Polypharmacy Among the Elderly

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.

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 medication education is conducted by the nurse. Medication education includes informing the patient the reason for the medication, when and how long to take the medication, drug interactions, and importance of checking with primary care provider prior to taking any over-the-counter or herbal products. If the nurse is unfamiliar with a certain medication, a drug book is available for the nurse to utilize and gain knowledge regarding the drug use, action, adverse reaction, and contraindications.

Method used to conduct ROL

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.