It is a fact; the older adult population is living longer. While many older adults are fit and healthy, others are frail and weak requiring necessary medication. It is more important than ever for all of the healthcare community to be conscious of safe prescribing and the proper use of medicine when taking care of older adults. Analysis and Risks As we age, the use of medication is often increased in an effort to treat illness and disease. In older adults this frequently results in the administration of multiple medications, both appropriately and inappropriately, at the same time. This is known as polypharmacy. While polypharmacy can exist with any age demographic, it is much more prevalent in older adults where the risk of multiple health conditions is greater. It is not uncommon, for example, for a patient to be treated with multiple therapeutic drug combinations in order to manage disease such as diabetes, heart failure and chronic obstructive pulmonary disease (Kaufman, 2011, p. 49). Polypharmacy is associated as a major factor placing older adults at risk for an adverse drug event. As the number of medications increase, the need for monitoring becomes much more crucial. When there is a breakdown in proper monitoring, the older adult is significantly placed at a higher risk for negative health outcomes due to serious side effects, poor adherence, adverse drug reactions and adverse drug interactions. Adverse drug events or medication errors that result from polypharmacy can often be difficult to predict and prevent. According to an article posted in the American Journal of Health-System Pharmacy (2012), drug –drug interactions may lead to increased toxicity levels when taken together. An example is the interactio... ... middle of paper ... ...fman, G. (2011, April). Polypharmacy in older adults. Nursing Standard, 25(38), 49-55. Miller, Carol A. (2012). Nursing for Wellness in Older Adults. (sixth edition). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. Woodruff, K., (2010, October). Preventing polypharmacy in older adults. American Nurse Today, 5(10). Retrieved from http://www.americannursetoday.com/article.aspx?id=7132 Wooten, J., & Galavis, J. (2005). Polypharmacy: Keeping the elderly safe. Retrieved from http://www.modernmedicine.com/modern-medicine/news/polypharmacy-keeping-elderly-safe Wright, A., FebloWitz, J., Phansalkar, S., Liu, J., Wilcox, A., Keohane, C., … Bates, D. (2012). Preventability of adverse drug events involving multiple drugs using publicly available clinical decision support tools. American Journal of Health-System Pharmacy, 69, 221-227.
Polypharmacy is the “concurrent use of several differ drugs and becomes an issue in older adults when the high number of drugs in a medication regimen includes overlapping drugs for the same therapeutic effect”(Woo & Wynne, 2011, p. 1426). The patient is currently taking several medications that can potential interact with each other, perform the same therapeutic effect, and creating side effects. The following is a list of her medications and their indications:
...teract. Many of the medications are very powerful in and of themselves. This article also presents additional approaches to medicating the elderly, including focus on reduction of number of medications prescribed. Both articles present the importance of considering the normal physiological changes within geriatric patients.
Patients are feel difficulty of medication compliance in long term treatment because patient have to be a regular on their medication. However, old people also require an extra attention on medication compliance because sometime noncompliance create a critical situation for them. Sometime patient takes a few dosage of medication and they stop taking medication as soon as they feel well which create a complication on long run. The implications of non-adherence are evident in the outcomes for many diseases, including HIV, cardiovascular disease, type 2 diabetes and high cholesterol (Scholefield,
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Elderly who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. Elderly who take over-the-counter medications, herbs, and supplements without consulting their physician are at risk for adverse reactions associated with polypharmacy. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients who continue to take medications which have been discontinued by the physician. There is a great need for nursing interventions regarding polypharmacy, including medication reviews also known as “brown bag”. As nurses obtain history data and conduct a patient assessment, it is essential to review the patients’ medications and ask open-ended questions regarding all types of medications in which the patient is taking. In addition, the patient assessment is also an opportunity for the nurse to inquire about any adverse reactions the patient may be experiencing resulting from medications. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
The geriatric population is rapidly growing as individuals continue to benefit from medical advances and pharmaceutical treatments. A large number of this population will need to take some form of medication to maintain a functional lifestyle. Multiple medications can affect the elderly population differently than younger generations. This paper will discuss how polypharmacy impacts geriatrics and the will focus specifically on analgesics and antihistamines. It will also examine demographic factors, changes within the aging body, prescription and nonprescriptive medications, and the role of the nurse practitioner when caring for these patients.
Darby, S. Marr, J. Crump, A Scurfield, M (1999) Older People, Nursing & Mental Health. Oxford: Buterworth-Heinemann.
* There are close to 2 million cases each year of drug complications that result in 180,000 deaths or life-threatening illnesses in the eldery (Langreth, 2004).
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.
Continuing to review a patient’s medication profile while residing in a healthcare facility every six to twelve months and with any medication alteration (Pham and Dickman, 2007). This frequency of review would allow for re-evaluation of current medications and discontinuation if applicable (Pham and Dickman, 2007). In addition, adverse drug reactions are known to occur more often in women, children, the elderly and in patients with renal insufficiency (Woo and Wynne, 2012). Close monitoring of these high risk populations would also provide opportunity to minimize adverse drug reactions in combination with close monitoring of the known high risk medications such as antiepileptic drugs, and antidepressants (Woo and Wynne,
...Jaecker, P. (2009). Medication use and increased risk of falls in hospitalized elderly patients: A retrospective, case-control study. Drugs & Aging, 26(10), 847-852. doi:10.2165/11317610-000000000-00000
In the United States today, the elderly make up approximately 13% of the population but use 30% of all prescriptions written.
Objective 3: review the safe use of medications with primary medical physician (Perkinson, Arthur, & Bruce, 2014).
When a patient is taking two or more drugs that react with each other is a drug-drug interaction. A drug-drug interaction may cause the drugs to create unwanted side effects or cause harm to the person taking the drugs. It’s important to look at statistics on drug-drug interactions, how drugs interact with each other and ask pharmacists about their knowledge of drug-drug interactions. Most people are unware of the drugs that they are taking may interact with each other, but I have come to understand that most people are not informed on what a drug-drug interaction is and how it could be harming them. Patients should be aware of how the drugs that they are taking interact with each other, and what the harmful effects could be. Drug-drug interactions can cause harm to patients if they are unware of how the drugs they are interact
Medication discrepancies account for approximately 25% of hospitalizations in older adults (Lancaster, Marek, Denison-Bub, & Stetzer, 2014, p. 536). There are approximately 1.5 million preventable adverse drug events each year, costing $3.5 billion (Lang, et al., 2015, p. 2). There are many factors that play into medication errors in the home, one of the primary causes is a lack of understanding of changes to the medication administration regimen on the part of the home care client, family, or caregiver (Lancaster, Marek, Denison-Bub, & Stetzer, 2014, p. 536). When the home care nurse understands the multi-dimensional factors that contribute to medication errors and conducts a comprehensive medication reconciliation, adverse medication events can be decreased. This paper will discuss the risk factors for adverse medical events in the home care setting, provide research information regarding adverse medication events, define medication reconciliation, and provide information on how to complete a thorough medication reconciliation for home care clients.
Adverse drug interactions of medications, their possible interactions with other drugs, chances of misuse or ill treatment ; excellence of product and cost effectiveness.