Affiliation:
1. RUDN University, Moscow, Russia
2. Municipal Clinical Hospital No. 24 of Healthcare Department of Moscow, Moscow, Russia
Abstract
Increased life expectancy along with an increasing share of elderly and senile patients in the structure of the population make the tasks of longer healthy life expectancy pressing. A set of activities aimed at optimization of management of patients within the framework of gerontological practice should include elimination and prevention of diagnostic and therapeutic errors. The basic risk factors of medical errors include high heterogeneity of elderly and senile patients, overburdened healthcare system, polypharmacy, including due to parallel prescription of drugs to the same patient by multiple medical professionals, concomitant diseases, and high comorbidity, measured by the Charlson Comorbidity Index. Mismanagement of elderly patients can result both from underestimated severity of the patient’s conditions, and from hyperdiagnostics. Typical errors of pharmacotherapy include use of potentially inappropriate medications, potential prescribing omissions, simultaneous prescription of drugs with high risk of clinically significant interactions, incorrect selection of dosage without taking into account the renal failure, which is associated with high risk of toxic effects. Affordability of medical aid for an elderly patient is another important social aspect influencing the patient’s quality of life. As far as basic ethical principles of management of elderly and senile patients go, it is necessary to respect independence, well-being and justice for the patients regarding possible obtaining of qualitative medical aid as compared with other age groups.
Publisher
Pirogov Russian National Research Medical University
Subject
General Agricultural and Biological Sciences,Philosophy,Classics,Physical and Theoretical Chemistry,Mechanical Engineering,General Chemical Engineering,Infectious Diseases,Cell Biology,Cellular and Molecular Neuroscience,Biochemistry,Law,Social Sciences (miscellaneous),History,General Economics, Econometrics and Finance,Business and International Management,Mechanical Engineering,Ocean Engineering,Aerospace Engineering,Condensed Matter Physics,Nuclear Energy and Engineering,Civil and Structural Engineering,Statistical and Nonlinear Physics,Statistics and Probability,Industrial and Manufacturing Engineering,Management Science and Operations Research,Statistics, Probability and Uncertainty,Statistics and Probability