Understanding Patients Prescriptions And Adverse Drug Events (ADE)

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

One of the critical core components of Skilled Nursing Facility is medication administration. As cited by Tenhunen, Tanner, and Dahlen (2014), they stated that 88% of the residents living in the nursing homes are aged 65 years old and older. They discussed that every five of administered medications in nursing home has one probability of error. This means that about half of the residents have the possibility of two or more medication errors daily. This applies to the Pasadena Care Center (PCC) because its residents are mostly older adults who require medications on a daily basis. Moreover, residents are prescribed with multiple medications, which make them vulnerable to medication errors. The staff at PCC is trying their best to ensure safe medication administration, however, it still in need of a major change. The goal of the proposed change is to decrease the medication errors in this organization to ensure patient safety.

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.

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.

Prescription medication use is widespread, complex, and increasingly risky. Clinicians have access to an armamentarium of more than 10,000 prescription medications, and nearly one-third of adults in the United States take 5 or more medications. Advances in clinical therapeutics have undoubtedly resulted in major improvements in health for patients with many diseases, but these benefits have also been accompanied by increased risks. An adverse drug event (ADE) is defined as harm experienced by a patient as a result of exposure to a medication, and ADEs account for nearly 700,000 emergency department visits and 100,000 hospitalizations each year. ADEs affect nearly 5% of hospitalized patients, making them one of the most common types of inpatient errors; ambulatory patients may experience ADEs at even higher rates. Transitions in care are also a well-documented source of preventable harm

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 main concern about having the elderly on so many medications at once is the chance of adverse drug reactions from potential drug interactions. They can be on both prescribed medications and over the counter medications, vitamins, or supplements. The most common over the counter medications that often lead to serious adverse drug reactions include acetaminophen, ibuprofen, and aspirin (Woodruff, 2010). Another reason that the elderly are more susceptible to adverse drug reactions is the fat and water composition changes, they have increased fat storage and decreased total body water, this allows for higher concentration of water soluble drugs and longer half-lives of fat soluble drugs (Woodruff, 2010). Changes in the liver and

Many issues and consequences can arise from polypharmacy which can become problematic to an aging adult’s health. These issues and consequences stem from “inappropriate medication use which ranges from 11.5 to 62.5 percent” (AGBONJINMI, L.A., 2017). Other issues that can follow inappropriate usage are noncompliance, adverse drug reactions/interactions, cognitive

With many of the elderly population taking more and more medications and seeing multiple prescribing providers, the risk for an adverse drug reaction increases. Adverse drug reactions are prevalent among the aging population and contribute substantially to both mortality and morbidity. Adverse drug reactions are a typical cause of declining functional or cognitive abilities, as well as the worsening of conditions leading to more admissions to acute care and eventually long term care facilities. Psychological

The pharmacokinetics and pharmacodynamics of many commonly used drugs vary significantly across all age groups. Adverse Drug Reactions are one of the major concerns in the elderly. Adverse drug reactions, especially those that may be preventable, are among the most serious concerns about medication use in elderly in clinical setting. The incidence of adverse drug reactions in patients more than 60 years old compared with younger patients (age less than 30 years) increased by two or threefold. The ageing process is associated with physiological and pathological changes. It then makes individuals at a higher risk of multiple morbidity and treatment-related complications. Predisposing factors to adverse drug reactions which have been noted including

Hospital readmission rates among the elderly are steadily becoming a growing topic of concern. Robinson, Esquivel, and Vlahov (2012) describe readmission or re-hospitalization "as a return to the hospital shortly after discharge from a recent hospital stay" (p. 338). The elderly, defined as 60 years of age and older, account for the highest hospital readmission rates in comparison to other age groups (Robinson, Esquivel, & Vlahov, 2012). With medical advances, life expectancy is on the rise, which means older people will have more comorbidities and consequently be required to take more medications for symptom management. Generally when a person takes anywhere from two-nineteen medications, the term "polypharmacy" is introduced (Pasina et al., 2014). In hospital settings polypharmacy is not an issue because there are nurses and medical providers to address questions and concerns, administer medications, and monitor a patient for potential adverse effects. However, once discharge occurs, this patient is left to juggle all aspects of their care on their own. A plan of care formulated to improve the elderly population 's quality of life outside of the hospital, speaks to one of the Institute of Medicine 's (IOM) core competencies, applying quality improvement.

Are any of you are aware of the terminology of any medication taken or do you all simply take the medication because it was prescribed by a doctor? it is undeniable that drugs do save lives, but few prescription medications are completely free of risks or side effects. Naturally, the more drugs that are taken at the same time, the greater the risk of adverse interactions and potentially devastating side effects. This problem of “overmedication” is increasing to almost epidemic proportions among the elderly. For example, a recent Washington Post article that described an 83-year-old grandmother who wished to remain anonymous. The woman had been hospitalized for an asthma attack. In the hospital, she was prescribed

Medication-noncompliance problems are common among elderly patients who are discharged from the hospital and are using several drugs for their chronic diseases (Ahmad et al., 2010). Medication management is a challenge for adults of all ages, but for the elderly, physical limitations, such as vision problems, memory loss, arthropathy) can make it particularly challenging to take medicine according to a set schedule(Simonson, 1984). In Australia, the population is ageing rapidly. Since 1970, the Australian population has aged significantly increase in the proportion of adults aged 85 years and older(Hillen et al., 2015). The prevalence of multiple chronic conditions in the older population is reported to be between 65% to 80%.(Hillen

This cost barrier may cause them to divide their medications to save budget or take their medications only during exacerbation period. On top of that, a lot of elderly facing problems to adhere towards their medications as majority of them are having a lot of diseases and complications, which lead to polypharmacy. Their forgetfulness worsened the fact that those medications have to be taken at different frequency, timing, and method to take.