How Polypharmacy Is An Essential Treatment Regimen For Patients

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:

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.

Polypharmacy, described as an individual taking more than four medications, can be concerning with the aging population. Polypharmacy concerns include adverse drug reactions, drug interactions, higher cost, decreased mobility, decreased quality of life and cognition impairment. Those at greater risk of negative polypharmacy consequences include elderly, psychiatric patients, recently hospitalized, individuals with multiple doctors or pharmacies and people with impaired vision or dexterity. There are times that polypharmacy is at times needed to help a person with their diagnosis, an example of this is using multiple medications to treat congestive heart failure which can include digoxin, diuretics, and angiotensin-converting enzyme inhibitors

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

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.

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

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

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).

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

Elderly patients that take several medications compound the risk of developing an adverse drug reaction. Not only does the aging process have an effect on how elderly bodies process medication, but elderly people take more medications than their younger counterparts. According to Conry (2005), the elderly patient takes an average of 5 prescription medications and two non-prescription medications (Conry, 2005). While medications are frequently necessary to enhance the quality of life of the elderly, non-pharmacologic methods should be used whenever possible. Healthcare providers need to understand how aging impacts the body’s response to medications, which drugs pose more risk to

Working directly in patients homes we have access to their medication cabinets, doctor orders, and medication sheets. Thorough review of their medications is the first step to identify polypharmacy. Lui, (2014) discusses the approach of deprescrbing unnecessary medications. Stopping unnecessary or harmful medication is an often overlooked yet important component of geriatric practice. This process may be time-consuming, as there are many factors to consider when deprescribing medications in elderly patients.

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

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

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.