How Polypharmacy Is An Essential Treatment Regimen For Patients

Fulton, M. M. & Allen, E. R. Polypharmacy in the elderly: a literature review. J Am Acad Nurse Pract 2005, 17: 123-32. Received from PubMed database (15819637).

Individuals who have encountered an event of a heart attack, angina, heart failure, stroke, coronary artery bypass graft, or heart valve surgery experience multiple unfavourable healthcare outcomes. Cardiac health conditions are an enduring healthcare concern with alarming associated complications and risks. These lifelong chronic conditions affect both patient and family’s quality of life, ultimately, requiring ongoing management for cardiac patients to live longer and healthier lives. Cardiac rehabilitation programs reduce mortality and morbidity rates (Dalal, Doherty & Taylor, 2015). These programs are medically controlled cardiac programs which will modify a patient’s wellbeing and lifestyle, by implementing new lifestyle skills to

Specific Aims 2: Determine the effect pharmacists have on preventing drug-drug and drug-disease interactions in nursing homes. Our working hypothesis is that the pharmacists, being drug experts, can identify medications that may interact with each other or interact with a certain condition before it occurs. The elderly have health status that is deteriorating and are more likely to have frequent modifications in drug therapy, as the conditions get worse. We predict that pharmacists in nursing homes will identify the interacts with continuous modification in

Perhaps the most challenging aspect of older adult pharmacology is the concomitant use of multiple medications. Among community-

As the elderly population increases so will the occurrences of ADEs. For this reason, it is important to protect the elderly patient from these negative consequences of polypharmacy. This is accomplished by understanding how the aging body reacts to medications, understanding which drugs are the most problematic for the elderly patient, and how to spot a drug-related problem and

As the population continues to live longer the older adult has had an increase in chronic conditions develop, resulting in an increase in multimorbidity. This causes the older adult to be more vulnerable to disability, poor quality of life, risk of death and adverse drug reactions (Salive, 2013). In general, the older adult is vulnerable to having an adverse reaction to medications. The older adult not only has a higher risk of an adverse reaction to any particular medication given, there is an increase in risk of reactions associated with the multiple medications older adults are frequently prescribed due to multi-chronic conditions (Hubbard, O’Mahony, & Woodhouse, 2013). Adverse drug reaction and multimorbidity can benefit from additional research to better understand the older adult reaction to medications and dosages, as well as management of multimorbidity. Until then physicians, nurses, the older adult, and the family need to collaborate to find the treatment plan that works best with the least amount of side effects from medications. Often times starting low with medication dosing and increasing to the dose to achieve therapeutic levels is done with the older adult to help decrease an adverse reaction to medication. Management of multimorbid conditions in which maximizing the quality of life the older adult has is the goal. This can be done by frequent assessment of the treatment plan and making

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

In elderly people, polypharmacy is known to be associated with adverse drug events otherwise defined as “presence of untoward and unintended symptoms, signs or abnormal laboratory values arising from the appropriate or inappropriate use of prescription or over-the counter medications” (13).

Mrs A is a 71 year old widow with CCF and osteoarthritis who has recently been exhibiting quite unusual behaviour. Her daughter is concerned about her mother's ability to remain independent and wishes to pursue nursing home admission arrangements. She fears the development of a dementing illness. Over the last two to three months Mrs A has become confused, easily fatigued and very irritable. She has developed disturbing obsessive/compulsive behaviour constantly complaining that her lace curtains were dirty and required frequent washing. Detailed questioning revealed that she thought they were yellow-green and possibly mouldy. Her prescribed medications are:

According to the Health Care Finance Administration (HCFA), on July 1, 1999, established a quality indicator that residents taking nine or more medications will be used to identify long-term facilities where medications potentially are overused and residents may be at increased risk for adverse drug reactions (ADR). However, this approach can be controversial because the medication is essential for older people health safety. There are many factors on the overuse of medication which can include age, health and the number health care visits. Especially on home care and long-term facilities, most of the elderly in this facilities are forced to take these medications due to facility policies (Hanlon, 2001). Another

Heart Failure is when the heart cannot move the right amount of blood throughout the body to meet the requirement. Heart failure entails four stages, A through D. Stage D Heart Failure is where a person’s symptoms are unmanageable. If someone with the following health problems: coronary artery disease, high blood pressure, or diabetes, they are at risk for being diagnosed with Heart Failure. Currently, there is not a cure for this disease; however, there are several ways to manage it. Someone with this disease can get treated by taking medication, use of devices, or by surgical means. A trial that this paper will focus on is Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH), which

“polypharmacy as the use of five or more prescription medications—is common among seniors and can lead to reduced compliance with medication regimens and problems with drug–drug interactions” (2012, p.428). Elderly patients are mostly at risk to polypharmacy issues due to aging effects on how the body tolerates medications, and also, as a result of taking more medications than younger patients. Reason et al., continues to demonstrate that the use of prescription increase with age and in association with multiple morbidities in the elderly patients. Medications such as over the counter drugs, herbal preps, and home remedies are widely used by older adults. These medications have a higher risk of causing adverse drug reaction especially with

Polypharmacy is very prevalent in the elderly, due to multiple diagnoses that require medication management. Polypharmacy can be very dangerous in many different ways. There are so many drug-drug, drug-food, drug interactions that could occur with every drug. When a patient is taking over 10 medications it is hard to understand every interaction that could occur with each medication. In a patient with polypharmacy, medication reconciliation is extremely important for patient safety.

The objective of this paper is to explain what is a Ventricular Assist Device, how does it work, it’s complications, the most up-to-date evidence base practice nursing interventions, the impact that has had in patient’s outcomes, This Author choose this topic due to the rise in Congestive heart failure patients, according to The Center for Disease and Control Prevention (CDC) approximately 5.7 million adults in the United States suffer from Heart Failure, and about half of those diagnosed with heart failure died within a period of five years. Ventricular assist device is used as a bridge to transplant giving a higher chance of survival for those patients wait for a heart transplant.

During my undergraduate career, I studied Exercise Science with an emphasis in Cardiac Rehabilitation. Before graduation, I was able to perform an internship with a Cardiac Rehabilitation facility at the Medical Center of Plano. During this time, I was able to learn about basic precautions for Cardiac patients, generalized progressions of workouts for these patients, how to take manual blood pressure, ECG set up and monitoring. Since this time, I have always been eager to learn more about the Cardiovascular and Pulmonary Physical Therapy, as I feel this may be an area in which I would like to specialize. Therefore, I find myself excited to begin this course to further my knowledge of the treatment and rehabilitation of patients with cardiovascular and pulmonary dysfunctions.