title: How applicable are clinical practice guidelines to elderly patients with comorbidities?
abstract: OBJECTIVE
  To examine the applicability of 10 common clinical practice guidelines (CPGs) to elderly patients with multiple comorbidities.
  
  
  METHODS
  Content analysis of published Canadian CPGs for the following chronic diseases: diabetes, dyslipidemia, dementia, congestive heart failure, depression, osteoporosis, hypertension, gastroesophageal reflux disease, chronic obstructive pulmonary disease, and osteoarthritis.
  
  
  METHODS
  Presence or absence of 4 key indicators of applicability of CPGs to elderly patients with multiple comorbidities. These indicators include any mention of older adults or people with comorbidities, time needed to treat to benefit in the context of life expectancy, and barriers to implementation of the CPG.
  
  
  RESULTS
  Out of the 10 CPGs reviewed, 7 mentioned treatment of the elderly, 8 mentioned people with comorbidities, 4 indicated the time needed to treat to benefit in the context of life expectancy, 5 discussed barriers to implementation, and 7 discussed the quality of evidence.
  
  
  CONCLUSIONS
  This study shows that although most CPGs discuss the elderly population, only a handful of them adequately address issues related to elderly patients with comorbidities. In order to make CPGs more patient centred rather than disease driven, guideline developers should include information on elderly patients with comorbidities.
authors.affiliation: Public Health and Preventive Medicine program, Dalla Lana School of Public Health, University of Toronto, Ontario.
authors.forename: Donatus R
authors.initials: DR
authors.lastname: Mutasingwa
authors.forename: Hong
authors.initials: H
authors.lastname: Ge
authors.forename: Ross E G
authors.initials: RE
authors.lastname: Upshur
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005853:Geriatrics / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D009864:Ontario; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D014481:United States / Q000453:epidemiology