Pharmacotherapy in Older Adults with Cardiovascular Disease

Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop

Janice B. Schwartz, Kenneth E. Schmader, Joseph T. Hanlon, Darrell R. Abernethy, Shelly Gray, Jacqueline Dunbar-Jacob, Holly M. Holmes, Michael D. Murray, Robert Roberts, Michael Joseph Joyner, Josh Peterson, David Lindeman, Ming Tai-Seale, Laura Downey, Michael W. Rich

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVES: To identify the top priority areas for research to optimize pharmacotherapy in older adults with cardiovascular disease (CVD). DESIGN: Consensus meeting. SETTING: Multidisciplinary workshop supported by the National Institute on Aging, the American College of Cardiology, and the American Geriatrics Society, February 6–7, 2017. PARTICIPANTS: Leaders in the Cardiology and Geriatrics communities, (officers in professional societies, journal editors, clinical trialists, Division chiefs), representatives from the NIA; National Heart, Lung, and Blood Institute; Food and Drug Administration; Centers for Medicare and Medicaid Services, Alliance for Academic Internal Medicine, Patient-Centered Outcomes Research Institute, Agency for Healthcare Research and Quality, pharmaceutical industry, and trainees and early career faculty with interests in geriatric cardiology. MEASUREMENTS: Summary of workshop proceedings and recommendations. RESULTS: To better align older adults’ healthcare preferences with their care, research is needed to improve skills in patient engagement and communication. Similarly, to coordinate and meet the needs of older adults with multiple comorbidities encountering multiple healthcare providers and systems, systems and disciplines must be integrated. The lack of data from efficacy trials of CVD medications relevant to the majority of older adults creates uncertainty in determining the risks and benefits of many CVD therapies; thus, developing evidence-based guidelines for older adults with CVD is a top research priority. Polypharmacy and medication nonadherence lead to poor outcomes in older people, making research on appropriate prescribing and deprescribing to reduce polypharmacy and methods to improve adherence to beneficial therapies a priority. CONCLUSION: The needs and circumstances of older adults with CVD differ from those that the current medical system has been designed to meet. Optimizing pharmacotherapy in older adults will require new data from traditional and pragmatic research to determine optimal CVD therapy, reduce polypharmacy, increase adherence, and meet person-centered goals. Better integration of the multiple systems and disciplines involved in the care of older adults will be essential to implement and disseminate best practices.

Original languageEnglish (US)
JournalJournal of the American Geriatrics Society
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

National Institute on Aging (U.S.)
Cardiovascular Diseases
Education
Drug Therapy
Polypharmacy
Research
Cardiology
Geriatrics
Patient Outcome Assessment
Systems Integration
National Heart, Lung, and Blood Institute (U.S.)
Delivery of Health Care
Patient Participation
Centers for Medicare and Medicaid Services (U.S.)
Medication Adherence
Health Services Research
Drug Industry
United States Food and Drug Administration
Internal Medicine
Practice Guidelines

Keywords

  • adherence
  • adverse effects
  • cardiovascular medication
  • de-prescribing
  • polypharmacy

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Pharmacotherapy in Older Adults with Cardiovascular Disease : Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop. / Schwartz, Janice B.; Schmader, Kenneth E.; Hanlon, Joseph T.; Abernethy, Darrell R.; Gray, Shelly; Dunbar-Jacob, Jacqueline; Holmes, Holly M.; Murray, Michael D.; Roberts, Robert; Joyner, Michael Joseph; Peterson, Josh; Lindeman, David; Tai-Seale, Ming; Downey, Laura; Rich, Michael W.

In: Journal of the American Geriatrics Society, 01.01.2018.

Research output: Contribution to journalArticle

Schwartz, JB, Schmader, KE, Hanlon, JT, Abernethy, DR, Gray, S, Dunbar-Jacob, J, Holmes, HM, Murray, MD, Roberts, R, Joyner, MJ, Peterson, J, Lindeman, D, Tai-Seale, M, Downey, L & Rich, MW 2018, 'Pharmacotherapy in Older Adults with Cardiovascular Disease: Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop', Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.15634
Schwartz, Janice B. ; Schmader, Kenneth E. ; Hanlon, Joseph T. ; Abernethy, Darrell R. ; Gray, Shelly ; Dunbar-Jacob, Jacqueline ; Holmes, Holly M. ; Murray, Michael D. ; Roberts, Robert ; Joyner, Michael Joseph ; Peterson, Josh ; Lindeman, David ; Tai-Seale, Ming ; Downey, Laura ; Rich, Michael W. / Pharmacotherapy in Older Adults with Cardiovascular Disease : Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop. In: Journal of the American Geriatrics Society. 2018.
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