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.
The varieties of pharmaceutical and prescription drugs that are available to the public provide many different consequences, which could lead to other health problems among users. Opioids, for example, are typical...
Medcohealth. Women and Aging: Our lives due change (2002). Retrieved November 18, 2002 from the World Wide Web: http://www.medcohealth.com
Lucian L. Leape Conducted a study in 1995 on “health policy analyst at the Harvard School of Public Health, found that 6.5 percent of patients at two teaching hospitals in Boston had been injured by their medicines, and one-third of these cases involved mistakes” (Stolberg, 1999). Due to this Study the F.D.A. official were convinced that the danger of prescription cascade is growing which prompted them to release a 150-page report which was made public, that called for pharmacists, doctors, hospitals and drug companies to work together to create ' 'a new framework ' ' for cutting down on overlapping prescription that have a high risk of causing a cascade. Explicit warning pamphlets were also created according to the new guidelines which requires manufacturers to release side effect possibilities in high risk drugs. (Stolberg, 1999)
According to the World Health Organization (WHO), the aging population will continue to grow due to the falling fertility rates and the increases in life expectancy. However, this population has distinctive, demographic factors that may influence their adherence to medication necessities. Dynamics that affect medication regimen in the elderly can be related to “memory and cognition (forgetting to take medication), dexterity (unable to open medication or break pills in half), low literacy, concern about side effects
* 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).
When administering medications it is critical to pay great attention to the task at hand. This task becomes more important when administering medications to the elderly because of the different physiological and psychological changes that occur in the body. Equally important are, the lab values related to the medications being administered, differences in administering medications to the elderly, and the use of the six rights and three checks.
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:
Medication errors are any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care profession, patient or consumer (Johnson, 2012). Approximate 1.3 million people injure each year due to medication errors in the United States. According to the Coordinating Council for Medication Error Reporting and Prevention describes medication errors as any event that cause or lead to inappropriate medication use or patient harm while on the medication (Comrade 2014). The Food and drug administration evaluates and report the most common medication error as improper dosage accounts for 41 percent of fatal medication error and failure
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.
contamination, toxicity, and side effects. Most people believe these medications are compounded or mixed by a trained and licensed individual. However, this is inaccurate because the pharmacy technician actually compounds a large percentage of a patient’s medications. Compounding involves a techn...
It is not sufficient to delegate elderly care to family practitioners. Though most family medicine programs address patients with chronic illness, the curriculum is not age specific. Individuals over the age of 75 report an average of three chronic health conditions and use more than 4.5 prescription drugs at any given time (Kovner, Meezey, & Harrington, 2002). These conflating comorbidities require a diverse range of skills. Trained geriatricians are adept at treating these conditions while bearing in mind the social, psychological, and biological changes that are associated with aging.
Darby, S. Marr, J. Crump, A Scurfield, M (1999) Older People, Nursing & Mental Health. Oxford: Buterworth-Heinemann.
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.
... 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.
Specific Purpose: To inform my audience about the dangers of prescription drugs when not taken as prescribed by your physician or pharmacist.