Defining "elderly" in clinical practice guidelines for pharmacotherapy

作者：Shamsher Singh, Beata V. Bajorek · 发表于：Pharmacy Practice · 年份：2014 · DOI：10.4321/s1886-36552014000400007 · 被引用次数：326 · 研究领域：Clinical practice guidelines implementation、Frailty in Older Adults、Pharmaceutical Practices and Patient Outcomes

OBJECTIVE: To identify how 'elderly' patients are defined and considered within Australian clinical guidelines for the use of pharmacotherapy. METHOD: Guidelines pertaining to the use of pharmacotherapy, focusing on conditions described in National Health Priority Areas, were identified using databases (Medline, Google Scholar) and organisation websites (Department of Health and Ageing, National Heart Foundation, National Health and Medical Research Council). Guidelines were reviewed and qualitatively analysed to identify any references or definitions of 'elderly' persons. RESULTS: Among the 20 guidelines reviewed, 3 defined 'elderly' by chronological age (i.e., years since birth) while the remaining 17 guidelines did not define 'elderly' in any way. All 20 guidelines used the term 'elderly', whilst some guidelines provided age (chronological)-based dosage recommendations suggesting an ageist or generalist approach in their representation of 'elderly', for which rationale was seldom provided. Thematic analysis of the statements revealed five key themes regarding how 'elderly' was considered within the guidelines, broadly describing 'elderly' persons as being frail and with altered pharmacology. Some guidelines also highlighted the limited evidence base to direct clinical decision-making. A continuum of perceptions of ageing also emerged out of the identified themes. CONCLUSION: Clinical practice guidelines currently do not adequately define 'elderly' persons and provide limit...