Polypharmacy In Health Care

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

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

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).

Tissot E, Cornette C, Limat S, et al. Observational study of potential risk factors of medication

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,

Optimizing drug therapy is an essential part of caring for an older person. The process of prescribing a medication is complex and includes: deciding that a drug is indicated, choosing the best drug, determining a dose and schedule appropriate for the patient's physiologic status, monitoring for effectiveness and toxicity, educating the patient about expected side effects, and indications for seeking consultation. Multiple factors contribute to the appropriateness and overall quality of drug prescribing. These include avoidance of inappropriate medications, appropriate use of indicated medications, monitoring for side effects and drug levels, avoidance of drug-drug interactions, and involvement of the patient and integration of patient values.

Pharmacist say they've had older people taking 3-5 prescriptions, that are confusing them because some are nullifying each other. Meanwhile doctors are over prescribing medications and patients are becoming junkies. Most people taking that many prescriptions hardly even know what drug it is.

The concept of “deprescribing medications” as mentioned in your paper is an interesting topic. This is a relativity new concept that the use of multiple medications that can increase the risk of adverse drug reactions to the patient. When polypharmacy is apparent, the risk of drug interaction falls hospitalization and death can occur. The APN has a role in the medical profession to start a trend of watching over and deprescribe medication for the polypharmacy patients. While compiling the prescribed medication and the medication the patient consumes the chance that they can overlap each other and cause harm is increased. With the elderly population deprescribing by tapering, stopping, and or discontinuing medication

“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

It is very important to remember that a health care system is comprised of many parts and members, all having an important role in the function of its evolution. Healing is much more welcomed and prevalent in a system that performs in a balanced and effective way. The purpose of this essay is to incorporate key points about team quality improvement as it relates to my specific nine-month quality improvement plan. This essay will first give some background information about the plan before explaining how specific management techniques may be employed to ensure a smooth and successful health care organization. The essay will also include potential issues that might arrive during this process.

Together with the increasing number of years added to the older adults’ life, is the rise in the use of medications by the elderly. As discussed by Touhy and Jett (2016) “Medications occupy a central place in the lives of many older persons: cost, acceptability, interactions, untoward side effects, and the need to schedule medications appropriately all combine to create many difficulties” (p. 112). One health condition from which many older adults have in common is pain, “chronic pain affects approximately 100 million US adults and is one of the most prevalent symptoms among seniors, affecting older adults more than any other age group” (West & Dart, 2016, p. 539). Thus, the “prevalence of chronic pain in the USA has been accompanied by an upsurge of therapeutic opioid utilization” (West & Dart, 2016, p. 539). Due to slow metabolism that goes with aging, it has been proven that “older adults are more vulnerable to the adverse effects of pain medication. Older age is also associated with an increased prevalence of impaired cognitive function, putting these patients at additional risk of unfavorable drug exposure” (West & Dart, 2016, p. 539). In addition, the co-morbidities of the older adults, also contribute to the “increase in polypharmacy use, which in turn increases the risk of experiencing adverse drug interactions” (West & Dart, 2016, p. 539).

Proper medication management among the elderly can be challenging. Medications are used as one of the interventional tactics in the prevention and management of numerous diseases. Although medications can be useful to patients when used appropriately, they can also be harmful to patients.

The disproportionately high health care utilization and resulting colossal Medicare spending among a small fraction of Medicare beneficiaries is well established.56,70,71 Nearly 50% of the health care spending is incurred by 5% of the Medicare population.58 These high-cost health care users are commonly referred to as “super-utilizers”.71 They often have complex health and social issues and have high rates of multiple chronic conditions (MCC) including mental health disorders.56,58 Substantial research shows that patients with MCC and polypharmacy are at high risk of medication nonadherence. The therapeutic regimen for patients with MCC is complex, often involving multiple concurrent medications, which puts them at greater risk of drug-drug interactions and makes these patients less likely to be adherent to their therapy.72-74 In addition, patients who experience frequent transitions of care are particularly at higher risk of drug therapy problems and medication discrepancies, which may contribute to low medication adherence. For instance, after hospital discharge nearly 14% to 75% of patients experience medication discrepancies,13,17,18,75 11% experience adverse drug events (ADE),20 and 23% to 48% do not take their medications as directed.14,18 Medication management is critical for super-utilizing patients since nonadherence to medications is associated with poor health outcomes, and higher hospital admissions and costs.5,38

Falstein who is an elderly patient that was prescribed two different benzodiazepines by the same doctor. Polypharmacy is one of the major risk factors for drug-drug interactions and adverse reactions associated with medication use. Yet the article states that the “use of the drugs has risen among older people, even though they are particularly vulnerable to the drugs’ ill effects.” This does not come as a surprise when considering the pharmacy curriculum and how medical professionals are taught to approach patient care (and the assumed similar physician curriculum). The current pharmacy curriculum promotes the use of disease state guidelines that map out which medications to prescribe and when. Pre-conventional pharmacists and physicians will strictly follow the guidelines and the pattern of prescribing more medications when more problems arise in a patient. The course I mentioned earlier, geriatric pharmacotherapy, was the one of the only courses that stressed the importance of de-prescribing and when de-prescribing should be considered in elderly patients. This course was an elective not required by the college leaving a majority of student without special instruction on the geriatric