Frailty among older adults heightens their risk of negative health outcomes, and medication use plays a major role in this increased vulnerability. Various aspects of medication use elevate the risk of poor outcomes in individuals with frailty. The current scoping review was designed to explore medication use in older adults with frailty in primary care, focusing on the prevalence of potentially inappropriate medications (PIMs), polypharmacy, medication adherence, and their role in contributing to adverse drug events. This scoping review was conducted using the Arksey and O’Malley, supplemented by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews (PRISMA-ScR) guidelines. A search of the literature was conducted from inception to November 2023 in Ovid EMBASE, PubMed (MEDLINE), Scopus, EBSCOhost CINAHL, and Ovid International Pharmaceutical Abstracts. Studies which met the eligibility criteria included older adults with frailty (≥65 years) living at home, defined frailty criteria, and assessment of medication use. Out of the 4726 studies screened, 223 were included, conducted across 39 countries. Frailty prevalence varied widely from 0.9% to 89.2%. Polypharmacy (5–9 medications) and hyper-polypharmacy (≥10 medications) were notably more common among individuals with frailty, with polypharmacy rates ranging from 1.3% to 96.4%. Twelve studies reported PIM prevalence among individuals with varying levels of frailty, ranging from 2.4% to 95.9%. This scoping review highlights the challenges and complexities involved in understanding the relationship between medication use and frailty in older adults.

Prolonged wait times in Canada's Emergency Departments (EDs) adversely impact patients, hospital staff, and the healthcare system. Despite the growing literature on ED wait times in Canada, our understanding of what strategies work to reduce wait time remains sporadic due to the absence of a current, comprehensive mapping of the interventions implemented within EDs. This scoping review aims to address this gap and map ED interventions in Canada, which may be useful for policymakers and healthcare professionals to make evidence-informed decisions. Scoping Review. Utilizing Arksey and O'Malley's methodological framework, we summarized peer-reviewed articles on interventions in Canadian EDs from January 2010 to May 2024. To categorize and interpret the diverse interventions, we conducted a narrative synthesis using Braun and Clark's thematic analysis method. We identified 21 articles, predominantly focusing on Ontario (n = 16). Most studies utilized retrospective evaluations (n = 16), followed by cluster randomized trials (n = 2), quasi-experimental design (n = 1), prospective survey (n = 1), and before-after design (n = 1). Nearly all were in high-volume urban EDs, with one in a rural setting. Interventions were categorized into five themes: Alternative Location, Financial Incentives, Health Workforce Enhancement, Process Improvement, and Integrated Intervention. While alternative ED locations, health workforce enhancement, and integrated approaches showed promise in reducing ED wait times, financial incentives and process improvement initiatives showed mixed results. The reviewed interventions focused on strengthening ED operational efficiencies, but sustainable wait time reduction necessitates multifaceted, context-specific approach. Future research should consider broader health system challenges and ED contextual issues.

AI-assisted learning has seen a remarkable uptick over the last few years, mainly due to the rise in popularity of Large Language Models (LLMs). Their ability to hold long-form, natural language interactions with users makes them excellent resources for exploring school- and university-level topics in a dynamic, active manner. We compare students' experiences when interacting with an LLM companion in two capacities: tutored learning and learning-by-teaching. We do this using Chrysalis, an LLM-based system that we have designed to support both AI tutors and AI teachable agents for any topic. Through a within-subject exploratory study with 36 participants, we present insights into student preferences between the two strategies and how constructs such as intellectual humility vary between these two interaction modes. To our knowledge, we are the first to conduct a direct comparison study on the effects of using an LLM as a tutor versus as a teachable agent on multiple topics. We hope that our work opens up new avenues for future research in this area.