Community Health Project 9: Community Health Advocacy

Community Health Project 9 Community Health Advocacy Project – Part Four Jeanette Walker Nur/544 September 01, 2013

Community health initiatives often focus on improving medication management and accessibility among the elderly population. As individuals age, they typically encounter increased health challenges necessitating medication therapies, which require proper oversight, guidance, and support systems to ensure safety and efficacy. A critical component of community health is assessing whether elderly patients possess adequate support networks capable of assisting with medication queries and concerns. Furthermore, understanding the benefits and drawbacks of utilizing public health and home care systems is vital in designing effective community-oriented interventions.

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One primary concern within community health is the adequacy of support that elderly patients receive concerning their medications. This issue is particularly pressing considering that home-based care is aimed at fostering independence among patients while enabling them to remain in their homes. However, patients often face the challenge of having someone available who can assist with medication-related queries. The reality is that home care providers, such as visiting nurses or caregivers, may not be available full-time or possess the specialized knowledge needed to address complex medication issues (Ellenbecker et al., 2008). Consequently, patients might need to consult their physicians or other healthcare providers for guidance, which can lead to delays or miscommunications, potentially endangering patient safety.

Data indicates that utilization rates of home healthcare services have fluctuated over the years, with a notable increase from 3,822 visits per 1,000 Medicare enrollees in 1992 to 8,376 in 1996, driven by expanded coverage criteria. However, after the implementation of the Balanced Budget Act of 1997, there was a decline, with rates falling to 2,295 visits per 1,000 in 2001 before rebounding to 3,409 visits per 1,000 in 2007 (Federal Interagency Forum on Aging-Related Statistics, 2010). This fluctuation underscores ongoing challenges in maintaining consistent access to home healthcare services, especially considering that the elderly, particularly women aged 65 and over, tend to use these services at significantly higher rates than men (Jones, Harris-Kojetin, & Valverde, 2012).

The advantage of utilizing public health and home care systems for medication management lies in the potential for improved oversight, reduced medication errors, and better adherence. A key benefit is the reduction of unnecessary or duplicate medications, which often result from fragmented healthcare services (Ellenbecker et al., 2008). Studies show that elderly patients discharged from hospitals frequently encounter issues such as taking unprescribed drugs, failing to adhere to prescribed regimens, or using outdated medications stored at home (Hughes, 2008). These challenges highlight the importance of medication reconciliation processes and ongoing support from healthcare professionals, including pharmacists and physicians, to ensure safe medication practices.

Despite these benefits, there are notable disadvantages to relying heavily on public health and home care resources. One significant concern is the high potential for medication errors due to improper medication management or inadequate supervision. Adverse drug events (ADEs), which include harm caused by medication errors, account for approximately 700,000 emergency department visits and 100,000 hospitalizations annually in the U.S. (Agency for Healthcare Research and Quality, 2005). Older adults are particularly vulnerable; nearly 15% of those discharged after hospitalization experience medication discrepancies, especially with critical drug classes such as anticoagulants and diuretics (Agency for Healthcare Research and Quality, 2005). These discrepancies can lead to serious health consequences, emphasizing the need for more robust medication management systems.

Financial barriers also pose significant challenges for elderly patients. Despite Medicare coverage, cost-related issues prevent some seniors from obtaining necessary prescriptions. Data reveals that 10.3% of the elderly population aged 65 and older experienced delays or inability to access medications in 2010 (Healthy People, 2013). Notably, only data from 25 states were available, leaving gaps concerning the true extent of the problem (Centers for Disease Control and Prevention, 2012). These financial constraints can lead to medication non-adherence, worsening health outcomes and increasing overall healthcare costs.

Medication abuse among seniors is an escalating concern. Studies predict that prescription drug abuse in those aged 50 and above could increase by 190% over two decades, from 911,000 in 2001 to approximately 2.7 million by 2020 (Johns Hopkins Medicine, 2010). Nonmedical use of psychotherapeutic medications was also reported by 6.1% of individuals aged 12 and older in 2008 (Substance Abuse and Mental Health Services Administration, 2013). These figures suggest that improper medication use, whether accidental or deliberate, is a critical issue requiring targeted interventions to prevent addiction, overdose, and other adverse outcomes.

To address these complex issues, healthcare providers often utilize structured medication questionnaires to assess patient understanding, compliance, and potential risks. Such questionnaires gather comprehensive data on medication use, allergies, side effects, and patient knowledge, facilitating personalized and safe medication management strategies. For example, questions about whether patients know what their medications treat or if they experience side effects help clinicians tailor education and follow-up care, thereby reducing medication errors and adverse events (Ellenbecker et al., 2008).

In conclusion, the integration of public health and home care services plays a vital role in managing elderly patients’ medication needs within community health frameworks. While these systems offer notable advantages, including improved oversight and enhanced safety, they also present challenges such as medication errors, financial barriers, and abuse risks. Addressing these issues requires comprehensive approaches, including better caregiver training, improved communication between patients and providers, policy reforms to reduce costs, and targeted screening for substance misuse. Ultimately, a balanced and multifaceted strategy is essential to optimizing medication safety for the aging population in community settings.

References

  • Agency for Healthcare Research and Quality. (2005). Medication errors. Retrieved from https://www.ahrq.gov
  • Centers for Disease Control and Prevention. (2012). National health interview survey 2011. Retrieved from https://www.cdc.gov
  • Day, T. (2013). The American perspective on aging and health. National Care Planning Council.
  • Ellenbecker, C., Samia, L., Cushman, M., & Alster, K. (2008). Patient safety and quality in home health care. Retrieved from https://www.ncbi.nlm.nih.gov
  • Federal Interagency Forum on Aging-related Statistics. (2010). 2010 Older Americans: Key indicators of well-being. Retrieved from https://agingstats.gov
  • Hughes, R. (2008). Medication management of the community-dwelling older adult. Retrieved from https://www.ahrq.gov
  • Jones, A., Harris-Kojetin, L., & Valverde, R. (2012). Characteristics and use of home health care by men and women aged 65 and over. National Health Statistics Report, 52(12).
  • Johns Hopkins Medicine. (2010). Drug abuse and the elderly. Retrieved from https://www.hopkinsmedicine.org
  • Healthy People. (2013). Healthy People 2020 objective topic area. Retrieved from https://www.healthypeople.gov
  • Substance Abuse and Mental Health Services Administration. (2013). The NSDUH report: Nonmedical use of prescription-type drugs. Retrieved from https://samhsa.gov

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