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FEATURE ARTICLE

FROM ALWAYS BEST CARE

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Understanding Polypharmacy in the Elderly

 

by David J. Caesar

 

As the geriatric population in the United States continues to rise, so do incidences of polypharmacy in the elderly. The term polypharmacy is typically defined as the concurrent use of multiple drugs by the same patient. Polypharmacy, however, is more complex than just the number of drugs that a patient takes. Clinically, the criteria utilized for identifying polypharmacy involves taking medications that have no apparent indication, using therapeutic equivalents to treat the same illness, concurrent usage of interacting medications, and using an inappropriate dosage.

 

According to an article published in the January 2008 edition of Critical Care Nursing (CCNQ), a peer-reviewed journal that provides current practice-oriented information for the continuing education and improved clinical practice of critical care professionals, including nurses, physicians, and allied health care professionals, polypharmacy in the elderly is a major problem and a challenge that contributes to costs, adverse drug events, confusion, compliance issues, and errors in management. The article goes on to say that a systematic approach to drug monitoring is an important aspect of  appropriate prescribing. In addition, attention to the prescribing of medications, a consistent review of medication lists, and re-evaluation of indications and outcomes of prescribing are essential to ensure that polypharmacy is minimized and safety for patients is maximized.

 

Each year, many people face complications due to dangerous drug interactions involving prescription, medications, and over-the-counter remedies. Elderly persons are the most likely age group to become ill from medication mistakes for a number of reasons. Older individuals typically have more than one physician. Elders may also use more than one pharmacy to have prescriptions filled and to satisfy other medicinal needs. Using multiple doctors and pharmacies are just two situations where an older person may accidentally acquire incompatible drugs.

 

Senior Home Care Companies, like Always Best Care Senior Services, provide Caregivers for elderly persons to help them with their daily activities of living, including assistance with medication reminders. Along with family members, Caregivers can also accompany seniors with visits to the pharmacy or to their physician. This can assist in providing medical professionals with an insight to the senior’s medical history or behavior and possibly reduce the risk of combining medications that work against each other.

 

Senior Home Care Companies can also play a role in helping to reduce polypharmacy in the elderly by providing clinical enrichment to nursing professionals through Continuing Education Units (CEU) and Educational Webinars.

 

According to Angela Graczyk, a Registered Nurse and Field Trainer with Always Best Care, seniors account for 12% of the population and over 32% of prescriptions, spending $3 billion annually on prescriptions. Angela facilitates an Educational Webinar that Care Coordinators at Always Best Care use to educate the nursing professionals they work with. In the webinar, Graczyk states that the most consistent risk factor for adverse drug reaction is the number of drugs being taken and that the risk of experiencing an adverse drug reaction rises exponentially as the number of drugs taken increases.

 

There are several ways seniors can help to reduce the risks of complications that may arise from polypharmacy. Recommendations include using one pharmacist/pharmacy when possible as well as reducing the need to see multiple Primary Care Physicians.

 

Seniors should implement a program called the "The Annual Brown Bag.” This is a program where on an annual basis, seniors place all of the medicines they are taking, including over-the counter medicines, creams, vitamins, supplements, and natural herbs, in a brown bag. They are then encouraged to take the brown bag with them on a visit to their physician to inform them of everything they are taking to treat medical issues. This program, along with the reporting all symptoms to the physician, play a huge role in reducing the risks of complications that may arise from polypharmacy.

 

To learn more about polypharmacy in the elderly, contact agraczyk@abcseniors.com or consult your local healthcare provider.

 

David J. Caesar is the Vice President of Franchise Operations at Always Best Care Senior Services. Through its network of independently owned and operated franchises, Always Best Care Senior Services provides non-medical in-home care, assisted living placement and skilled home health care for seniors across the country. Visit Always Best Care Senior Services at www.alwaysbestcare.com.

 

Always Best Care Senior Services

Always Best Care Senior Services (www.alwaysbestcare.com/) is based on the belief that having the right people for the right level of care means peace of mind for the client and family. Always Best Care Senior Services has assisted over 25,000 seniors, representing a wide range of illnesses and personal needs. This has established the company as one of the premier providers of in-home care, assisted living placement assistance, and skilled home health care.

 

September, 2010

 

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