By Jayna Holroyd-Leduc, Madhuri Reddy

The newest addition to the Evidence-Based publication sequence, Evidence-Based Geriatric Medicine presents non-geriatrician clinicians an summary of key subject matters critical to the care of the older sufferer. This advisor makes a speciality of the administration of universal difficulties within the aged taking into consideration their lifestyles events in addition to therapy of particular stipulations. top geriatricians with services in evidence-based drugs make the most of the simplest to be had proof and current this data in a concise, easy-to-use, question-based structure. Evidence-Based Geriatric Medicine is a different advisor to the optimal administration of older sufferers

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Overt urinalysis proteinuria or micoralbuminuria (>30 mg per 24 hours) +/− serum biochemical renal impairmenta 3 Antiplatelet therapy in diabetes mellitus if one or more coexisting major cardiovascular risk factor present (hypertension, hypercholesterolemia, and smoking history) 4 Statin therapy in diabetes mellitus if one or more coexisting major cardiovascular risk factor present a GFR <50 mL/min. development of geriatric syndromes. Geriatric syndromes associated with the inappropriate use of medications include cognitive impairment, falls and consequent injuries, and urinary incontinence (Level 2c evidence) [37].

This approach encourages the physician to ask the patient about indications for each medication and to review the patient’s perception of each medication’s beneficial and/or harmful effects. This approach also helps 26 to ensure the patient is taking their medications as intended [18]. Several excellent reviews cover a variety of topics relating to how to best apply the principles of evidence-based medicine to the appropriate prescribing of medications for older individuals [8, 18–20]. This chapter reviews: definitions, epidemiology, and consequences of inappropriate prescribing and polypharmacy; the interrelated concepts of errors of commission and errors of omission; how to approach appropriate prescribing in the individual older patient; and predictors of drug adherence and strategies to maximize adherence.

23. Feldstein A, et al (2006) Electronic medical record reminder improves osteoporosis management after a fracture: a randomized, controlled trial. J Am Geriatr Soc 54(3): 450–457. 24. Judge J, et al (2006) Prescribers’ responses to alerts during medication ordering in the long term care setting. J Am Med Inform Assoc 13(4): 385–390. 25. Peterson JF, et al (2005) Guided prescription of psychotropic medications for geriatric inpatients. Arch Intern Med 165(7): 802–807. 26. Peterson JF, et al (2007) Physicians’ response to guided geriatric dosing: initial results from a randomized trial.

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