The Hidden Epidemic: Medication Mismanagement
For immediate assistance call our Customer Care department at:. Practically every medication comes with side effects, but side effects like dizziness, nausea, lightheadedness or sleepiness make performing daily tasks -- like managing medications -- much more difficult. So if you notice that many of their pills go unopened, or you get a call from the pharmacy about prescriptions that have not been picked up, it could be a sign that something bigger is going on.
After speaking with their doctor, you should also take the following steps to promote their health and safety at home: Just be aware that some physicians may require your loved one to sign a release allowing you to gain access to certain parts of their health care file. Discuss the side effects ahead of time. You should be particularly wary if your loved one is prescribed a type of blood thinner or an oral hypoglycemic medication as these typically cause the most side effects.
Get your loved one a medication dispenser. If your loved one has difficulty opening pill bottles or keeping track of when to take their pills, an automatic medication dispenser is the perfect solution. Simple to use and affordable, these devices allow you to organize pills based on the day and time they need to be taken. An alarm tone and blinking light will alert your loved one at the designated time, and all they have to do is tilt the medication dispenser on its side to retrieve the pills.
Improving and standardising the management of controlled drugs
Plus, depending on which medication dispenser you purchase, many come with a tamper-proof locking system to prevent over-medicating. Invest in a medication management service. Services like Pill Pack pre-package both prescription and over-the-counter medications in packets that clearly label the date and time your loved one needs to take them.
Not all providers are alike, and there are, unfortunately, some doctors who prescribe medications inappropriately, in excess, or for unapproved uses. Knowing the potential side effects and interactions can help you stay alert to any health changes that may occur in response to a new medication or combination of medications. If you do notice health changes, contact a physician right away. This will help the provider properly diagnose the problem — and help the patient avoid unnecessary or dangerous medications.
This is particularly important for older adults who are taking multiple medications, to ensure that they know what each medication is for and how to take it properly. Keeping the number of doctors and pharmacies to a minimum is better for you and better for the providers who must coordinate care.
You should also talk to your provider if you are thinking of stopping a medication. This one might go without saying, but if you or your loved one has had a bad reaction to any medication in the past, let your doctor and pharmacist know. Have you or a loved one ever experienced a health scare related to polypharmacy or incorrect medication management?
Why Seniors Are at a Greater Risk
Share your experiences with our readers in the comments. We bought a Med-Q for our Mom. She is 86 and in good health. Our problem was getting her to take her pills at the right times. Mom has been using it for 3 months and hasn;t missed a pill!. Just take the pills in the flashing box. The brand is egreen.
Nursers can check all the statics of the dosage taken by the patients. If the dosage is not taken correctly or in time, there will be an alert. Also it has an up-to-date medication list with brand name, dosages, dosage frequencies, etc. My name is Joe from http: I have developed a decorative medi planner for those who take multiple medications per day. My products can help in the organization and distribution of medications on a daily basis.
12 Medication Management Tips That May Save Your Life
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Medication management is a complex process that consists of multiple activities. Medication reconciliation is a key first step in medication management. Multiple studies have demonstrated large discrepancies in what medications are ordered by the prescribing provider and the actual medications the older adult is taking. Evidence supports medication reconciliation interventions that include a screen for inappropriate medications and adverse drug interactions, in addition to verification of medications that are prescribed.
Other areas of medication management include assessment and interventions related to medication procurement, medication knowledge, physical ability, cognitive capacity, and intentional nonadherence. Ongoing monitoring of these areas is crucial. Nurses play a pivotal role in the medication management process of older adults. Considering the expense of prescription drugs in the current health care system, a small investment in providing comprehensive assessment and interventions to assist older adults in accurate and safe management of their medications will provide cost-effective care and increase the quality of life of older adults struggling to manage their often-complex medication regimens.
Key search terms used alone and in combination included medication adherence, compliance, elderly; aged; outcomes; polypharmacy; medication management; chronic illness; chronic disease; and individual types of chronic illnesses. All searches were limited to patients ages 65 and older and Web sites in the English language. The ISI Web of Science was used to track citations to major works, and article references were reviewed for inclusion. Bibliographies of retrieved articles also were searched for relevant articles not identified in the reference database searches. The authors would like to thank Lenore R.
Turn recording back on. National Center for Biotechnology Information , U. Show details Hughes RG, editor. Risk Factors There is a wide variety of factors that place the community-dwelling older adult at risk for problems in medication management. Research Evidence Medication Reconciliation Medication reconciliation is the first step in assisting older adults in the medication management process. Medication Procurement Not filling or refilling prescriptions is a common cause for medication nonadherence in older adults.
Physical Ability Poor vision and low manual dexterity are associated with poor medication self-management. Cognitive Capacity Poor cognition is associated with both over adherence and under adherence of a prescribed medication regimen. Intentional Nonadherence One study of chronically ill persons who were starting a new medication found that almost a third did not take their medication as prescribed, and half of the time it was deliberate.
Ongoing Monitoring Older adults have narrow therapeutic windows and require close monitoring, especially when on multiple medications. Medication Management Practice Guidelines Medication Reconciliation Review with patient all prescribed and nonprescribed medications the patient is taking. Include over-the-counter OTC medications, herbs, and vitamins. Screen for adverse drug interactions. If adverse drug interactions are identified, report to the prescribing provider any medications of concern.
Identify the primary or secondary medical diagnosis related to each prescribed medication. If the medical diagnosis is unknown, request the diagnosis from the prescribing provider. Provide to the prescribing provider s a list of all medications prescribed and OTC the patient is taking and a list of corresponding medical diagnoses. Verify prescribed medications and related medical diagnoses with the prescribing provider s.
Provide the patient or caregiver a current list of all medications the patient is taking with dose and frequency; have the patient share this list with the prescribing provider or other health care providers as needed. Assess how the patient pays for medications. Assess if medications doses are ever missed due to lack of funds. If the patient or caregiver has difficulty obtaining or refilling prescriptions, assist the patient with creating a system to procure medications via Pharmacy delivery.
Refill reminders or automatic refill service. If funds to purchase medication are a problem, 89 , 93—98 Refer the patient to a social worker to obtain Medicare Part D coverage, other insurance coverage, or participation in drug company programs. Consult the prescribing physician about availability of drug samples. Medication mode of action. Side effects to monitor and report. With each change in medication regimen including OTC drugs , review medication purpose, dosage, frequency, side effects to monitor and report, and other medication-specific instructions.
Interventions related to medication knowledge include 16 , 21 , 91 , , — Provide written instructions related to medications in large letters and bullet or list format. Tailor instructions to how the patient takes his or her medicine. Group information starting with generalized information, followed by how to take the medicine, and then the outcomes such as side effects to watch for and when to call the doctor. Use medication schedules or charts to reinforce instructions. If the patient did not know important medication information at a previous encounter, review dose, time, side effects to monitor and report, and special instructions at the next visit.
If the patient uses an inhaler, observe the use of the inhaler. If the patient is required to break tablets, assess his or her ability to do so. If the patient is unable to open or see the label and contents of each medication container, provide one of the following: Pill box or other easy-open container. Medication calendar with pill box. If tablet breaking is required and the patient has difficulty doing it, consult with the pharmacist about tablets that are easier to break or tablets that are the correct dosage without requiring breaking.
Assess what dose is most difficult to remember. Assess how often a dose is missed or an extra dose is taken. Teach the patient or caregiver the use of memory cues based on one of the following methods: Ask if the patient or caregiver is usually aware of the time of day or keeps track of time through a watch or clock. Daily ritual, such as using the bathroom in the morning, shaving, or hair combing. If the patient requires additional support, Provide memory-enhancing methods or devices such as Medication calendar or chart.
Electronic reminder or alarm. Combine methods and devices when possible. Discuss dose simplification with the prescribing provider. Intentional Nonadherence Assess if medication doses are missed intentionally.
- 12 Medication Management Tips That May Save Your Life?
- Preventing medication mismanagement;
- To Honor and Trust (Bridal Veil Island Book #3).
ACE-inhibitors , Beta-blockers , Calcium channel blockers , If the patient intentionally misses doses, assess the reason s. Belief medication is not helping. Fear of adverse side effects. The following medications are most risky for patients to miss: If the patient misses medication doses for reasons related to health beliefs, Explore with the patient his or her health concerns for not taking medication.
Discuss the benefits of taking medication as prescribed. Provide positive reinforcement for taking medication as prescribed. For patients on high-risk medications, reinforce the danger of missing medication doses. If the patient misses medication doses for reasons related to medication side effects, Explore with the patient a plan to manage the side effects.
Ongoing Monitoring For all patients on a prescribed medication regimen, monitor the patient with each encounter for the following: Medication adherence Monitor both under- and overadherence. For persons using inhalers, assess Inhaler emptying rate. Use of short-acting inhaler. Medication side effects 67 , If medication side effects present, notify the prescribing provider, as appropriate.
Lab work, as appropriate, for prescribed medications Cockcroft-Gault Formula or other creatinine clearance measure at least annually. Medication effectiveness If signs and symptoms of the problem the medication is treating are present, notify the prescribing provider, as appropriate. Research Implications There is a large volume of research related to medication management and the elderly. Conclusion Medication management is a complex process that consists of multiple activities.
Drug-related morbidity and mortality. The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Drug-induced illness as a cause for admission to a community hospital. J Am Geriatr Soc. Drug related hospital admissions: Factors predictive of outcome on admission to an acute geriatric ward. Depression, cognitive impairment, and understanding of medication directions in hospitalized elderly patients. Adherence to antihypertensive medications across the life span.
Elderly patients' problems with medication. An in-hospital and follow-up study. Eur J Clin Pharmacol. Self-reported memory of medication use by the elderly. Am J Health Syst Pharm. Compliance of osteoporotic patients with different treatment regimens. Isr Med Assoc J. Inconsistent use of diabetes medications, diabetes complications, and mortality in older Mexican Americans over a 7-year period: Impact of patient perceptions on compliance with treatment for hypertension. Ethnic differences in antihypertensive medication use in the elderly.
Epub Dec Age as a major factor affecting adherence to medication for hypertension in a general practice population. Drug therapy in the elderly: Br J Clin Pharmacol. PMC ] [ PubMed: Social support and compliance with hypertensive regimens among the elderly. Journal of Mental Health and Aging. Impaired cognitive function and compliance with antihypertensive drugs in elderly: Medication adherence in persons with cardiovascular disease. Social support and patient adherence to medical treatment: Lorenc L, Branthwaite A. Are older adults less compliant with prescribed medication than younger adults?
Br J Clin Psychol. Major depression and medication adherence in elderly patients with coronary artery disease. Relation of sociodemographic, clinical, and quality-of-life variables to adherence in the cardiac arrhythmia suppression trial. Noncompliance with antihypertensive medications: J Gen Intern Med. Treatment of depression improves adherence to interferon beta-1b therapy for multiple sclerosis. How does depression influence diabetes medication adherence in older patients? Am J Geriatr Psychiatry. Predictors of older adults' capacity for medication management in a self-medication program: Depression increases diabetes symptoms by complicating patients' self-care adherence.
Individuals with type 2 diabetes and depressive symptoms exhibited lower adherence with self-care. Incidence and types of preventable adverse events in elderly patients: Adverse drug events in high risk older outpatients. Variation in medication understanding among the elderly.
Medication regimen complexity and adherence among older adults. Image J Nurs Sch. Compliance with sulfonylureas in a health maintenance organization: Communication, compliance, and concordance between physicians and patients with prescribed medications. Am J Public Health. Medication adherence in elderly patients receiving home health services following hospital discharge. Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community? Factors contributing to medication noncompliance in elderly public housing tenants. Drug Intell Clin Pharm. Cognitive factors and the use of over-the-counter medication organizers by arthritis patients.
The effects of initial drug choice and comorbidity on antihypertensive therapy compliance: Discrepancies in the use of medications: Botelho RJ, Dudrak R.
- Background?
- Patient Safety and Quality: An Evidence-Based Handbook for Nurses.!
- Top 6 Reasons for Medication Mismanagement in the Elderly!
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- Top 6 Reasons for Medication Mismanagement in the Elderly - Family First Home Companions New York;
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Home assessment of adherence to long-term medication in the elderly.