New horizons in clinical practice guidelines for use with older people.
Globally, more people are living into advanced old age, with age-associated frailty, disability and multimorbidity. Achieving equity for all ages necessitates adapting healthcare systems. Clinical practice guidelines (CPGs) have an important place in adapting evidence-based medicine and clinical car...
| Publicado en: | Age & Ageing Vol. 53; no. 7; pp. 1 - 11 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jul2024
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=178718770&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 178718770 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jul2024 vid: 53 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 178718770 10.1093/ageing/afae158 ppf: 1 ppct: 10 formats: tig: atl: New horizons in clinical practice guidelines for use with older people. aug: au: Martin, Finbarr C Quinn, Terence J Straus, Sharon E Anand, Sonia van der Velde, Nathalie Harwood, Rowan H affil: Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London , London, UK School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow , Glasgow, UK Department of Medicine, University of Toronto and Li Ka Shing Knowledge Institute of St. Michael's , Toronto, Ontario, Canada Departments of Medicine and Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University , Hamilton, Ontario, Canada Department of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam , Amsterdam, The Netherlands Amsterdam Public Health Research Institute (Aging and Later Life) , Amsterdam, The Netherlands School of Health Sciences, University of Nottingham , Nottingham, UK su: Elder care Health services accessibility Socioeconomic factors Decision making Evaluation of medical care Patient-centered care Patient participation Medical protocols Frail elderly Functional status Cognition disorders Evidence-based medicine Stakeholder analysis Comorbidity sug: subj: Elder care Health services accessibility Socioeconomic factors Decision making Evaluation of medical care Patient-centered care Patient participation Continuing Care Retirement Communities Medical protocols Frail elderly Functional status Cognition disorders Evidence-based medicine Stakeholder analysis Comorbidity keyword: applicability evidence-based guidelines methodology older people patient-centred applicability evidence-based guidelines methodology older people patient-centred ab: Globally, more people are living into advanced old age, with age-associated frailty, disability and multimorbidity. Achieving equity for all ages necessitates adapting healthcare systems. Clinical practice guidelines (CPGs) have an important place in adapting evidence-based medicine and clinical care to reflect these changing needs. CPGs can facilitate better and more systematic care for older people. But they can also present a challenge to patient-centred care and shared decision-making when clinical and/or socioeconomic heterogeneity or personal priorities are not reflected in recommendations or in their application. Indeed, evidence is often lacking to enable this variability to be reflected in guidance. Evidence is more likely to be lacking about some sections of the population. Many older adults are at the intersection of many factors associated with exclusion from traditional clinical evidence sources with higher incidence of multimorbidity and disability compounded by poorer healthcare access and ultimately worse outcomes. We describe these challenges and illustrate how they can adversely affect CPG scope, the evidence available and its summation, the content of CPG recommendations and their patient-centred implementation. In all of this, we take older adults as our focus, but much of what we say will be applicable to other marginalised groups. Then, using the established process of formulating a CPG as a framework, we consider how these challenges can be mitigated, with particular attention to applicability and implementation. We consider why CPG recommendations on the same clinical areas may be inconsistent and describe approaches to ensuring that CPGs remain up to date. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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