Blood pressure targets in the very old: development of a tool in a geriatric day hospital.

PROBLEM ADDRESSED: Canadian hypertension guidelines do not address blood pressure (BP) targets in the very old (older than 85 years of age), making BP management in this group difficult. OBJECTIVE OF PROGRAM: To develop a BP target tool and implementation process in order to facilitate management of BP in the very old at the Bruyère Continuing Care Geriatric Day Hospital in Ottawa, Ont. PROGRAM DESCRIPTION: A BP target tool and implementation process were developed to target, monitor, and communicate BP goals within the care team, to the patient and family, and to other prescribers. An audit was conducted of the first 10 weeks of the tool's implementation and illustrated good use with areas for improvement noted.
CONCLUSION: The development and use of a BP target tool increased prescriber consistency and confidence in managing BP in the very old. The tool filled a gap in the absence of guidelines specific to BP management in the very old. The BP target tool has implications for practice, as well as for the training of health care professionals involved in treating and monitoring BP in very old patients. Copyright© the College of Family Physicians of Canada.