AGS GEMS vs DIRE

AGS Geriatrics Evaluation & Management Tools (GEMS) App The AGS Geriatrics Evaluation & Management Tools (GEMS) App provides guidance to clinicians and trainees who are caring for older adults. Over 20 clinical topics are covered following a History & Physical (H&P) format. Download the AGS Geriatrics Evaluation & Management Tools App and access the templates on Immunizations and Telehealth for free and then subscribe to access all of clinical topics available in this convenient App. The AGS GEMS App is the perfect tool for: • Quick consult for those with experience and training in geriatrics • Checklist for clinicians who are caring for older adults • Teaching tool 1 year subscription for $9.99. Subscriptions will start from at the time of the date of purchase. Your subscription will automatically renew via your iTunes account 24-hours prior to the end of your subscription at the rate of $9.99 for one year. You can turn off the auto-renew feature up to 24-hours before the end of your subscription by going to your Account Settings after purchase. Subscriptions cannot be cancelled during the active subscription period. Privacy Policy - http://www.americangeriatrics.org/legal/privacy_policy/ Terms of Use - http://geriatricscareonline.org/static/terms

The DIRE Score is a tool that can be used to aid clinicians in their decision-making process when considering prescribing opioids for chronic non-malignant pain. Using the DIRE Score, the clinician rates seven factors each on a scale of 1, 2 or 3 with 1 being the least favorable or highest risk for prescribing opioids and 3 being the most compelling or lowest risk for prescribing. The seven DIRE factors are: Diagnosis, Intractability, Risk (there are four risk factors—psychological and chemical health, patient reliability and social support/life roles) and Efficacy. Adding the scores for these seven factors gives a total of 7 – 21. A score of 7-13 was predictive of a low probability of success when prescribing opioids; whereas a score of 14-21 was more likely to be associated with a successful prescribing process and outcome. The DIRE Score does not take into account medical risk factors for opioid prescribing such as comorbid medical conditions (chronic obstructive lung disease, sleep apnea, concomitant use of benzodiazepines, etc.). The clinician should understand that active use of illicit drugs, drug diversion and other aberrant behaviors is incompatible with ongoing opioid prescribing no matter what the DIRE Score may be. The DIRE Score is not meant to be a substitute for sound clinical judgment in the context of any individual patient. This App is meant for informational use only, and is not intended to aid in the diagnosis, treatment or prevention of disease. Decisions about prescribing are solely the responsibility of the licensed prescriber.