Polypharmacy

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

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.

drugs can be potentially dangerous for a patient, particularly if they are receiving medications from different clinicians who are not communicating with each

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

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.

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

With the growing reliance on medication therapy as the primary intervention for most illnesses, patients receiving medication interventions are exposed to potential harm as well as benefits. Medicines have proven to be very beneficial for treating illness and preventing disease. This success has resulted in a dramatic increase in medication use in recent times. Unfortunately, this increase in use and expansion of the pharmaceutical industry has also brought with it an increase in hazards, error and adverse events associated with medication use.

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).

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,

The subject for the Polypharmacy in Older Adults interview is an 86-year-old female whom was interviewed in her private residence. For the purposes of confidentiality, we will address her by the name “Janet” throughout the study. Her present and past medical history includes, autoimmune hepatitis with severe cirrhosis of the liver, a cerebellar stroke at age 75, and a history of complete heart block requiring pacemaker insertion.

Much of the vast information that has been researched and provides evidence about polypharmacy is from an organization called the National Hospice and Palliative Care Organization (NHPCO). The NHPCO helped to support my Indirect Clinical Project. The mission statement and values are is to help lead and improve end of life care and to respect others, collaborated and exceed expectations. This organization hopes to help families and patients who are facing terminal illness to address death, and grief with the best people to help them through it (National Hospice and Palliative Care Organization, n.d.). This organization is committed to people at the end of life and improving their quality of life, for however long they have left. By researching and learning more