Shane O'Hanlon

Shane O'Hanlon
St. Vincents University Hospital & University College Dublin · Geriatric Medicine

MBChB BAO MSc BMedSci LLB DGM MRCPI

About

88
Publications
5,182
Reads
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442
Citations
Citations since 2016
48 Research Items
374 Citations
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2016201720182019202020212022020406080100120
2016201720182019202020212022020406080100120
2016201720182019202020212022020406080100120
Introduction
Geriatric Oncology Surgical Liaison Geriatrics Rehabilitation Legal Medicine Health Informatics
Additional affiliations
June 2019 - present
University College Dublin
Position
  • Professor (Associate)
October 2017 - June 2019
University College Dublin
Position
  • Professor (Assistant)
December 2016 - March 2018
British Geriatrics Society
Position
  • Honorary Secretary

Publications

Publications (88)
Article
The COVID-19 pandemic poses a barrier to equal and evidence-based management of cancer in older adults. The International Society of Geriatric Oncology (SIOG) formed a panel of experts to develop consensus recommendations on the implications of the pandemic on several aspects of cancer care in this age group including geriatric assessment (GA), sur...
Article
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Response to: Savulescu J, Cameron J. Why lockdown of the elderly is not ageist and why levelling down equality is wrong [published online ahead of print, 2020 Jun 19].
Article
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Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) establishes a right to legal capacity for all people, including those with support needs. People with disabilities have a legal right to be given the appropriate supports to make informed decisions in all aspects of their lives, including health. In Irela...
Article
A majority of cancer cases now occur among older people, but this group is less likely to receive treatment and outcomes are poorer than in younger people. Age by itself can be a poor predictor of who will benefit from treatment with surgery, chemotherapy or radiotherapy. Comprehensive geriatric assessment is a multidisciplinary, multidomain proces...
Article
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For physicians, it is important to know which treatment outcomes are prioritized overall by older patients with cancer, since this will help them to tailor the amount of information and treatment recommendations. Older patients might prioritize other outcomes than younger patients. Our objective is to summarize which outcomes matter most to older p...
Article
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The treatment of cancer can have a significant impact on quality of life in older patients and this needs to be taken into account in decision making. However, quality of life can consist of many different components with varying importance between individuals. We set out to assess how older patients with cancer define quality of life and the compo...
Preprint
Take Home Message New imaging techniques (including MRI and PET with performant tracers) are more sensitive in prostate cancer than conventional imaging and reveal sites of disease that may never have been seen with conventional imaging; resulting in stage migration and potentially a change in the clinical management. Until such time that long-term...
Article
Purpose of review: Delirium is a common and important adverse event in the perioperative period. Older people with cancer are at significant risk, and outcomes are poor. There is increasing awareness of the effect of psychological distress and social support on pathogenesis and outcomes of delirium in this setting. This review aimed to describe re...
Article
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Context There is uncertainty regarding the most appropriate criteria for recruitment, monitoring, and reclassification in active surveillance (AS) protocols for localised prostate cancer (PCa). Objective To perform a qualitative systematic review (SR) to issue recommendations regarding inclusion of intermediate-risk disease, biopsy characteristics...
Article
Gastroesophageal adenocarcinoma is a disease of older adults with very poor survival rates. Its incidence has risen dramatically across the world in recent decades. Current treatment approaches for older adults are based largely on extrapolated evidence from clinical trials conducted in younger and fitter participants than those more commonly encou...
Article
Background: Understanding what information patients want and need is an important step in optimizing care. Therefore, we set out to collect all available evidence about the information that is most important to older patients with a new cancer diagnosis and whether or not these information needs are sufficiently addressed. Method: A systematic l...
Article
Introduction It is purported that patients with peripheral arterial disease (PAD) may have impaired cognitive function due to concomitant cerebrovascular disease. Such disease may be clinically unrecognized but can impact on a patient's recovery and prognosis. The purpose of this systematic review was to interrogate the body of published evidence o...
Article
Context Surgical techniques aimed at preserving the neurovascular bundles during radical prostatectomy (RP) have been proposed to improve functional outcomes. However, it remains unclear if nerve-sparing (NS) surgery adversely affects oncological metrics. Objective To explore the oncological safety of NS versus non-NS (NNS) surgery and to identify...
Article
Context: While urinary incontinence (UI) commonly occurs after radical prostatectomy (RP), it is unclear what factors increase the risk of UI development. Objective: To perform a systematic review of patient- and tumour-related prognostic factors for post-RP UI. The primary outcome was UI within 3 mo after RP. Secondary outcomes included UI at 3–12...
Article
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Context: The impact of surgeon and hospital volume on outcomes after radical prosta�tectomy (RP) for localised prostate cancer (PCa) remains unknown. Objective: To perform a systematic review on the association between surgeon or hospital volume and oncological and nononcological outcomes following RP for PCa. Evidence acquisition: Medline, Medline...
Article
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Covid-19 is a true gerontological pandemic, with frailty, multimorbidity and geriatric syndromes being of great importance. There has been a lack of geriatrician involvement in planning and delivery of care for older people with Covid-19 in many arenas. Lack of mobilisation of geriatric expertise has led to inconsistent policy responses and ageism....
Article
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Gastroesophageal adenocarcinoma (GOA) is a disease of older people. Incidence is rising in the developed world and the majority of patients present with advanced disease. Based on clinical trial data, systemic chemotherapy in the advanced setting is associated with improvements in quality of life and survival. However, there is a recognised mismatc...
Preprint
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Background Post-operative anaemia affects up to 90% of patients undergoing major surgery [1]. Post-operative anaemia can contribute to slower rehabilitation, increased morbidity, and increased mortality [2]. AimsWe aimed to examine the frequency, investigation, and management of anaemia in patients admitted to St. Vincent’s University Hospital (SVU...
Article
To the Editor In their Teachable Moment, Edward and Gopal¹ describe an important case in which unnecessary use of aspirin in addition to anticoagulation therapy likely caused a greater degree of injury than may have otherwise occurred to a man who had 2 mechanical falls as well as 3 prior falls. I would like to add 2 points to the discussion.
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We describe the expansion and adaptation of a frailty response team to assess older people in their usual place of residence. The team had commenced a weekend service to a limited area in February 2020. As a consequence of demand related to the COVID-19 pandemic, we expanded it and adapted the model of care to provide a 7-day service to our entire...
Article
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Background Hip fractures in the older person are associated with significant morbidity and mortality. Screening patients for frailty and assessing baseline mobility and function may help predict poorer outcomes Methods All patients >/= 60 years old with a hip fracture admitted under the orthopaedic team between February 2016-February 2018 were inc...
Article
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Background Hip fractures are an increasing phenomenon in the older population. Receiving post-operative rehabilitation is associated with better outcomes and a higher likelihood of returning to preexisting level of functioning. Best rehabilitation practices for people with dementia have not been established. Methods All patients >/= 60 years old w...
Article
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Background Ascertaining and discussing resuscitation status should be a routine part of medical practice. However, it is frequently neglected until a patient is acutely unwell. The National Consent Policy1 recommends that discussion around “Do not attempt cardiopulmonary resuscitation” (DNACPR) orders should occur for patients with “an identifiable...
Article
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Background The documentation of discussions about resuscitation status with patients and their relatives is an important part of medical care, but can be a time-consuming process. These discussions may be difficult, particularly for patients who have cognitive impairment or are acutely unwell. The National Consent Policy1 recommends that resuscitat...
Article
Radiotherapy is an effective, albeit underutilised, treatment for cancer in older adults, especially for those who are surgically inoperable or for whom chemotherapy poses too great a risk. It is estimated that approximately half of patients with cancer could benefit from radiotherapeutic management. This article synthesises the basics of how radio...
Chapter
Delirium is common among surgical patients, and is associated with several poor outcomes. Despite this, it is under-recognised and often not included in pre-operative consent. A new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is democratized and all staff have a role in management. Key feature...
Conference Paper
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In Ireland, codes of practice are in development to support healthcare professionals to practice in accordance with the Assisted Decision-Making (Capacity) Act 2015. This Rapid Realist Review (RRR) will deepen understanding of the mechanisms that support the implementation of assisted decision-making (ADM) with older people in the acute setting. Me...
Chapter
Increasing life expectancy has led to a higher incidence and prevalence of cancer in older people, with the largest increase in the 75 and over age group. This group is much more likely to develop cancer than younger people. The incidence rate is higher for older males and varies by cancer type. The rate begins to decline in the 85 and over age gro...
Article
Information technology has the potential to transform healthcare and eradicate many of the inequities seen in the area by improving availability and management of health information. However the use of electronic means to process sensitive health data poses significant risks. Electronic health records have been designed to be more secure than tradi...
Article
PURPOSE: Over 5,100 colorectal cancers (CRC) are diagnosed in the United Kingdom 85 year and older age group per year but little is known of cancer progression in this group. We assessed clinical, pathological and molecular features of CRC with early and late mortality in such patients. METHODS: Data were analysed in relation to early mortality an...
Chapter
Information technology has the potential to transform healthcare and eradicate many of the inequities seen in the area. However, the use of electronic means to process sensitive health data poses significant risks. Electronic health records have been designed to be more secure than traditional paper records, but there have been notable cases where...
Article
BACKGROUND A sizable number of patients presented to our Geriatric Medicine department with a history of syncopal episodes at mass. We hypothesized that those who suffered from syncopal episodes at mass were more likely to suffer from orthostatic hypotension (OH) when compared with a cohort of age matched individuals with no history of syncope. M...
Article
MASS ASSOCIATED SYNCOPE Counihan E, Flynn C, O'Hanlon S, Lyons D Dynamic manoeuvres such as kneeling from sitting and standing from sitting, and prolonged periods of standing are a classic feature of the Catholic celebration of mass. As a result of these manoeuvres, many elderly people experience episodes of collapse during the ceremony. In this...
Article
In replyWe thank Dr Sethi for his comments. There is longstanding controversy regarding the most appropriate term—many others have been suggested in addition to nonepileptic events and nonepileptic seizures. We agree with LaFrance1 that the term seizure does not inherently infer epilepsy. In practical terms, we also find that patients are very fami...
Article
Delirium is a complex neuropsychiatric syndrome that impacts adversely upon patient outcomes and healthcare outcomes. Delirium occurs in approximately one in five hospitalised patients and is especially common in the elderly and patients who are highly morbid and/or have pre-existing cognitive impairment. However, efforts to improve management of d...
Article
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Introduction: Do Not Attempt Resuscitation (DNAR) orders represent a difficult and challenging area of practice for many health professionals. Many studies have examined the perspective of physicians, but recent changes have enhanced the role of nurses in the UK. Despite this, there remains a knowledge gap regarding their interactions with DNAR ord...
Chapter
Many developing nations have begun to introduce elements of e-Health to improve service provision. This chapter provides an account of work in the area including case studies where pioneers have utilised modern mobile technologies to quickly and efficiently introduce new mHealth interventions, despite being resource-limited and having a heavy disea...
Chapter
Information technology has the potential to transform healthcare and eradicate many of the inequities seen in the area. However, the use of electronic means to process sensitive health data poses significant risks. Electronic health records have been designed to be more secure than traditional paper records, but there have been notable cases where...
Article
The term pseudoseizure remains in common use despite calls for it to be replaced with less pejorative alternatives. The word pseudo means “to deceive,” so using the term pseudoseizure can arouse suspicion in those who hear it that the symptoms of a seizure are being intentionally produced, which is not true. Such false impressions undermine the doc...
Article
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Status Epilepticus (SE) is an important medical emergency. There are several challenges when treating older people, including increased mortality, lack of evidence for treatment options, and a high rate of adverse effects. There are few studies focusing on management of SE in older people. This review highlights aspects of care in older patients, p...
Chapter
E-health has been heralded as a possible solution to reducing the major problem of preventable medical error. However, the available evidence is not strong, and there is increasing awareness that implementation of health information technology can result in error of itself. E-health has the potential to alter workflows in unpredictable ways, introd...
Chapter
e-Health has become a major focus for research in healthcare, with significant funding and political support at an international level. Older people stand to benefit more than others, as e-Health aims to facilitate provision of care at a distance and promote independent living for as long as possible. However, barriers remain including an immature...
Conference Paper
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Article
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Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing...
Article
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Limited literacy is associated with a nearly twofold increase in mortality in older patients. The aim was to assess the readability level of patient information leaflets in Ireland. The SMOG formula is a validated tool to assess readability of text, providing an estimate of the years of education needed to understand a piece of writing. We evaluate...
Article
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It was switching to decaffeinated coffee that started it all. In a flash of lucidity I realised the dubious ethical basis for drug company representatives’ courtship of doctors. I noticed that my pattern of prescribing was mostly learnt from observing colleagues, many of whom sourced drug information primarily from drug representatives. I decided t...
Article
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Community geriatrics has evolved as a specific aspect of geriatric medicine in the UK. In Ireland there is uncertainty as to how it should be planned. This is the first national survey of consultants, specialist registrars and general practitioners to seek their opinions. Most consultants and GPs reported already having a community aspect to their...
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Older adults often present to their general practitioner with mobility impairment. Finding the cause can be a challenging process. This article discusses the assessment and investigation of deterioration in mobility in older adults.
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Hypodermoclysis, or subcutaneous infusion of fluids, is an alternative means of administration of fluid. It is sometimes used in older patients in whom there is difficulty achieving intravenous access, or who are entering the terminal stage. It is considered a relatively low-risk procedure. We report a case where a patient's death may have resulted...
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Going on a medical elective is an exciting opportunity. No matter where the destination, for most people it is an intensely rewarding experience, and the memories last a lifetime. However poor preparation can impinge on an otherwise productive elective, leading to lost opportunities. A little time spent considering your options will be time well sp...
Article
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