Molly B Conroy, Janice C Zgibor, Laurey R Simkin-Silverman, Julie M Donohue, Steven M Albert, Lewis H Kuller and Anne B Newman
Background: Many older adults do not obtain important preventive services, which are critical for avoiding disease and disability. This is due in part to guidelines and interventions that take a “one disease at a time” approach, a lack of strategies to promote adherence to key services, and fragmented delivery systems. Many conditions common in older adults have overlapping risk factors; therefore, preventive services may be delivered more effectively as a “bundle,” especially given limited resources available for such programs. Methods and results: We outline a rationale for bundled preventive interventions by describing 5 “Ps”: priorities (preventive services of greatest benefit in older adults), place (clinical vs. community settings for delivery of services, including the integration of the public health system); package (rationale for bundled interventions, including examples), population/promotion (reaching those in greatest need); and policy implications. Conclusions: We conclude that new approaches to delivery of prevention and adherence to prevention for older adults are needed, and suggest an agenda for future comparative effectiveness research in this area.