Defining an ‘older’ patient in the context of therapeutic decision making: perspectives of Australian pharmacists and nurses

Objective: Our aim was to explore Australian nurses and pharmacist’s perspectives on defining an ‘older’ patient in the context of decision making around pharmacotherapy. Design: A qualitative study was conducted using semi-structured interviews, facilitated by a purpose-designed interview guide. Setting: Practitioners were recruited from the primary care (i.e. registered community pharmacists, registered community nurses, general practice nurses) and tertiary care settings (i.e. referral hospitals, specialist clinics). Participants: Non-prescribing health professionals directly involved in medication management (i.e. nurses, pharmacists) with experience in caring for older patients. Results: This exploratory study identified three key themes: (1) defining ‘older’ patients is difficult, given the heterogeneity of the population; (2) age is more than a number and, therefore, cannot be used alone for tailoring and managing a patient’s treatment; and (3) a contemporary definition of an ‘older’ patient needs to be integrated into guidelines for treating aged patients. Overall, Australian nurses and pharmacists shared similar perspectives about defining an ‘older’ patient, favouring holistic assessments of individual patients. Conclusions: Non-prescribing health practitioners, such as nurses and pharmacists, advocate an individualised approach, rather than a number-based approach, to decision making in older patients.