Drugs are a double-edged sword by providing therapeutic effects with the potential to be toxic when it is not used properly. Medication safety has become a concern, especially with the rise in chronic illness and the aging population leading to polypharmacy, where a patient take multiple medications, increasing risk of drug related problems (Kwan & Farrell, 2013). As a solution, the Government of Ontario introduced and funded a pharmacist led medication review program called MedsCheck. Started in 2007, patients who take over three chronic medications are eligible for an annual 30 minute one-to-one medication consultation with the pharmacist to make sure medications are taken properly and safely. This program was expanded in 2010 to include …show more content…
For adults over the age of 65 in Canada, fall-related hospitalization accounted for 85% of injury-related hospital admissions and 7% of all hospitalization in this age group in 2008 to 2009. (Scott, Wagar, Sum, Metcalfe, & Wagar, 2010). The result from a pilot study performed by Roja-Fernandez, Seymour, & Brown (2014) showed a 57% relative increase in fall reduction overtime when pharmacist at a LTC facility in Ontario assessed risk of fall injury due to medication while performing a medication review with the aid of an algorithm. Therefore, discontinuation of unnecessary medication or medication change suggested by pharmacist during medication review can prevent fall injury and hospitalization for seniors (Roja-Fernandez, Seymour, & Brown, …show more content…
One of the most successful programs implemented led by pharmacist was the Asheville Project started in the late 1990s in Asheville, North Carolina to provide management for diabetes patient (Smith, 2009). The pharmacist would provide diabetic medication consultation, patient training on glucose monitoring device, educate patient on lifestyle management and ultimately develop a plan that is patient specific to help meet his health target with follow-ups (Smith, 2009), which is similar to the goals outlined in MedsCheck for Diabetes in Ontario (Ontario Ministry of Health and Long-Term Care, 2011). The Asheville program demonstrated many positive patient outcome including 50% of participants improved the mean glycated hemoglobin (HbA1c) value and reduced low-density lipoprotein (LDL) levels, which ultimately led to a decrease in emergency department visits to a rate of one-third of the national average (Cranor, Bunting, & Christensen, 2003). In fact, the success of this initiative allowed the extension of the Asheville program to include management for asthma, hypertension and high cholesterol (American Pharmacists Association,
Due to the large number of consumers being prescribed multiple medications, and the complexity of managing those medications, it is of a major safety concern that systems are in place for clinicians to reconcile patients medications to resolve any discrepancies in what the patient is using, or should be using, and newly added ones.
Inappropriate prescribing commonly occurs in adults aged 65 or older, who have a higher prevalence of chronic disease, disability, and dependency (Page II, Linnebur, Bryant, & Ruscin, 2010). Exposure to inappropriate medications is associated with increased morbidity, mortality, and health care utilization (Page II, Linnebur, Bryant, & Ruscin, 2010). Below is a list of measures that concentrate on the prescribing of correct medications in the hospital
Human health and theIR quality of life have been improving in the past 100 due to changes in medicine and in public health (Mattes et al., 2013). Patients are placed on multiple medications at the same time and it important to understand their safety, efficacy, drug interaction, and toxicity (Mattes et al., 2013). As Mr. Cynthia Nurse practitioner, my job is to understand what affect her prescribing medication is having on her body. I have place Mrs. Cynthia on Lisinopril for her hypertension and metformin for her type II diabetes.
This essay will inform readers about the best practices, published guidelines, and clinical pathways for management of diabetes. Diabetes is a serious issue that affects millions of people. Unrecognized pre diabetes is also a growing concern that is increasing dramatically. Diabetes is not diagnosed for most homeless people, because they do not do have a yearly physical check-up. Published guidelines are useful to patients and practitioners because they focus on the improvement of care. Clinical pathways are also important, because they focus on the outcome and assessment of their achievement.
In the article “The Political Economy of FDA Drug Review: Processing, Politics and Lessons for Policy”, the author Daniel P.Carpenter discusses different aspects of the FDA’s drug processing system and the political effects that can alter the routes and outcomes of that process. The role of the FDA is often thought to be mainly focused on protecting the public from non-efficient drugs and that that is the reason behind its popularity. However, the article points out how this role is actually more focused on protecting the FDA’s own reputation; as a long-time FDA observer said, “The FDA is very responsive to what I would call ‘opinion leaders’ in the scientific and medical communities. It cares very much about what these people think as to how the agency is doing”. It is rather surprising and makes complete sense at the same time. I believe because the public often saw the FDA as a heroic agency that shielded them from harmful drugs with no concern of the outcomes. But this vision would certainly vanish if the
Nearly half of seniors do not take their medications when or how they were prescribed. There are mistakes on dosages, methods of delivery, time of delivery, what they should be taken with, and even if they should still be taken. Compounding the issue, most seniors over the age of 65 are taking between 8 and 13 different medications. Put these numbers together and it is no wonder that problems with medication management are one of the leading reasons seniors end up in the emergency room, and is the number one reason seniors end up back in the hospital after being recently discharged. According to a study published in "Pharmacotherapy", nearly 70 percent of hospitalized seniors suffered from at least one
The increase in patients falls and the number of patients that are fall risks has greatly increase. Part of this is due to the aging population. While there are many prevention methods in place, patients are continuing to experience falls. “Problem solving relies on decision-making, critical thinking, and/or clinical judgement” (Chamberlain College of Nursing, 2015). I recently had a patient that had two falls during his admission. I placed the patient on 1:1 observation. He was a fall risk due to his history, mental status, and medications (narcotic pain meds and antipsychotics). The patient did not fall again while I was at work. However, after my days off I came back and got report that the patient fell again. The patient had been taken
The rate of diabetes in the United States is one of the highest compared to other developed countries. An estimate of 9.3% of the population have diabetes, of those with diabetes 27.8% have yet to be diagnosed (Centers for Disease Control and Prevention [CDC], 2014). This means that approximately 8.1 million people are currently living with diabetes, but are unaware of it. As of 2012, 12.3% of people with diabetes were 20 years old or older, the largest population diagnosed with diabetes were adults 65 years old or older. 25.9% of this population lives with diabetes (CDC, 2014). On a national level, the CDC have launched initiatives that focus on prevention and disease management. The National Diabetes Prevention Program is an example of one such initiative. This program focuses on lifestyle changes,
3) advocates autonomy and independence of the residents. According to the guideline states that medication review is an evidence-based intervention and this review should be performed regularly (ACSQHC 2009, p. 72). A meta-analysis was conducted in aged care facilities and the relationship polypharmacy and falls, and fall injuries were found out. Residents taking cardiovascular medications, including diuretics, antiarrhythmics, digoxin, have higher fall risks. But, by reviewing their medication, the risks of fall were reduced up to 66% (Baranzini et al. 2009, p. 228). A randomise controlled trial was conducted targeting residents in aged care facilities, and a comparison between medication-reviewed population and non-reviewed population performed. The effectiveness of medication review was statistically confirmed that reviewed population showed 38% lower number of falls than the non-reviewed population (Zermansky et al. 2006, p. 589). Therefore, in aged care facilities, falls are obviously a big problem and often harm the residents. Medication is a major factor for falls because the vast majority of residents are taking multiple medications. However, reviewing their medications, fall risks are significantly reduced. As a nurse, careful observation for the residents and frequent collaboration with pharmacists or doctors should be performed to ensure the residents
Safety is one of the most important traits of providing care to a patient. Medical mistakes are a growing concern within the health care field, as each year an estimated 400,000 lives are lost to preventable medical mistakes (James, 2013). One important subset of medical mistakes is medication errors. The National Coordinating Council for Medication Error Reporting and Prevention defines a medication error as “…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 professional, patient, or consumer” (National Coordinating Council for Medication Error Reporting and Prevention, 2014). Health care
drugs can be potentially dangerous for a patient, particularly if they are receiving medications from different clinicians who are not communicating with each
In the article published by Sirkin and Rosner (2009), it was reported that 70% of individuals above the ages of 65 years have hypertension and approximately a third of them fall every year. It was found that hypertension and fall are common in elderly and coexist in most of the cases. It has been thought that the medication that the hypertensive elderly use put them at risks fall. For instance, it has been found that psychotropic agents, antidepressants, hypnotics, anticholinergic and anxiolytics cause falls in many patients. These drugs have been reported to have serious neurological and autonomic effects among the vulnerable individuals (Sirkin & Rosner, 2009). Due to the high correlation between falls and medication, organizations are encouraged to have pharmacy staff provide an ongoing review of patient medication regimens. Through the active participation of nurses, vulnerable patients should be identified and managed according to the required plan.
Falls are considered a leading cause of mortality and injury among older adults and majority of the falls occurs while hospitalized. One would think being in the hospital would be one of the safest places for older adults as far as fall prevention is concern due to the fact that hospitals provide staffing around the clock for patients but more and more falls have been occurring in the hospital especially in the older adult population. Fall is an unintended descent to the ground. It raises public and family care liability; it also decreases patient’s functioning because it causes pain and suffering, and increases medical costs (Saverino et al, 2015). The Center for Disease Control
Diabetes is associated with wide range of complications such as chronic renal failure, blindness, amputations, heart disease, high blood pressure, stroke, and neuropathy (Alotabi, A., et al., 2016). There is no known cure for diabetes, but the disease can be controlled through health management that includes multiple perspectives of care such as medications, blood glucose monitoring, diet, nutrition, screening for long-term complications and regular physical activity (Alotabi, A., et al., 2016). Managing diabetes may be complicated and requires the knowledge and skills of both healthcare providers and the clients. Studies have shown that to prevent or delay diabetic complications due to diabetes, counseling and other lifestyle interventions are the effective therapy. Even with many policies set up for diabetes, 8.1 million Americans are undiagnosed with diabetes mellitus, and approximately 86 million Americans ages 20 and older have blood glucose levels that considerably increase their risk of developing Diabetes Mellitus in the next several years (CDC, 2015). For diabetes care to be successful there needs to be a good understanding of the disease and management by both patients and healthcare providers,
Several nationwide programs and incentives were administered in the last couple of decades to promote awareness of diabetes and hopefully help prevent millions of Americans from developing diabetes. Health Agencies, such as World Health Organization (WHO) and Center of Disease Control and Prevention (CDC), have developed objectives to tackle diabetes. Some of these objectives include conducting surveillance and obtaining diabetes data to identify trends in the population, spreading awareness about the condition, and developing programs that will enhance diabetes care and ensure the longevity of the patients. Various programs have been developed but while some excel, others fail to benefit the lives of the patient.