AGS Choosing Wisely Workgroup: American Geriatrics Society Identifies Five Things that Healthcare Providers and Patients Should Question

Review of the development and final recommendations for the Choosing Wisely Top Five recommendations from the American Geriatrics Society.

 

American Geriatrics Society identifies five things that healthcare
providers and patients should question

AGS Choosing Wisely Workgroup

Thanks to pharmaceutical and surgical breakthroughs, the development of vaccinations against once-devastating infectious diseases, and greatly improved sanitation, Americans are living far longer than their predecessors just a few generations ago. Adults turning 65 this year can expect to live, on average, another 19 years.

For a significant part of their later years, however, many older Americans are living with serious health problems. Many have more than one. More than half of all adults 65 and older in the United States have three or more chronic diseases, thereby meeting the criteria for multimorbidity.

Treating older patients can be challenging. Due to age-related anatomical and physiological changes, older adults may respond differently to medications and procedures than younger patients. Because older adults — particularly older adults with multiple disorders — are underrepresented in clinical trials, judging the appropriateness of treatments for aging patients can be difficult.

Further complicating care for the more than 50 percent of older patients with multimorbidity, current clinical practice guidelines tend to focus on the treatment of individual disorders and, consequently, may not be applicable to those with multiple disorders. According to a seminal 2005 study, following all of the individual clinical guidelines applicable to a hypothetical, 71-year-old woman with chronic obstructive pulmonary disease, type 2 diabetes, osteoporosis, hypertension, and osteoarthritis would result in her taking a list of medications that would put her at significant risk of multiple drug side effects, and drug-drug interactions.

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