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Choosing wisely in case of hypertension, diabetes and hyperlipidemia in older patients

Peter Dovjak1

  • 1Department of Acute Geriatrics, Salzkammergutklinikum Gmunden, Miller von Aichholzstraße 49, 4810, Gmunden, Österreich. peter.dovjak@gespag.at.

Wiener Medizinische Wochenschrift (1946)
|January 27, 2016
PubMed

Insights

Applying Choosing Wisely principles to elderly patients with hypertension, diabetes, and hyperlipidemia avoids low-value care. Utilizing frailty assessments improves treatment decisions, preventing unnecessary interventions and adverse effects.

Area of Science:

  • Geriatric Medicine
  • Primary Care
  • Evidence-Based Practice

Background:

  • The Choosing Wisely campaign encourages avoiding unnecessary medical interventions.
  • Hypertension, diabetes, and hyperlipidemia are prevalent in primary care.
  • This review assesses the feasibility of Choosing Wisely principles for these conditions in the elderly.

Purpose of the Study:

  • To review the application of Choosing Wisely principles in managing hypertension, diabetes, and hyperlipidemia in older adults.
  • To identify strategies for avoiding low-value care in geriatric primary care.

Main Methods:

  • A PubMed search was conducted using keywords: "choosing wisely", "elderly", "hypertension", "diabetes", "hyperlipidemia".
  • The search included original articles and reviews in English and German published between 1982 and 2015.
  • A manual search of references from relevant articles was also performed.

Main Results:

  • Precise indications for pharmacological treatment in older patients can prevent adverse effects.
  • Functional assessments like frailty scores aid in treatment decision-making.
  • Evidence supports avoiding or withdrawing unnecessary medical interventions.

Conclusions:

  • Adhering to current knowledge on treatment indications for hypertension, diabetes, and hyperlipidemia in the elderly minimizes risks and low-value care.
  • Comprehensive geriatric assessments enhance decision-making for initiating and adjusting medical treatments.
  • These approaches help prevent unnecessary interventions in older patients.
Abstract

Keywords:
Choosing wiselyDiabetesHyperlipidemiaHypertensionOlder patients

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