Annotated Bibliography

End of Life and Systems of Care

• 1.Beers, MH. Explicit Criteria for Determining Potentially Inappropriate Medication Use by the Elderly: An Update. Archives of Internal Medicine; 1997; 157:1531-1536.[Annotation]
• This study updates criteria regarding the appropriate use of medications for frail elderly. The author conducted a literature review to develop the criteria, submitted the criteria to reviewers, and sought consensus from 6 nationally recognized experts in geriatrics and pharmacology. The experts agreed on the validity of 28 criteria describing the potentially inappropriate use of medication by the general population and 35 criteria defining potentially inappropriate use of medication by the elderly known to have any of 15 common medical conditions. Tables of the final criteria independent of diagnosis and considering diagnosis are included. The author concludes that explicit criteria, such as drugs to be avoided by the elderly and dosage/frequency of administration, provide useful tools for assessing the quality of prescribing to older persons.[Pub Med]

• 2. Billings, JA. What is Palliative Care? Palliative Medicine; 1998; 1:1:73-81. [Annotation]
• This essay brings together the definitions of palliative care and considers what the finer points of palliative care have become. The author compares and contrasts hospice and palliative care, and he discusses the new palliative care physician as a generalist with an area of special competence. He characterizes palliative care by dissecting the elements of definition and embracing the elements of diversity. He comments on the growth and acceptance of palliative care, citing multiple clinical centers, journals, books and a diversity of physicians as examples. [Pub Med]

• 3. Kane, RA. Definition, Measurement, and Correlates of Quality of Life in Nursing Homes: Toward a Reasonable Practice, Research, and Policy Agenda. The Gerontologist; 2003; 43: Special Issue II:28-36.[Annotation]
• This theoretical analysis is based on the literature and the author’s own large scale studies on the quality of life in nursing homes. The author argues that the nursing home resident must have a say in his/her quality of life. She suggests 5 challenges for measuring quality of life: designing questions with appropriate response categories and time frames, developing a sampling strategy, aggregating information at the individual and facility levels, validating what are ultimately subjective constructs, and developing an approach using observation and proxies to assess quality of life for those unable to speak for themselves. She emphasizes that nursing home policy which present barriers to good quality of life should be reviewed and that good research protocols are needed both in methodological research and in the study of the correlates of quality of life. [Pub Med]