The patient presenting with ‘Acopia’ - Acute Medicine Journal (original) (raw)

Abstract

Patients may be referred to Acute Medical Units (AMUs) with a diagnosis of ‘acopia’. This term is offensive and lazy, implying fault on the part of the patient and allowing the assessing doctor to erroneously label the patient as a ‘social admission’ when, in fact, such patients are likely to be frail with co-morbidities and have an acute (potentially reversible) illness. Frail older patients should be assessed using the principles of Comprehensive Geriatric Assessment, informed by an understanding of the concept of frailty and of geriatric syndromes such as falls and delirium.

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References

1. Kee YY, Rippingale C. The prevalence and characteristic of patients with ‘acopia’. Age and ageing 2009; 38(1): 103–5.
2. Ellis G, Langhorne P. Comprehensive geriatric assessment for older hospital patients. British Medical Bulletin 2005; 71(1): 45–59.
3. Stuck AE, Siu AL, Wieland GD, et al. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 1993; 342(8878): 1032–6.
4. Ellis G, Whitehead MA, Robinson D, et al. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials. BMJ 2011; 343.
5. Martin F. Comprehensive Assessment of the Frail Older Patient. http://www.bgs.org.uk/index.php/topresources/publicationfind/goodpractice/195-gpgcgassessment. Accessed 26th May, 2013.
6. National Institute for Health and Clinical Excellence. Delirium: diagnosis, prevention and management. London: National Institute for Health and Clinical Excellence, 2010.
7. Nicolle LE, Bradley S, Colgan R, et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2005; 40(5): 643–54.
8. Scottish Intercollegiate Guidelines Network. Management of Suspected Bacterial Urinary Tract Infection in Adults. Algorithm:Suspected UTI in older people. http://www.sign.ac.uk/pdf/sign88_algorithm_older.pdf. Accessed 30th July, 2013.
9. American Psychiatric Association. Diagnostic and statistical manual of mental disorders : DSM-IV-TR. 4th ed., text revision. ed. Washington, DC: American Psychiatric Association, 2000.
10. Obeid JL, Ogle SJ. Acopia‘: a Useful Term or Not? Australasian Journal on Ageing 2000; 19(4): 195–98.
11. McVean A. Acopia—unable to cope or to copy? Age and ageing 2009;38(4):490–91.
12. King D. Acopia is a town in Peru, not a medical term to describe people… Nursing Standard 2004; 18(18): 31.
13. Urban Dictionary. Acopia. http://www.urbandictionary.com/define.php?term=acopia. Accessed 29th April, 2013.
14. Dr Nick. Acopia! - I’m all for it! http://drnickonline.blogspot.co.uk/2006/07/acopia-im-all-for-it.html. Accessed 27th April, 2013.
15. Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. The Lancet 2013; 381(9868): 752–62.
16. Woodford HJ, George J. Diagnosis & management of urinary tract infection in hospitalized older people. Journal of the American Geriatrics Society 2009; 57(1): 107–14.
17. Ninan S, Barlow G. Investigation & management of urinary tract infection in older age. Geriatric Medicine 2012; 14(2): 66–73.
18. Davis ID, Zajac JD. Can’t cope with ‘acopia’. Internal medicine journal 2005; 35(9): 574; author reply 74-5.
19. Oliver D. ‘Acopia’ and ‘social admission’ are not diagnoses: why older people deserve better. Journal of the Royal Society of Medicine 2008; 101(4): 168–74.
20. Kingston M. Reply. Internal medicine journal 2005; 35(9): 574–75.
21. Royal College of Physicians. Hospitals On The Edge. The Time for Action. http://www.rcplondon.ac.uk/sites/default/files/documents/hospitals-on-the-edge-report.pdf. Accessed 30th July, 2013.

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8th March 2016

PMID: 24098878

Cite this article as:

Granger K, Ninan S, Stopford E. The patient presenting with 'acopia'. Acute Med. 2013;12(3):173-7. PMID: 24098878.