Challenging Patient
description
Transcript of Challenging Patient
![Page 1: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/1.jpg)
Challenging Patient
The Older Patient with Multiple Co-Morbidities
![Page 2: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/2.jpg)
Objectives for the Day
Role of FM in caring for an aging population
Aging Chronic disease and aging Prescribing for older adults
![Page 3: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/3.jpg)
3 million
35 million
70 million
4.2 million
21 million
![Page 4: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/4.jpg)
Increases in the Oldest OldU.S. Population Aged 85+ (millions)
Source of data: U.S. Census Bureau, “We the American Elderly,” September 1993.
![Page 5: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/5.jpg)
Percentage of Americans Age 65 Expected to Survive Age 90
Source of data: US Census Bureau
![Page 6: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/6.jpg)
Prevalence of Chronic Conditions
0%5%
10%15%20%25%30%35%40%45%50%
Pre
vale
nce (
%)
HTN Arthritis CVD COPD Cancer Diabetes
Disease
NHIS, 2000, 2007
![Page 7: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/7.jpg)
Percentage of Medicare Beneficiaries with 2 Chronic Conditions
0%10%
20%
30%
40%50%
60%
70%
80%
Perc
en
tag
e
65-74 75-84 85+
Age Group
>1 conditionFair or poor health
Medicare Beneficiary Survey, 2000
![Page 8: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/8.jpg)
![Page 9: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/9.jpg)
![Page 10: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/10.jpg)
Health Affairs, 2004
![Page 11: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/11.jpg)
Health Affairs, 2004
![Page 12: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/12.jpg)
![Page 13: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/13.jpg)
Case 1
Mr. D is a 70 y/o patient with h/o HTN and hyperlipidemia.
Recent lab includes FBS of 140 and 176. He presents for follow-up of lab.
Your task: “Outline” your visit -what will you ask, look for on examwhat is your initial assessment? Your plan?
![Page 14: Challenging Patient](https://reader036.fdocuments.in/reader036/viewer/2022062305/56814838550346895db5556f/html5/thumbnails/14.jpg)
Case 1 - More data
Meds: HCTZ 25, Simvastatin 20 mg VS: BP 144/84, P 72, Wt 85 kg, Ht
170 cm Lab: BUN 18, Cr 0.8, TC 200, LDL
130, HDL 44