- Author
-
P. Jepma
- Title
- Bringing the pieces together
- Subtitle
- Integrating cardiac and geriatric care in older patients with heart disease
- Supervisors
-
W.J.M. Scholte op Reimer
R.J.G. Peters - Co-supervisors
-
B.M. Buurman-van Es
C.H.M. Latour - Award date
- 8 July 2021
- Number of pages
- 335
- ISBN
- 9789083102740
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
Due to the increasing aging population, the number of older cardiac patients is also expected to rise in the next decades. The treatment of older cardiac patients is complex due to the simultaneously presence of comorbidities and polypharmacy, and geriatric conditions such as functional impairment, fall risk and malnutrition. However, the assessment of geriatric conditions is not part of the medical routine in cardiology and therefore these conditions are frequently unrecognized although they have a significant impact on treatment and on outcomes. In addition, treatments are mostly based on single-disease oriented guidelines and inadequately take other conditions into account. This may lead to conflicting recommendations and treatments that do not address important outcomes for older patients such as daily functioning, symptom relief and quality of life. Thus, the care of older cardiac patients is currently suboptimal which increases the risk of functional loss, readmission and mortality.
The overall aim of the work described in this thesis is to explore the integration of cardiac and geriatric care for older patients with heart disease. First, by examining how hospitalized older cardiac patients at high risk for adverse events could be identified. Second, by investigating lifestyle-related secondary prevention of cardiovascular complications in older cardiac patients. And third, by developing a transitional care intervention for older cardiac patients and evaluating the effect on unplanned hospital readmission and mortality. - Persistent Identifier
- https://hdl.handle.net/11245.1/a8cda596-2475-43d4-af44-c933222aa31a
- Downloads
-
Thesis (complete)
Front matter
Chapter 1: General introduction
Chapter 2: Readmission and mortality in patients ≥ 70 years with acute myocardial infarction or heart failure in the Netherlands: A retrospective cohort study of incidences’ and changes in risk factors over time
Chapter 3: Prediction models for hospital readmissions in patients with heart disease: A systematic review and meta-analysis
Chapter 4: The performance of the Dutch Safety Management System frailty tool to predict the risk of readmission or mortality in older hospitalised cardiac patients
Chapter 5: Lifestyle modification in older versus younger coronary artery disease patients
Chapter 6: Older patients’ perspectives toward lifestyle-related secondary cardiovascular prevention after a hospital admission: A qualitative study
Chapter 7: The Cardiac Care Bridge program: Design of a randomized trial of nurse-coordinated transitional care in older hospitalized cardiac patients at high risk of readmission and mortality
Chapter 8: The nurse-coordinated Cardiac Care Bridge transitional care programme: A randomised clinical trial
Chapter 9: Experiences of frail older cardiac patients with a nurse-coordinated transitional care intervention: A qualitative study
Chapter 10: General discussion
Chapter 11: Summary; Samenvatting
Author contribution; PhD portfolio; Publication list; Dankwoord; Curriculum vitae
- Supplementary materials
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