Introduction
A financial burden such as the cost of medication can cause decreased compliance, increased complications and sometimes death . In 2005, a national study showed that 90 percent of the elderly take up to five prescription drug medications daily, thus, placing a tremendous financial burden on the elderly causing the decrease in dose or the refusal to get the prescription filled (Safran et al, 2005). The cost of medication on the elderly has been identified before, however, little has been done to assist the elderly in this endeavor. The purpose of this paper is to identify 3 best practice interventions to assist the elderly with medication cost and enhance compliance.
Identifying Problem
In 2005, twenty-six percent of seniors reported cost, as the reason for not filling prescriptions, the went without food to afford the prescription, they skipped or cut back on the medication doses to make the prescription last longer ( Safran et al, 2005). Seniors with low income and chronic illnesses were equal in relation to cost noncompliance, however those without medication coverage scored higher than both of those categories (Safran et al, 2005). This was before the Medicare coverage prescription drug plan was in place, but studies have shown little has improved over the years. The rate of cost noncompliance remained the same, but a reduction in forgoing basic necessities was improved (Madden et al, 2008). Home Health nursing places this issue at the forefront of caring for the elderly. Several large pharmacy chains have attempted to lower the cost of medication, however, doctors continue to prescribe medication that are too expensive for the patients to obtain. This nurse’s concern is when the patient stops taking the ...
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According to Statistics Canada Report 2013, “life expectancy in Canada is one of the highest in the world” and it is expected to grow, making the aging population a key driver to our health-systems reform. By 2036, seniors in Canada will comprise of twenty five per cent of the population (CIHI, 2011). Seniors, those aged 65 years and older are the fastest growing population in Canada. Currently there are approximately 4.8 million Canadians aged 65 or greater. It is projected that this number will increase to 9 to 10 million by 2036 (Priest, 2011). As the population get aged the demand for health care and related services are expected to increase. Currently, the hospitals in Ontario are frequent faced with overcrowding emergency departments, full of admitted patients and beds for those patients to be transferred to. It has been reported that 20% of the acute care beds in the hospital setting are occupied by patients that do not require acute hospital care. These patients are termed Alternate Level of Care (ALC). ALC is “When a patient is occupying a bed in a hospital and does not require the intensity of resources/services provided in this care setting (Acute, Complex, Continuing Care, Mental Health or Rehabilitation), the patient must be designated Alternate level of Care at that time by the physician or her/his delegate.” (Ontario Home Care Association, 2009, p.1).
(II) The enacting of Medicare Part D in 2006 only helped to fuel America’s hunger for prescription medication. In 2003, President George W. Bush announced and signed the Medicare Prescription Drug, Improvement, and Modernization Act (also known as the Medicare Modernization Act, or MMA) on December 8th. The roughly $400 billion dollar measure was marketed to the American public as something that will provide care for the millions of senior citizens who, at the time, were struggling to afford prescription medication. This was the largest development of Medicare since 1965, which is when the program was initially created, and gave hope to those wishing for positive medical reform. According to title XI of the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003”, the most significant change will be the affordability of prescription drugs by implementing the importation of drugs from Canada, along with necessary safety measures, in order to lessen the cost (United States Congress, 832). For those who were in retirement homes and lacked a steady income, the affordability of drugs was often a deciding factor in the decision to seek medical attention and the idea that those individuals ceased to live simply because they lacked the funds tugged at the heartstrings of many Americans.
Zhang, Y. B., Harwood, J., Williams, A., Ylänne-McEwen, V., Wadleigh, P. M., & Thimm, C.
The question, however, is whether or not such drug coverage is a worthwhile project to undertake. Is the problem indeed serious enough to call for the type of reform that the candidates are proposing? Medicare is already a very costly program to keep up, and adding prescription-drug coverage would increase these costs even more. In order to fund this project, there will need to be a tax hike. Should taxpayers subsidize this prescription-drug benefit? Is there a good reason why this redistribution should take place? What are the benefits and costs of this proposal? These and other questions will be addressed in this paper as we examine the following topics: the need for senior citizens to have prescription-drug coverage, the political rhetoric involved with this issue, the projected shortfall in the budget of the Medicare program, and who really would benefit if a prescription-drug benefit was added to Medicare.
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African American senior citizens face a health care crisis too. They have worked all of their lives to secure retirement, but their retirement has been threatened because of the rising cost of long-term medical care. Insurance companies have failed to provide affordable long-term care, protection that most senior citizens need. This lack of long term care and affordability has been a serious problem for the health care system. In some cities, the shortage of hospital beds is so serious that it is common for patients to stay in emergency rooms before they can be admitted to an inpatient room (Drake 109). More than one thousand hospital beds are occupied by people who could be better care for in nursing homes or through home health care (Drake 110). Of the disabled elderly 1.3 million reside in nursing homes (Drake 10). These patients are unable to perform two or more of the basic activities of daily living without assistance.
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
There are three issues when it comes to the health care cost rising. The first is the rising cost in prescription drugs. The second area of rising cost is the increased technologies when it comes to the medical industry. The third problem is the aging population. Prescription drugs are the area of the fastest growing health care expense, and it is projected to grow at 20 to 30 percent each year over the next several years. There are many newer, more expensive drugs on the market, and the use of these prescriptions is exploding. In addition, with so much television advertising, many consumers ask their doctors for expensive, brand name drugs when there may actually be a generic drug that works just as well.
During the years of 1999-2000 only 6.3 percent of Americans used five or more medications, and then in the years of 2007-2008 about 10.7 percent of Americans used five or more medications, that is a 4.4 percent increase. In the last decade alone the use of five or more medications has increased 70 percent. Creating the stronger need for healthcare providers to communicate about the care of their patients is becoming evident. However in recent years more hospitals are using electronic medical records that can be sent to each healthcare provider, this helps the patient relive some of the stress in remembering what all medications they take and the dosages they are taking. Also healthcare providers can now see when their patient was last in to see another doctor and what there diagnosis was creating a more stable health system and less medication reactions. Although there is always room error but if every hospital adopts this system there is a good possibility that polypharmacy may be a thing of the past. Polypharmacy is becoming a fatal epidemic for the elderly, it is pertinent to know the risks and ways to prevent
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?
A search for current peer reviewed research studies was conducted using CINAHL, Medline, and PubMed. The research articles were generated by utilizing the search entry with the terms of polypharmacy, polypharmacy among the elderly, adverse drug reactions and polypharmacy, and consequences and polypharmacy. After receiving a few research articles, a new search was conducted replacing the term of polypharmacy with multiple medications. These searches yielded limited research articles pertaining to the topic of polypharmacy.
With the creation of Medicare in 1966 in order to expand access for the elderly to the American healthcare system, the ways in which medicine and its corresponding industries were conducted were irrevocably changed. Prior to its inception, only 65% of people over 65 actually had proper health insurance, as the elderly paid three times as much for healthcare as young people (Stevens, 1998). The private medical sector had much more control over who they would treat, how much they would charge, and more; the passing of Medicare freed up the elderly to have reasonable access to healthcare as a consequence of a lifetime of paying into the system.
... their mediation regimen closely. Many elderly patients are taking several drugs that can reduce the efficacy and increase the toxicity of one another. In order to avoid complications it is important to always educate the patients on proper usage, side effects and specific drug interactions. If a patient misses a dose they should never double up. This could increase their risk for possible overdose. Certain OTC drugs and herbal supplements can have adverse reactions and reduce the efficacy of these drugs. Patients should be advised to that alcohol or tobacco consumption may alter the absorption of the medication and should be avoided. Lab work should be completed routinely to avoid renal and liver toxicity when taking these two classes of drugs.