While palliative care and polypharmacy are two aspects of chronic disease management that are achieving growing interest, there are few established teaching programs that provide primary care providers with an approach that encourages them to make rational clinical care plan and medication decisions in the face of failed evidence-based guidelines and overprescribing from multiple specialty providers. Communication skills that promote goal-centered care address each patient’s unique needs and values and remain the domain of the primary care physician. This program is based on a series of in-depth seminars for the advanced longitudinal geriatric curriculum for chronic disease and palliative care management for family practice residents.
Recognize developmental tasks of aging that provide the foundation for using goals of care and patient preferences in geriatric chronic disease management as a basis for treatment choices
Apply clinical guidelines involved in person centered care for establishing chronic disease care plans for patients with multiple chronic conditions based on AGS task force.
Recognize tools such as BEERS and STOPP and other resources to identify clinical syndromes, cascades, and classes of medications associated with adverse drug events in older adults with multiple chronic conditions and align treatment choices with goals
Describe organizational and personal barriers to establishing a palliative care plan and leadership skills required by the primary care provider on the interdisciplinary team.