title: Choosing wisely in case of hypertension, diabetes and hyperlipidemia in older patients.
abstract: BACKGROUND
  The Choosing Wisely™ campaign was created by the American Board of Internal Medicine, it asks medical specialty societies to indicate five diagnostic and/or therapeutic interventions in their specialty to be avoided in specific cases. The aim of this campaign is to stimulate discussion between patients and their doctors about the usefulness of each procedure and also to avoid unnecessary, possibly wasteful measures. Hypertension, diabetes and hyperlipidemia are the most common conditions seen in primary care. The feasibility of applying the principles of Choosing Wisely in these cases was the target of this mini-review.
  
  
  METHODS
  A PUBMED query based on entering the terms "choosing wisely", "elderly", "hypertension", "diabetes" and "hyperlipidemia" was performed. The search was limited to studies in human subjects using original articles and reviews in English and German that were published in the period of 1982-2015. In addition, a manual search from all relevant references and screened articles was performed.
  
  
  CONCLUSIONS
  Using the up to date knowledge of precise indication for the pharmacological treatment of hypertension, diabetes and hyperlipidemia in older patients protects them from adverse effects and avoids interventions of low value. Additional tests of functionality like a frailty score or the comprehensive geriatric assessment can improve decision making for starting of medical interventions and for adjusting the intensity of treatment. Based on current literature they can help to withdraw or to abstain from unnecessary medical interventions.
authors.affiliation: Department of Acute Geriatrics, Salzkammergutklinikum Gmunden, Miller von Aichholzstraße 49, 4810, Gmunden, Österreich. peter.dovjak@gespag.at.
authors.forename: Peter
authors.initials: P
authors.lastname: Dovjak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D016330:Frail Elderly; D019983:Guideline Adherence; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D006973:Hypertension / Q000188:drug therapy*; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Choosing wisely; Diabetes; Hyperlipidemia; Hypertension; Older patients
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