CALL FOR PAPERS: CARE OF OLDER PEOPLE -PHARMACY'S CONTRIBUTION

摘要

Commentaries, policy documents, reports and a plethora of research papers have heralded the ageing of the population as a major challenge for healthcare practice and policy. The number of persons aged 60 years or above is expected to more than double by 2050 (compared with 2017) and to more than triple by 2100, rising from 962 million globally in 2017 to 2.1 billion in 2050 and 3.1 billion in 21001. Again, the number of persons aged 80 years or over at a global level is projected to triple by 2050, from 137 million in 2017 to 425 million in 2050. By 2100 it is expected to increase to 909 million, nearly seven times its value in 2017, representing major achievements in life expectancies. In response to this phenomenon, the World Health Organization (WHO) published the first 'World report on ageing and health', which reviewed the current knowledge and gaps, and provided a public health framework for action2. The report highlighted a number of actions that may encourage healthy ageing, which the authors defined as "the process of developing and maintaining the functional ability that enables wellbeing in older age". The report recognised that although life expectancy was increasing, this was not necessarily accompanied by good health. The authors suggested that to promote healthy ageing, there needed to be an alignment of health systems to the needs of older people (e.g. an appropriately trained workforce), the development of appropriate systems to provide long-term care (e.g. supporting carers and establishing meohanisms for co-ordination of care), promotion of age-friendly environments (combating ageism and supporting autonomy through self-care) and an improvement in the measurement, monitoring and understanding of health ageing. Population ageing is responsible for the marked rises in prevalence of long-term conditions such as dementia, stroke, chronic obstructive pulmonary disease and diabetes. These conditions are often present in the same patient at the same time, which has given rise to the term 'multimorbidity'. And central to the management of multimorbidity are medicines. Jerry Avorn, a geriatrician and researcher, has said that "The use of medications in older patients is arguably the single most important health care intervention in the industrialised world".