Polypharmacy in the Older Adult: Too Much of a Good Thing Essay

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

Hello Professor. I agree that medications are the magic solution to treat diseases if they are used appropriately. For example, when antipsychotic medications are not used correctly could lead to functional decline and cognitive impairment. The health care professionals’ knowledge of safe medication use, risks and benefits, and the drug-related problem are important when taking care of elderly patients. “In 2015, the AGS Beers Criteria were again updated by an expert panel of healthcare and pharmacy experts to help prevent potential medication side effects and other medication-related problems in older adults” (Health in Aging, 2015). It is pivotal to use the guidelines of Beers Criteria in our daily practice to prevent inappropriate use of

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.

Older adults commonly take NSAIDS chronically. There are a lot of adverse effects associated with chronic NSAID use including the risk of peptic ulcer disease, acute renal failure, and stroke/myocardial infarction, as well as exacerbate a number of chronic diseases including heart failure and hypertension, and can interact with a number of drugs (eg, warfarin, corticosteroids) ultimately increasing hospitalizations in the elderly population.

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

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

With increasing clinical complexity of the older patient, increases the need for the intervention of different specialists; and the lack of coordination of care among different providers and potential drug-drug interactions may lead to the occurrence of adverse drug events (17). Certain drugs are considered inappropriate in older patients because of intolerance related to adverse pharmacokinetics and pharmacodynamics as part of the aging process, as

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.

Secondly, a national pharmacare program resolves the problems of underuse of needed therapy (Morgan, et al. 2015). The current system separates the management of medicine from the management of health care; consequently, this approach negatively impacts the safe and effective use of medicines (Morgan, et al. 2015). Studies reveal that one in three elderly Canadians receive prescriptions for drugs known to pose health risks for older patients (Morgan, et al. 2015). Canada needs a program to ensure the safe use of

McCance, K. L., & Huether, S. E. (2010). Pathophysiology: The biologic basis for disease in

Because of the aging process, multiple medications that are taking can be harmful to their bodies. It is not uncommon “for a client with multiple medical conditions to be on 6-9 medications” (Carroll, C., & Hassanin, A., 2017). If they are to become hospitalized it is possible that during their stay, they are prescribed new medications for an existing condition. These new medications can put an elderly client at risk for polypharmacy. The client may become overwhelmed and confused, and may add their new medication to their existing pill regimen and take both old and new. There may also be a situation where the elderly client has multiple physician appointments and they are all prescribing medications which can lead to “inadequate or lack of health counseling on pharmacological management” (Carroll, C., & Hassanin, A.,

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

To ensure the best health care provided to older adults, nurses need to apply the nursing process to all their patients to reduce their hospitalization and help them live better lives. This also provides the health care provider all the information needed to plan their care. L. Lilley, S. Collins, and J. Snyder (2013) explain the importance of lifespan considerations with elderly patients, “More than 80% of patients taking eight or more drugs have one or more chronic illnesses. More complicated medication regimes predispose elderly patients to self-medication errors, especially those with reduced visual acuity and manual dexterity.” (p. 43) Considering our patients age of being over 65, special considerations are needed

Elderly patients are more at risk for ADEs because of the number of medications that they are on and the effects that they can have (Vejar 72). It is important to educate patients about their prescriptions and over the counter drugs. The patients should know why they are taking each medication and what the side effects of their medications are. This is why it is recommended that patients bring all the medications they are taking with them to their doctor’s appointments so the physician can see exactly what medications they are taking. This can also help to make sure they are not taking too many medications that are supposed to treat the same things. One goal is to have all the patient’s active medications recorded in the EMR (Vejar 74). Improving the rates of medication documentation provided safer and higher quality of care for patients. Some of the most effective outcomes for teaching patients about their medications were found to be reminder notes in the exam rooms talking about how medications react differently when mixed with other medications. Not only is polypharmacy a safety issue, but it is also an example of quality improvement and patient-centered care (Vejar

For example, the elderly often take many drugs and have a risk of adverse effects.They are particularly vulnerable to drug-drug interactions. Medicinal herbs can interact with prescribed drugs and lead to adverse effects.