Non Polypharmacy In The Elderly

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

Senior citizens are the people who are most likely to take multiple medications due to the occurring chronic conditions as the aging process continues. Given the several medicines they take, they are ironically the age group that is very much sensitive to medication side effects, both therapeutic and negative.

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

De-prescribing is, therefore, a complex process that is required for the safe and effective cessation of inappropriate medications to improve the quality of life (Hasler, Senn, Rosemann, & Neuner-Jehle, 2015). Page et al. (2016) suggested a five-step approach for safe and successful de-prescribing: (1) consider all medications currently taken and the indication for each medication, (2) evaluate the overall risk of medication-induced harm in an individual, (3) assess each medication for its potential to be de-prescribed, (4) sort medications by the order of priority to de-prescribe, (5) implement and monitor de-prescribing regimen. While de-prescribing appears feasible and relatively safe to reduce the impact of polypharmacy in older adults,

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

Have you ever stopped to think how many different medications one has to take to be at risk for polypharmacy? Is polypharmacy a matter of too much medications at one time or, can it be a complex medication regimen that is being used to treat side by side health problems? Polypharmacy has many different meanings such as, more than five medications taken by an individual on an everyday basis. Another description may be multiple medications that are taken to treat one or more conditions within an individual. In either case, polypharmacy among the elderly “represent one of the fastest growing segments of the population” (AGBONJINMI, L. A., 2017).

In the United States today, the elderly make up approximately 13% of the population but use 30% of all prescriptions written. This article focuses on the importance of understanding patients’ prescriptions and their adverse drug events (ADE), as well as the best ways to care for patients with many prescriptions. The article also discusses the best ways to avoid ADEs.

The US is an aging society like many societies around the world and as a result, there is an increase in the number of patients admitted to nursing homes. The elderly population is a fragile population that undergoes mental and physical decline in health. This increases the number of medications used, which increase the risk of adverse drug reactions due to drug-drug and drug-disease interactions. Pharmacists have become increasingly active in nursing homes by providing medication therapy management services, but the benefit in reducing prevalence of these adverse drug reactions is not fully understood. Medication therapy management is a growing field that has been incorporated by pharmacists in different states to optimize therapeutic outcomes in individual patients. Understanding the relationship between medication management and drug- drug

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.

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 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

According to an article written by Anna Gorman of Health Leaders Media, the use of prescription drugs is a growing concern. The article mentions Lola Cal, a patient in a geriatric unit in Santa Monica, California whose medical records show that she is on 36 different medications. Although people born from 1946 to 1964, known as the baby boomer generation, only make up 16% of the U. S. population, this generation accounts for one-third of prescription drug use. Many elderly patients take several medications to treat chronic illnesses and raise their chances for serious side effects and dangerous drug interactions. Dr. Maristela Garcia, director of the inpatient geriatric unit at UCLA Medical Center in Santa Monica states that polypharmacy is “America’s other drug problem.

As a result, an increasing number of seniors (who may already be suffering from physical and mental health problems and who may be on a fixed budget) are becoming addicted to the medicines that were supposed to help them. Addiction to prescription medication is an often poorly understood problem and one that can quickly tear a person 's life and health to shreds.