Evidence-Based Versus Evidence-Biased Medicine in Geriatric Cardiology: From Trials to Real World
Elderly people are now the most rapidly growing part of the patient population worldwide, thanks to more focus on primary prevention of diseases and improvements in healthcare for the younger ill patient. Aging is often accompanied by chronic (multiple) diseases, comorbidity, disability, frailty, and social isolation. As a consequence, elderly persons are more likely to receive a high number of drugs; this phenomenon is called “polypharmacy” and is a problem affecting advanced decades and may lead to an increased risk of inappropriate drug use, underuse of effective treatments, medication errors, poor adherence, drug–drug and drug–disease interactions, and, most importantly, adverse drug reactions . Moreover, the lack of well-designed clinical studies recruiting elderly limits the availability of evidence-based information on the effect of drugs on clinically relevant outcomes such as functional and cognitive decline, quality of life, adverse events, and mortality. This is a real problem for the majority of chronic conditions, particularly for cardiac diseases, which are predominant in elderly persons.
KeywordsChronic Heart Failure Randomize Clinical Trial Elderly Person Inappropriate Drug Drug Regulatory Agency
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