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Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
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Individualizing Prevention for Older Adults.

Sei J Lee1,2, Christine M Kim3

  • 1San Francisco Veterans Affairs Medical Center, University of California, San Francisco.

Journal of the American Geriatrics Society
|November 21, 2017
PubMed
Summary
This summary is machine-generated.

Preventive care for older adults should balance potential benefits against harms. A framework comparing life expectancy (LE) with intervention time to benefit (TTB) helps personalize prevention strategies, optimizing care for healthier seniors.

Keywords:
cancer screeninglife expectancypreventiontime to benefit

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Area of Science:

  • Gerontology
  • Preventive Medicine
  • Clinical Decision-Making

Background:

  • Preventive interventions can benefit older adults by addressing conditions early.
  • However, interventions may cause harm if conditions are unlikely to manifest within an individual's lifetime.

Purpose of the Study:

  • To propose a framework for individualizing preventive care in older adults.
  • To guide clinical decisions by comparing life expectancy (LE) with time to benefit (TTB) for interventions.

Main Methods:

  • Developed a framework comparing LE and TTB to determine intervention benefit/harm.
  • Explored methods for estimating LE and TTB for common preventive measures.
  • Created communication strategies for integrating this framework into clinical practice, such as Medicare annual wellness visits.

Main Results:

  • When LE < TTB, interventions pose risks without likely benefit and are generally not recommended.
  • When LE > TTB, individuals are likely to benefit from preventive interventions.
  • When LE ≈ TTB, individual values and preferences are key determinants for intervention decisions.

Conclusions:

  • Individualized prevention strategies, guided by the LE vs. TTB framework, can optimize care for older adults.
  • Prevention should be prioritized for healthier older adults, while symptom-oriented care is more appropriate for sicker individuals.