challenging patient
DESCRIPTION
Challenging Patient. The Older Patient with Multiple Co-Morbidities. Objectives for the Day. Role of FM in caring for an aging population Aging Chronic disease and aging Prescribing for older adults. 70 million. 35 million. 21 million. 3 million. 4.2 million. - PowerPoint PPT PresentationTRANSCRIPT
Challenging Patient
The Older Patient with Multiple Co-Morbidities
Objectives for the Day
Role of FM in caring for an aging population
Aging Chronic disease and aging Prescribing for older adults
3 million
35 million
70 million
4.2 million
21 million
Increases in the Oldest OldU.S. Population Aged 85+ (millions)
Source of data: U.S. Census Bureau, “We the American Elderly,” September 1993.
Percentage of Americans Age 65 Expected to Survive Age 90
Source of data: US Census Bureau
Prevalence of Chronic Conditions
0%5%
10%15%20%25%30%35%40%45%50%
Pre
vale
nce (
%)
HTN Arthritis CVD COPD Cancer Diabetes
Disease
NHIS, 2000, 2007
Percentage of Medicare Beneficiaries with 2 Chronic Conditions
0%10%
20%
30%
40%50%
60%
70%
80%
Perc
en
tag
e
65-74 75-84 85+
Age Group
>1 conditionFair or poor health
Medicare Beneficiary Survey, 2000
Health Affairs, 2004
Health Affairs, 2004
Case 1
Mr. D is a 70 y/o patient with h/o HTN and hyperlipidemia.
Recent lab includes FBS of 140 and 176. He presents for follow-up of lab.
Your task: “Outline” your visit -what will you ask, look for on examwhat is your initial assessment? Your plan?
Case 1 - More data
Meds: HCTZ 25, Simvastatin 20 mg VS: BP 144/84, P 72, Wt 85 kg, Ht
170 cm Lab: BUN 18, Cr 0.8, TC 200, LDL
130, HDL 44