An expected 47 million grown-ups being in the United States were age 65 and older in 2017, according to a study conducted by SeniorLiving.org. The Population Reference Bureau predicts that number will more than doubled to nearly 100 million people by 2060.
The combination of the expanding elderly community taken together with an ordinary lifespan of 78.6 years for men and somewhat more than 81 years for women highlights the need to improve medication-related consequences in this population. Promoting how senior citizens maintain their prescriptions by employing technology, payment systems, healthcare providers, and other sources are the right places to start.
Geriatric sufferers face many difficulties in managing their medicines, which is seldom very challenging due to their diseased cases,” says Jin Seon Kim-Paglingayen, MD, an assistant clinical professor of health physics in the field of family physicians at University of Southern California Riverside.
Authorities have many opinions when it comes to pinpointing the most apparent difficulty in helping senior citizens manage their medications. However, polypharmacy appears to be a recurring theme—especially as prescription medication use remains to grow.
Prescription medicine use among the geriatric community has more than increased over the last 20 years. A 2015 study issued in The Journals of Gerontology that assessed data from 13,869 adults ages 65 and older in the National Health & Nutrition Examination Survey (1988-2010) found that older patients took a median number of two medicines in 1988; by 2010, that number had doubled to four medication with 40% of the sufferers taking 5 or more drugs.
Jessica Triboletti, PharmD, assistant professor of medicine practice at Butler University College and ambulatory care clinical medicine professional at Eskenazi Health in Indianapolis, notes the medicine administration is not exclusive to prescription medications. Comprehensive medication administration should also cover over-the-counter medicines, dietary additions, and vegetal products.
Mental Or Physical Limitations
According to Jacqueline Hagarty, PharmD, BCGP, a mobile clinical medicine professional at Banner Pharmacy Services in Phoenix, taking increased medicines can have severe outcomes. A high pill burden adds to low adherence rates, but poor comprehension or lack of education on the medications also hinders sufferer adherence.
“I see that many of my sufferers do not know the connections for all of their medications, so they do not recognize the value of taking them every day,” she records.
Hagarty further finds that some sufferers may seem confused by maintaining their medications. Many cases are also concerned about side effects and communications, but they do not always show these companies to their health care providers.
Polypharmacy, the need for enhanced collaboration among healthcare experts, and improving information are not the only difficulties in the world of medicine department. Kim-Paglingayen points out that special features such as language barriers, lack of transport, and physical or mental injuries need unique answers.
Older sufferers who are injured or without access to transport may also lack material assistance, such as having a family or colleague to pick up their prescriptions and refill calls immediately.
Those who have mental or physical limitations may not be able to adhere to high-maintenance prescription regimens, such as those requiring many glucose checks and severe dietary restrictions to avoid sharp drops in their blood sugar.
Age-related changes add another layer of complexity. Fading out kidney and liver function may hinder the speed by which medicines are made from the body, causing pills to last longer and improve the risk for side effects.
Triboletti cites other age-related changes, such as new sources of complexities. For instance, factors such as improved fatty tissue weakened bodily fluid, and overall weight-loss can alter the volume of the order, warranting the need to adjust medication doses.
Special populations, such as homebound patients—both young and old—may face a higher risk for adverse drug events associated with complex medication regimens. Frequently, these individuals live with multiple chronic conditions and take various medications to treat each disease, increasing the risk for complications and costly medication regimens and poor medication adherence.
Melissa Morgan-Gouveia, MD, a geriatrician with Christiana Care Health System’s Department of Medicine who studies in home-based primary care with Christiana Care’s Visiting Nurse Association, states that open lines of dialogue between all healthcare providers involved—including caregivers—is crucial to enhancing the patient activity and outcomes.
She cites the improved potential for OTC medication information as a model. Many OTC medicines are combination products with multiple different medications, which can increase the risk of unintentional overdoses of drugs such as acetaminophen.
Triboletti grants. “Information is a key, and pharmacologists are in a different position to provide convenient and compatible medication support,” she says.
“Communication with sufferers and caregivers are essential to help recognize concerns, barriers, and underlying causes for nonadherence.”
Hagarty highlights the value of reviewing medicines with the patient can help improve their knowledge.
To Sum Up
Doing so could better patient adherence while promoting the pharmacist’s experience to recognize possibilities to optimize their medical treatment.
Examples of this include discontinuing unnecessary prescription and duplicate treatment, understanding new drug communications, and finding solutions to barriers to access such as shipping or price. Seldom, healthcare providers must adjust the answers to suit the patient’s environment.
“Home health providers should identify the over-the-counter medicines a patient is taking when handling a prescription review, including questioning about prescription containers seen during the visit that the sufferer may neglect to consider such as the over-the-counter sleep medication on their nightstand,” Morgan-Gouveia says.
“They alert the patient’s primary care provider [and the pharmacist] about any over-the-counter medication a patient is taking that is not on their medication list.”