Guidelines, practice policies, and parameters: the case for geriatrics.
OBJECTIVE
As the population ages, the care of older persons becomes more important. At the same time, practice guidelines that provide recommendations for appropriate care are being published in greater numbers. The purpose of this work is to determine the proportion of guidelines that contain specific information about older persons.


METHODS
Through a random sample of published guidelines listed in the AMA Directory of Practice Parameters, 1992 Edition, we determined the proportion of guidelines that contain specific age-related information. We also determined if, over time, there was a difference in the proportion of practice guidelines containing information about older persons.


RESULTS
45.9% (95% CI, range 33.4-58.4) of guidelines that could conceivably pertain to older persons contain no age information; 24.6% (95% CI, range 13.8-35.4) of guidelines contain information only about persons less than 65 years of age; 29.5% (95% CI, range 18.1-41.0) of guidelines contain specific information about older persons. Moreover, there were no secular trends in the proportion of guidelines pertaining to older persons.


CONCLUSIONS
Only a minority of practice guidelines contain information about older persons. Possible causes and solutions to this shortfall are discussed.
Rudberg
M A
MA
Department of Medicine, University of Chicago, IL 60637.
Barr
G
G
Cassel
C K
CK
Hayward
R S
RS
Sussman
E J
EJ
Roizen
M F
MF
D000367:Age Factors; D000368:Aged; D005853:Geriatrics / Q000592:standards*; D006291:Health Policy; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D014481:United States