Polypharmacy Among the Elderly

Introduction

Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Patients who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. There is a great need for nursing interventions in conducting a patient medication review also known as “brown bag”. As nurses obtain history data from patients at a provider visit, the nurse should ask “what medications are you taking?” and the answer needs to include over-the-counter medications as well. If the response does not include any medications other than prescribed meds, it is incumbent upon the nursing professionals to question the patient further to ensure that no over-the-counter medications or supplements are being consumed. This is also an opportunity for the nurse to question about any adverse reactions the patient may be experiencing resulting from medications. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients continuing to take medications that have been discontinued by the physician. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.

Project Purpose

PICO Question: Among the elderly patients receiving care at Cary Medical Center on Med/Surg, who are currently taking multiple medications due to comorbidities, would reviewing medications at each provider visit reduce polypharmacy and its associated adverse reactions?

Currently, through observations and clinical experience on Med/Surg at Cary Medical Center, medication is administered by the nurse. Nurses are responsible and accountable for administrating medications to patients. Patient me...

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...d a gap in the number of studies conducted regarding this issue. From the studies reviewed, the results demonstrate that the increasingly health related issue of polypharmacy among the elderly requires the immediate attention of health care professionals. The studies revealed that in conjunction with medication reviews (brown bag), the STOPP criteria is a tool in which can be effective in detecting PIMs. The studies also revealed that nurses are in the position to address and assess for adverse drug reactions associated with polypharmacy by utilizing the “brown bag”, medication review, and STOPP criteria. Regarding the PICO question, the results of these studies support the essential need of medication reviews to be implemented by nurses and healthcare professionals at every provider visit to reduce the risk of polypharmacy and its associated adverse reactions.