Author + information
- James T. Dove, MD, FACC, ACC President⁎,
- Susan J. Zieman, MD, PhD, FACC, FSGC,
- Karen Alexander, MD, FACC and
- Andrew Miller, MD, FACC
- ↵⁎Address correspondence to:
James T. Dove, MD, FACC, American College of Cardiology, c/o Padmini G. Rajagopal-Moorehead, 2400 N Street NW, Washington, DC 20037
Are we, as cardiologists, equipped to care for the rapidly increasing number of older patients as the baby boomers hit their “golden” years? Over the past 25 years, tremendous advances in therapies, imaging, and technology have greatly reduced cardiovascular morbidity and mortality in younger patients. In contrast, a wide gap still exists between our treatment strategies, which are largely extrapolated from trials involving subjects age <75 years, and significant reductions in cardiovascular morbidity and mortality in older patients.
Ten years ago, in his President’s Page column in the Journal (1), William Parmely, MD, MACC, asked, “Do we practice geriatric cardiology?” In his column, Dr. Parmely provided 2 answers to his question:
• Yes, because we care for this age group;
• No, because we are less well prepared to fully coordinate the care of the frail elderly.
Ten years later, many cardiovascular specialists are still less than fully prepared for the needs of this special group of patients. Over the past 25 years, tremendous advances in therapies, imaging, and technology have greatly reduced cardiovascular morbidity and mortality in younger patients. In contrast, a wide gap still exists today between our treatment strategies and significant mortality reductions in older patients.
Dr. Parmely further concluded, “We need to learn from the geriatricians those elements of care that will fully equip us to practice geriatric cardiology” (1). The number of geriatricians in the U.S. will never match the needs of the growing number of seniors; therefore, cardiologists, internists, and other specialists need to equip themselves with the knowledge to match optimal therapeutics and interventions with the challenges of both robust and frail older adults. Additionally, we need to strive to better define the questions raised by extrapolated data with evidence-based practices and guidelines.
The American College of Cardiology (ACC) and the Society of Geriatric Cardiology (SGC) Accept the Challenge
To respond to this charge, geriatricians, cardiologists, and those who are trained in both specialties are now joining forces to optimize education and care of our older patients with cardiovascular disease. The ACC and the SGC are developing the Essentials of Cardiovascular Care in Older Adults (ECCOA), an innovative curriculum that will equip cardiology fellows with the tools they need to provide optimal, specialized care for older adults. This first-of-its-kind, web-based geriatric cardiology curriculum for cardiology fellows and their teachers, which is funded by the John A. Hartford Foundation and the Association of Specialty Professors, will deliver content on key concepts of caring for older adults with cardiovascular disorders to electronically-savvy cardiology fellows. Using case-based and interactive learning modules, the program will improve knowledge, skills, and confidence in providing optimal specialized care for older adults.
Implementation of the ECCOA curriculum represents a major step toward reducing treatment and outcome disparities in older patients. The goals of this educational tool will be to:
• Raise awareness of age-specific changes and how they impact disease assessment and management;
• Appreciate evidence-based care of older adults;
• Identify and pursue gaps in our knowledge;
• Stimulate research efforts to fill the gap; and
• Reduce morbidity and mortality through judicious and individualized care.
The ECCOA end product will eventually be posted on the ACC In-Service platform of Cardiosource, the ACC’s educational website (www.cardiosource.com), which already houses the electrocardiogram modules and the Heart Songs.
The ECCOA curriculum embraces the ACC’s major education goal for the next 5 years, which is the development of e-learning opportunities. Cardiosource already houses extensive self-assessment and educational tools that include case studies, clinical collections, performance improvement continuing medical education, and clinical collections. The College plans to build even more educational tools, portfolios, and interactive references similar to ECCOA that will allow for self-assessment, self-direction, and lifelong learning for cardiovascular professionals.
Because of this joint effort by the ACC and SGC, the implementation of the ECCOA curriculum will represent a significant step toward reducing the treatment and outcome disparities in older patients with cardiovascular disease. It also represents a significant step toward building useful, flexible education tools that will help cardiovascular professionals stay up-to-date in their field as they create their own learning portfolios designed to fit their specific interests and needs.
- American College of Cardiology Foundation