
Continuing professional development CPD upcoming events
Information on CFPC Website - Training
Care of the Elderly Residency Program
Directors
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• Also see resources at CFPC Library Care of the Elderly Subject Guide http://www.cfpc.ca/CareOfTheElderly/
• To get to library pages: Resources pulldown > Library Services or use search box
Information on CFPC Website - Library
Search for HCOE resources
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Search box
P L E A S E T A K E A F E W M I N U T E S T O E X P L O R E H E A L T H C A R E O F T H E E L D E R L Y R E S O U R C E S
O N T H E C F P C W E B S I T E .
Q U E S T I O N S ?
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Information on CFPC Website
2. Guidelines: what do you do?
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Favorite website?
Google?
Guidelines databases?
Other databases e.g. TRIP?
Books – digital or print?
Guideline articles in journals?
Integrated with your EMR?
Ask a colleague?
Other?
2. Guidelines
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Advantages & disadvantages of different methods?
Google may work well, but it can be difficult to determine whether you have the most recent information, since results are not sorted by date
National guidelines databases may be comprehensive, but may not be very user-friendly
Not enough Canadian content can be a problem
Guidelines
National Guidelines Databases (all topics) CMA – CPG Infobase
US National Guidelines Clearinghouse
UK - NICE Guidance NHS http://www.nice.org.uk/
The above are all listed on CFPC Library Guidelines page
HCOE Guidelines American Geriatrics Society Guidelines
British Geriatrics Society Guidelines
Regional Geriatric Program, Hamilton ON Resources
Towards Optimized Practice (Alberta) – Clinical Practice Guidelines (Note: scroll to foot of individual guideline summaries for full download, or click on CPG download from left hand menu)
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TOP – Clinical Practice Guidelines
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Guidelines – Examples
Antiphospholipid Syndrome , Thrombosis Interest Group of Canada Heart Failure diagnosis and management, Canadian Cardiovascular
Society, 2006 [PDF] 2009 update [PDF] Dementia. Diagnosis and treatment of dementia: 6. Management
of severe Alzheimer disease CMAJ article also free in PubMed Central, PubMed record (5 other articles in this series)
Diabetes Mellitus Clinical Practice Guidelines (Canadian Diabetes Association)
Hypertension CHEP /Hypertension Canada Recommendations 2011 update
Mental Health: Assessment and Treatment of Delirium Guideline (Canadian Coalition for Seniors’ Mental Health)
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TRIP database http://www.tripdatabase.com/
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Evidence based
Fast & free
Developed by UK general practitioners
Filter retrieval by resource type
Guidelines is a resource type – others: synopses, systematic reviews, etextbooks, clinical Q&A, patient information, news
Trip Database: Clinical Search Engine
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Trip Database: Clinical Search Engine
P L E A S E T A K E A C O U P L E O F M I N U T E S T O P R A C T I C E W I T H T R I P O R E X P L O R E O T H E R
G U I D E L I N E S S I T E S
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Guidelines
3. How do you keep up to date?
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Email alerts
RSS feeds
Podcasts
CPD events and courses
Others?
EvidenceUpdates
Regular email alerts of best evidence from the literature
Published by BMJ Group
Free but need to register
Tailor to discipline – e.g. geriatrics, or other options
Tailor for relevance and newsworthiness ratings
Also a searchable database of all alerts
http://plus.mcmaster.ca/EvidenceUpdates/
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Or a Population
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Select a Discipline
EvidenceUpdates in your Mailbox
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RSS feeds
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• RSS = Really Simple Syndication
• Way to disseminate regularly updated content such as news and announcements
• Feeds contain a list of summaries along with a link to the full version of the Web content
• Feed readers automatically check for updates and download new files to your computer
• Feed readers incorporated in browsers eg Internet Explorer or web-based such Google Reader
RSS feeds in Internet Explorer
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RSS icon will be orange if
it detects a feed
Another example of website with feed
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RSS icon will be orange if
it detects a feed
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…This dialogue box appears
Clicking on RSS icon takes you to feed page
See your feeds by clicking on Favorites
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Go to Favorites when you want to see what’s new
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List of feeds in Google Reader
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For more information “Getting started with Google Reader”
Podcasts
Use RSS technology
Feed readers e.g. iTunes automatically check for updates and download new files to your computer
Audio files in MP3 format
Listen on computer, iPod, other MP3 player
Most are free
Learn about iTunes podcasts here
OR use other free software e.g. Juice
Help at most sites that have podcasts, e.g. CDC here
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Podcasts - Examples
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Therapeutics Education Collaboration (Canadian)
Journal contents & highlights from many journals e.g. JAMA
CDC http://www2a.cdc.gov/podcasts/ see “Healthy aging” series under Browse
Johns Hopkins podcasts
InfoPOEMS podcast (Essential Evidence Plus)
Subscribe to podcasts in iTunes
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Go to iTunes Store in the left column of the jukebox window
Select “Podcasts” from the menu bar along the top of the store …. There’s also a link to Podcasts at the foot of the screen
If you click the little arrow to the right of Podcasts on the top menu bar, you can select a category, e.g. Science & Medicine
Subscribe by clicking on “Subscribe” icon, or copying and pasting the address of the podcast you want into your feed reader
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iTunes Store
iTunes store link
Science & Medicine podcast page
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Click here to Subscribe
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You can also search iTunes & filter by Podcasts
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CPD – where to find lists?
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CFPC website > CPD > Upcoming Events
Online CME – Geriatrics
Medscape Geriatrics Learning Center and News
Free but need to register
Portal of Online Geriatric Education POGOe Free public repository of geriatric educational materials in various e-learning formats, including lectures, exercises, virtual patients, case-based discussions, simulations, as well as links to other resources.
Need to register, but some content is freely accessible e.g. http://www.pogoe.org/cme
Upcoming CPD Events on CFPC website
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Portal of Online Geriatric Education POGOe
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P L E A S E T A K E A C O U P L E O F M I N U T E S T O E X P L O R E S O M E O F T H E S E R E S O U R C E S
Q U E S T I O N S ?
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Keeping up to date
4. Clinical Practice Tools
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Where to find?
Association and organization pages
Dedicated web pages
Collections of resources e.g. Regional Geriatrics Program
Apps on iTunes
Others?
Many clinical practice tools are listed in the Resources section of the Health Care of the Elderly Program Committee
Regional Geriatric Programs of Ontario rgps.on.ca
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Geriatrics, Interprofessional Practice and Interorganizational Collaboration Toolkit
Collection of many tools
Free but need to register
Other examples of Clinical Practice Tools
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Cognitive Impairment Flow Sheet (BC Ministry of Health PDF)
Dementia Predictor Calculators (Sunnybrook Health Sciences Centre)
Depression Assessment & Treatment Tool (NICE)
Driving and Dementia Toolkit (RGP Eastern Ontario)
Geriatric Depression Scale
at Stanford http://www.stanford.edu/~yesavage/GDS.html
Various other locations e.g. BC Guidelines in PDF
Geriatric Patients Annual Follow-up (PDF)
Montreal Cognitive Assessment Tool (MOCA)
Trail Making Tests, Parts A & B (University of Iowa)
Life expectancy calculator (MediResource Inc.)
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Other examples of Clinical Practice Tools
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Geriatrics At Your Fingertips – App on iTunes
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Geriatrics At Your Fingertips
P L E A S E T A K E A F E W M I N U T E S T O E X P L O R E T H E S E R E S O U R C E S
D O Y O U H A V E O T H E R S U G G E S T I O N S ?
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Clinical practice tools
5. Patient & health information for seniors
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Public Health Agency of Canada, Seniors’ Health
MedlinePlus – Seniors area
NIH Senior Health
Medical Library association – top senior health websites
CDC Healthy Aging http://www.cdc.gov/aging/
Public Health Agency of Canada Aging & Seniors
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National Institutes of Health Senior Health
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Medical Library Association – Senior Health Websites you can Trust
Senior Health
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D O Y O U H A V E O T H E R S U G G E S T I O N S ?
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Patient information
Health Care of the Elderly: Summary
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We looked at 5 different types of HCOE information and where to find them:
1. CFPC & other associations & organizations
2. Guidelines
3. Keeping up to date
4. Clinical practice tools
5. Patient & health information
Questions?
T H A N K S !
D R . F R E D M A T H E R , H C O E P R O G R A M C O M M I T T E E
L Y N N D U N I K O W S K I
D I R E C T O R O F L I B R A R Y S E R V I C E S , C F P C
Q U E S T I O N S T O : c l f m @ u w o . c a
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