Renal Supportive Care
People who are frail experience a higher incidence and severity of adverse drug events because of their medicine use and potential changes in pharmacokinetics and pharmacodynamics.
Medicines prescribed for chronic conditions need to be reviewed frequently to assess whether they are providing net benefit or net harm.
Step 1: Define the patient’s problem
Step 2: Specify the therapeutic objective
Frail older people are rarely represented in clinical trials, so there is limited evidence to support the efficacy and safety of most treatments for these patients.
Step 3: Verify whether the treatment is suitable for the patient
Subgroup analysis of controlled trial data suggests that in frail older people intensive blood pressure control may reduce the risk of cardiovascular events, stroke and mortality However, these outcomes may not be as high a priority for some frail older patients as reducing the risk of falls, which may increase with antihypertensives.
Step 4: Start the treatment
Discuss the therapeutic decision with the patient and their carers. Adjust the dose to account for the pharmacokinetic and pharmacodynamic changes of frailty
Step 5: Provide information, instructions and warnings
Step 6: Monitor the treatment, and cease or alter if required
When prescribing it is essential to consider the patient’s goals of care, function, comorbidities and overall medication load. Frequently review all medicines for frail older patients to ensure that they are receiving net benefit.
Medicines prescribed for chronic conditions need to be reviewed frequently to assess whether they are providing net benefit or net harm.
Step 1: Define the patient’s problem
Step 2: Specify the therapeutic objective
Frail older people are rarely represented in clinical trials, so there is limited evidence to support the efficacy and safety of most treatments for these patients.
Step 3: Verify whether the treatment is suitable for the patient
Subgroup analysis of controlled trial data suggests that in frail older people intensive blood pressure control may reduce the risk of cardiovascular events, stroke and mortality However, these outcomes may not be as high a priority for some frail older patients as reducing the risk of falls, which may increase with antihypertensives.
Step 4: Start the treatment
Discuss the therapeutic decision with the patient and their carers. Adjust the dose to account for the pharmacokinetic and pharmacodynamic changes of frailty
Step 5: Provide information, instructions and warnings
Step 6: Monitor the treatment, and cease or alter if required
When prescribing it is essential to consider the patient’s goals of care, function, comorbidities and overall medication load. Frequently review all medicines for frail older patients to ensure that they are receiving net benefit.
