Patient-Centred Care of Older Adults With Cardiovascular Disease and Multiple Chronic Conditions

Area of Science:

• Gerontology
• Cardiology
• Clinical Medicine

Background:

• Multimorbidity, the presence of two or more chronic conditions, is prevalent in older adults with cardiovascular disease (CVD).
• These patients face increased risks of adverse health outcomes and high healthcare utilization.
• Managing multimorbidity in CVD presents challenges due to patient heterogeneity, complex regimens, limited evidence, and fragmented care.

Purpose of the Study:

• To outline a patient-centered approach for managing older adults with cardiovascular disease and multimorbidity.
• To guide clinicians in optimizing treatment strategies for this complex patient population.
• To enhance the quality of life and functional status in elderly patients with multiple chronic conditions.

Main Methods:

• Review of clinical practice guidelines and evidence for managing cardiovascular disease in the context of multimorbidity.
• Emphasis on a patient-centered strategy integrating individual preferences, prognosis, and treatment feasibility.
• Discussion of optimizing adherence, managing polypharmacy, and considering drug-drug/drug-disease interactions.

Main Results:

• Current guidelines for single diseases may lead to impractical or harmful combined regimens in multimorbidity.
• A patient-centered approach can maximize benefits and minimize harms by prioritizing essential treatments.
• Individualized treatment decisions should consider the prognosis and time horizon for benefits versus harms.

Conclusions:

• A patient-centered approach is crucial for effectively managing older adults with cardiovascular disease and multimorbidity.
• Optimizing treatment involves prioritizing essential therapies and potentially discontinuing non-essential or harmful medications.
• Focusing on aspects of health that most impact functioning and quality of life is key to successful outcomes.