Clinical Guidelines in the Context of Aging and Multimorbidity

Abstract

Clinical guidelines play an important role in ensuring the delivery of evidence-based care to patients and reducing variation in practice. Clinical guideline development is structured to ensure that recommendations are based on the available evidence, but clinical guidelines are most commonly focused on single conditions, and the cumu- lative effect of following individually-rational recom- mendations from many guidelines can be irrational: for example, because recommendations for different diseases are contradictory or because the implied treatment regimen is too burdensome to the patient (Boyd et al., 2005). This matters because aging populations and improving survival from acute conditions like myocardial infarction mean that patients increasingly live with multiple chronic conditions.