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School of Medicine
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Older Adults with Multiple Chronic Conditions
Forty-eight percent of older adults have three or more chronic conditions, and the number of older adults with multiple chronic conditions will continue to increase dramatically. The presence of multiple chronic conditions independently predicts adverse outcomes, including quality of life, mortality, disability, and complications of treatment beyond the effects of the individual conditions. Currently, there is a significant gap in our understanding of how best to provide care for patients with multiple chronic conditions.
In recent work, Johns Hopkins researchers, led by Dr. Cynthia Boyd, have shown that implementing multiple single-disease clinical practice guidelines in older adults with multiple chronic conditions may result in polypharmacy and nonadherence, both of which detrimentally influence patient safety and clinical outcomes. Additional work has demonstrated how the entire process of clinical practice guideline development will need to be modified in order to develop appropriate clinical practice guidelines for patients with multiple chronic conditions.
Current Research Studies
- Treatment burden in multiple chronic conditions
- Development of clinical practice guidelines for patients with multiple chronic conditions
- Clinical preventive services for patients with multiple chronic conditions
- Improving patient-clinician communication and shared decision making in patients with multiple chronic conditions
- Patterns of multiple chronic conditions
- Performance measurement for patients with multiple chronic conditions
- Methodological approaches to assess the balance of benefits and harms
- Incorporating prognosis into the care of older adults
- Reducing use of potentially inappropriate therapies in older adults
Collaborators at Johns Hopkins
- Wendy Bennett, MD
- Kay Dickersin, PhD
- Sydney Dy, MD, MSc
- Tianjing Li, MD
- Milo Puhan, MD, PhD
- Cynthia Rand, PhD
- Jodi Segal, MD, MPH
- Orla Sheehan, MD, PhD
- David Roth, PhD
- Ravi Varadhan, PhD
- Renee Wilson
- Jennifer Wolff, PhD
- Tsung Yu, PhD
- Qian-li Xue, PhD