Table 3

Frequency of clinical questions per ageing factor

Aging factorFrequencyDefinitionExamples
Special considerations when choosing optimal treatment18 (26%)Selection of an optimal individualised treatment considering ageing factors such as risk/benefit and comorbidities. Successful outcome is more difficult because of underlying ageing issuesWhat is the preferred A1c goal in the ageing population?
What is the best treatment choice for diabetes when the patient also has heart failure?
Special prescribing considerations13 (19%)Medication prescription needs to be adjusted to maximise compliance, and minimise side effects/organ damage (eg, by adjusting medication dose)What is the geriatric dose of buspar for depression?
What is the CrCl cut-off for alendronate?
Complex management of side effects9 (13%)Consideration of side effects. Issues such as polypharmacy and lower medication tolerance contribute to a higher incidence of and more complexity in managing side effectsIs hallucination a side effect of rivastigmine?
Is there adjunct treatment of depression that does not cause drowsiness?
Condition prevalence8 (11%)Condition related to the questions is much more prevalent in the elderly. Questions related to these conditions would be less common in non-ageing patientsWhat is the best treatment choice for cognitive dysfunction?
Understanding other provider’s rationale6 (9%)Unable to interpret rationale of other providers due to lack of enough information (eg, prescription without reason, diagnosis without explanation). Complex ageing patients are often cared for by multiple providersWhat are these eye drops used for?
What are the indications of concomitant use of aspirin and warfarin?
Dx testing considerations4 (6%)Ageing risk factors need to be considered in the choice of diagnostic interventionIs contrast indicated for chest X-ray to assess aspiration in a patient with GERD?
Access to health services4 (6%)Health services that are more commonly needed or that have special requirements in elderly patientsWhere should I refer this patient for mental health?
Difficult diagnosis4 (6%)Difficult diagnosis due to underlying ageing factors (eg, multiple comorbidities, different presentation). Difficult to interpret new set of symptoms/signs/findings in light of the overall patient’s pictureWhy is this patient osteopaenic?
What is the cause of this patient's weight loss?
Gender considerations1 (1%)Decisions in the elderly that are affected by gender (eg, different statin dose, different osteoporosis treatment)How do I manage cardiovascular risk in elderly women?
Need for geriatric tool1 (1%)Need for tools (eg, assessment tools) that are specific for geriatricsWhere can I find a template for haematology–oncology assessment
No ageing factor2 (3%)Question not motivated or mediated by ageing and answer is not ageing-specificWhere can I find patient education information on cholesterol diet?
  • GERD, gastroesophageal reflux disease.