Development and validation of the Patient Benefit Index for the dermatocosmetic treatment of aged skin.

This study aimed to develop and validate an instrument for the assessment of patient-relevant benefit in dermatocosmetic treatment, i.e., skin care, of aged skin. Based on an open item collection with 33 elderly persons, items on patient-relevant treatment goals were collected. An expert panel selected 20 items to be most relevant and feasible for the questionnaire named Patient Benefit Index for Aged Skin (PBI-AS). The instrument, which assesses goal importance and achievement, was tested in a cognitive debriefing and validated in a longitudinal study (n = 80) along with the Dry Skin Area and Severity Index (DASI) and the Dermatology Quality of Life Index (DLQI) as convergent validation criteria. The cognitive debriefing showed the good practicability and feasibility of the instrument. Significant correlation with change in DASI (r = -0.527; p < 0.001) supports convergent validity of the PBI-AS. By contrast, correlation with DLQI was poor, indicating the different constructs. The PBI-AS is a valid and feasible tool for the patient-centered assessment of dermatocosmetic treatment benefit in aged skin.

A Long-Term Study to Evaluate Acidic Skin Care Treatment in Nursing Home Residents: Impact on Epidermal Barrier Function and Microflora in Aged Skin.

BACKGROUND: The pH of the stratum corneum (SC) in the elderly is elevated and linked to impaired SC function. Therefore, this paper addresses the question of whether acidic skin care generates positive clinical, biophysical, and microbiological effects in aged skin. METHODS: This study was performed to assess skin care effects in nursing home residents (aged 80-97 years). Visual, biophysical, and microbiological methods were used. Subjects were randomly assigned to 1 of 2 groups and treated over 7 weeks with skin care products adjusted to a pH of 4.0 (group A) or a pH of 6.0 (group B). RESULTS: Compared to baseline, SC integrity improved significantly in group A (p = 0.007), whereas there was no change in group B (p = 0.672). SC recovery 24 h after perturbation increased significantly in group A (p = 0.004) compared to baseline. The SC recovery in group B was not significant compared to baseline (p = 0.327). CONCLUSION: Long-term treatment with pH 4.0 skin care results in a significant improvement in epidermal barrier function compared to identical products with a pH of 6.0. In addition, effects on skin dryness and resident flora were demonstrated, but without significant differences, between the 2 groups. Based on these results, we recommend adjustment of skin care products for the elderly to a pH of 4.0 to maintain the health of aged skin. © 2015 S. Karger AG, Basel.

Geriatric drug therapy: neglecting the inevitable majority.

Demographic evolution will considerably increase the number of people aged 65 years and beyond in the coming decades. The elderly not only represent the most heterogeneous population, but also are a major user group for prescribed medicines, a predominance that will continue to further increase. Medicines and medication management are much more complex and challenging in the elderly and can only be addressed through a multidisciplinary approach. There is strong evidence that the elderly are able to properly manage their medication; however, their medications require different features than the standard medications used by adults. The elderly are exposed to several chronic disease conditions and their treatments, as well as experience age-related changes and limitations that need to be reflected in their medication management strategies. Geriatric drug therapy remains a multidisciplinary task. The health care industry, physicians, pharmacists, nurses and care givers provide and guide the patient's therapy according to individual needs, while the health care system and regulatory authorities build the necessary framework of support and resources.Any realistic and significant enhancement to the elderly patients' medicines and medication management needs to be addressed by all disciplines and stakeholders involved since the absence of any of the stakeholders in the overall process negatively impacts the achievable enhancement in geriatric drug therapy.