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2012 and December, 2014 with six-month follow-up. Age, sex,
cardiovascular risk factors, comorbidity, New York Heart Association
functional class (NYHA), functional status, geriatric syndromes,
treatment, left ventricular ejection function and laboratory variables
were included. Global mortality within six months was the primary
outcome. A multivariate logistic regression analysis was performed.
Statistical analysis: SPSS version 23.0.
Results:
665 consecutive patients with an average age of 89 (SD5)
were included. Four hundred and eighty-two patients (72.5%) were
women. The median age adjusted Charlson Comorbidity index was
6.15 (IQR 5
–
8). Within six months 246 (37%) patients had died. The
final model covariates were hemoglobin levels <10 g/dL (Odds ratio
(OR)1.75; confidence interval 95% (CI95%)1.08
–
2.92), glomerular
filtration rate <60 mL/min(OR: 2.33; CI95% 1.57
–
3.44), albumin
levels <3 g/100 mL (OR: 2.32; CI95% 1.56
–
3.44), NYHA III
–
IV(OR:
1.65; CI95%1.12
–
2.44), score on Katz ADL index <2 (OR: 2.01; CI 1.34
–
3.01). The area under the Receiver operator characteristic (ROC) curve
was 0.71 (CI95% 0.67
–
0.75).
Conclusion:
The present model may define which geriatric heart
failure patient is a palliative patient as it has proved to be a good
predictor of six-month mortality. Furthermore, this study may help
clinicians with decision-making in older patients with acute heart
failure.
P-195
Factors associated with readmission in older patients with acute
heart failure
J.M. Abarca
1
, L.F. Arana
1
, E.L. Alonso
1
, F.J.M. Sánchez
1
, P.G. Gregorio
1
.
1
Geriatric Medicine Department at Clínico San Carlos Hospital, Madrid,
Spain
Objective:
The aim of this study is to identify the factors associated
with readmission of patients over age 70 with HF.
Methods:
Observational cohort study. Patients discharged with AHF
diagnosis between January, 2012 and December, 2014 were analyzed
with a follow-up period of one year. Study variables included age, sex,
cardiovascular risk factors, comorbidity, New York Heart Association
functional class (NYHA), functional status, geriatric syndromes, medi-
cation prescribed, left ventricular ejection function, laboratory vari-
ables and date of readmission for AHF and other causes. Multivariate
logistic regression analysis was performed.
Results:
571 patients were analyzed with average age of 89 (SD 5). Four
hundred and thirteen patients (72.2%) were women and the median
age-adjusted Charlson Comorbidity index was 6 (IQR 5
–
8). The
primary outcome measures were 30-day and 1-year hospital readmis-
sion. 295 patients (51.7%) were readmitted in a period of time of 1 year.
The proportion of readmissions is 37.9% on the first month, 43% from 1
to 6 months and 17.3% from 6 to 12 months. The principal cause for
rehospitalizationwas AHF (p < 0.001). Multivariate analysis for 30-day
readmission: Anaemia (Odds ratio (OR): 1.91, confidence interval (CI)
95% 1.1
–
3.5), previous hospitalizations for AHF(OR: 2, CI95% 1.1
–
3.8),
NYHA II (OR: 3.1, CI95% 1.4
–
7.1), NYHA III-IV OR: 2.5 (p = 0.57).
Multivariate analysis for Late readmissions: Pulmonar Hypertension
OR: 3.9(p = 0.043), Uric acid OR: 1.26(p = 0.003). Length of hospital
stay >22 days: OR: 0.22(p = 0.007).
Conclussion:
Half of hospitalized patients have at least one readmis-
sion on the first year. Exacerbation of the disease (AHF) and anemia are
responsible for early readmission. Late readmissions are related to
other comorbidities.
P-196
Assembly of a drug file for use within the SENATOR trial
M. McCarthy
1
, S. Cullinan
1
, D. O
′
Mahony
2
, S. Byrne
1
.
1
Primary Care
Research Group, School of Pharmacy, University College Cork,
2
Department of Geriatric Medicine, Cork University Hospital, Cork
Introduction:
The European Union has funded the development and
trial of a new Software ENgine for the Assessment and optimization of
drug and non-drug Therapy in Older peRsons (SENATOR). The aim of
SENATOR is to develop a software engine capable of assessing; (1)
clinical status, (2) pharmacological and (3) non-pharmacological
therapy of elderly, multi-morbid patients. In order to (1) optimise
patient
’
s pharmacotherapy, (2) highlight potential risk of adverse drug
reactions (ADRs) and (3) advise non-pharmacological treatment.
Objectives:
To assemble a comprehensive drug file, suitable for use
within the electronic Case Report Form (eCRF) and SENATOR software,
combining drug databases from six participating E.U. countries
(Ireland, UK, Iceland, Belgium, Italy and Spain).
Methods:
The creation of a comprehensive SENATOR drug file consis-
ted of five steps; (1) Consultation with partners at each E.U. site. (2)
Assembling existing data fromeach jurisdiction. (3) Verifying data from
each country. (4) Modifying for SENATOR including removal of com-
bination products. (5) Continual updating and validation of the file.
Results:
(1) Achieved agreement regarding the key pieces of
information needed for each product in the common drug file. (2)
Developed a standardised template for data collection. (3) Two
versions of the final drug file; o a larger comprehensive drug file
(n = 65,535 entries) o a streamlined file for use within SENATOR trial
(n = 51,172 entries) (4) A standardised template and procedure for
updating the drug file.
Conclusions:
This uniquely challenging process produced the first
example of a multinational drug file assembled specifically for use
within a CDSS.
P-197
Short assessment of health literacy and medication adherence in
older adults with polypharmacy and acute conditions
J.A. Melo
1
, S.Q. Fortes-Filho
1
, M.J.R. Aliberti
1
, D. Apolinario
1
,
W. Jacob-Filho
1
, J.M. Farfel
1
.
1
Division of Geriatrics, Department of
Internal Medicine, University of São Paulo Medical School, São Paulo,
Brazil
Objectives:
To investigate the relationship between functional health
literacy and medication adherence in a sample of older patients with
polypharmacy admitted in a Geriatric Day Hospital (GDH) focused on
the treatment of acute events and decompensated chronic diseases.
Methods:
A cross-sectional study involving 171 older adults with
polypharmacy and independent for taking medications. Functional
health literacy was assessed with the 18-item Short Assessment of
Health Literacy for Portuguese-speaking Adults (SAHLPA-18), a
validated instrument to evaluate pronunciation and comprehension
of commonly used medical terms. Medication adherence was
measured using the pillbox test and a medication knowledge scale.
The first evaluated the ability to understand and organize a
prescription and the second to report your own prescription. Logistic
regression models were controlled for demographic data and Charlson
comorbidity index.
Results:
The mean of age was 77.3 years (SD 8.4 years) and mean of
education in years was 6.1 (SD 5.1). Functional health literacy below
adequate was found in 38% of the sample. In a fully adjusted logistic
regression model, patients with inadequate functional health literacy
were more likely than patients with adequate functional health
literacy to did not complete pillbox test correctly (OR = 8.76; 95% CI 2.4
to 30.9) and to did not report at least 80% of yours own prescription
(OR = 6.9; 95% CI 3.2 to 15.2).
Conclusion:
Inadequate functional health literacy was associate with
poor medication adherence in older adults with acute conditions.
This finding reinforce the importance of educational approach in non-
adherence patients.
P-198
Comparing comorbidity and evolution of geriatric patients with
nonagenarians admitted to a subacute intermediate care hospital
R. Miranda
1,4
, N. Gual
1,2
, C. Arnal
1
–
3
, P. Burbano
1
, A. Contra
1
,
M. Inzitari
1,2
.
1
Parc Sanitari Pere Virgili,
2
Universitat Autònoma de
Barcelona,
3
Hospital Universitari Vall d
′
Hebrón, Barcelona, Spain;
4
Hospital Beatriz Ângelo, Lisboa, Portugal
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S80