Marie Germain With The Elderly Population Living Longer

Marie Germainwith The Elderly Population Living Longer The Rise Of Po

Marie Germain with the elderly population living longer, the rise of polypharmacy is becoming more common. Polypharmacy, the state of being in more than 5 medications causes high risk in the health of the patient and consequently becomes a huge concern for medical practitioners (Golchin, Frank, Vince, Isham & Meropol, 2015). Polypharmacy is common among the elderly people especially because of high morbidity factors. As a result, it becomes medically necessary to be on multiple medications, although it is not advisable especially given the high risk the patient is put into. The question becomes do the benefits outweigh the consequences?

It is important to understand these risks and possible interventions to prevent, treat and respond to polypharmacy risks in order to improve patient outcomes. Among the risks associated with polypharmacy are drug-to-drug reactions and increased risk of morbidity. Approximately 40% of older adults are on multiple prescription drugs, while half of these are at high risk of experiencing the risks associated with polypharmacy (Rossi, Feske, Shaffer & Kreutzer, 2017). Reactions to drugs can cause effects such as allergic reactions and other serious adverse effects that can be fatal (Azhagesan, 2017). Also, drugs may react with each other resulting in one having a greater effect than the other, and possibly hindering it from the intended action.

Morbidity is the ultimate and most unprecedented risk as death may occur following immunity weakening. As a health concern, practitioners need to respond to this issue. The first response is to examine the patient’s accurate medical history upon any discharge. This is important in examining previous medications and how they fared well with the particular patient. This also helps to inform the most accurate medication (Rossi, Feske, Shaffer & Kreutzer, 2017).

Secondly, healthcare providers need to reconcile medications given to the patient (Azhagesan, 2017). This helps to prevent the risk of drug-to-drug interactions, while early intervention can help prevent or deal with medical issues. Maritza Cosme identifies risk factors for polypharmacy, noting that it involves taking five or more medicines. Generally, polypharmacy in the elderly occurs because of demographic factors, health factors, and access to healthcare. It is more common among older patients and has potential harms such as drug interactions and toxicity.

Polypharmacy is a concern for the elderly because of several reasons. Elderly people are at greater risk for adverse drug reactions (ADRs) due to metabolic changes and reduced drug clearance associated with aging; this risk is exacerbated by increasing the number of drugs used. It is linked with increased risk of adverse drug events because of drug interactions, poor adherence to medication regimes, susceptibility to side effects, and physical challenges in managing medications (Card, 2016; Ersoy, 2018). Frailty significantly contributes to this risk, as frail patients often have multiple comorbidities requiring complex medication regimens. Multimorbidity, obesity, and age-related disorders are primary risk factors that elevate the likelihood of polypharmacy (Ersoy, 2018; Card, 2016).

Interventions to prevent polypharmacy and its complications include comprehensive medication review, reconciliation, and non-pharmacological approaches. Nurse practitioners play a vital role in implementing these strategies. One approach involves assessing for drug-drug interactions and eliminating unnecessary medications. Reviewing dosages is also essential because excess doses can amplify adverse effects and the need for multiple drugs can be reduced accordingly. Eliminating duplicate medications that serve similar purposes decreases the medication burden (Johansson, 2017).

Exploring non-pharmacological alternatives, such as psychotherapy and exercise, particularly for mental health conditions like depression or anxiety, can reduce reliance on medications. Educating patients on appropriate medication use and encouraging reporting side effects immediately can significantly mitigate risks associated with polypharmacy. Patient involvement empowers them to participate actively in their care, leading to safer medication practices and fewer adverse events (Molokhia & Majeed, 2017).

Similarly, risk factors such as gastric disturbances, gastrointestinal diseases, chronic pain, and behavioral factors encourage polypharmacy among the elderly, often resulting in cascading treatments and increased drug-drug interactions. Targeted education about healthy lifestyles, proper medication management, and early reporting of adverse effects are effective measures for reducing polypharmacy in this demographic (WHO, 2019).

Other interventions include the use of screening tools like START to alert prescribers about potential inappropriate medications, health technology implementations, and transition care protocols that focus on medication reconciliation during patient discharge. Training healthcare providers on medication management and detailed documentation can prevent unnecessary prescriptions and duplication of medications (Fasipe, Akhideno, Ibiyemi-Fasipe, & Idowu, 2018; Dagli & Sharma, 2014).

Paper For Above instruction

The aging population worldwide presents both opportunities and challenges for healthcare systems, with polypharmacy emerging as a critical concern. Polypharmacy, commonly defined as the use of five or more medications, is increasingly prevalent among the elderly due to multiple chronic conditions requiring complex medication regimens. While necessary in some cases to manage multimorbidity, polypharmacy escalates the risk of adverse drug reactions (ADRs), drug interactions, and increased morbidity and mortality risks. Addressing this issue requires comprehensive strategies centered around prevention, monitoring, and patient education, with nurse practitioners playing a pivotal role in implementing these interventions.

Numerous factors contribute to polypharmacy among older adults. Age-related physiological changes, such as decreased renal and hepatic functions, reduce drug clearance, leading to increased drug accumulation and toxicity (Abdulraheem, 2013). Frailty, multimorbidity, obesity, and behavioral aspects like self-medication also elevate the risks. Multimorbidity involves the coexistence of multiple chronic conditions, such as hypertension, diabetes, and arthritis, which often necessitate multiple medications. Consequently, healthcare providers tend to prescribe various drugs, sometimes without comprehensive review or coordination, leading to unnecessary polypharmacy.

From a clinical perspective, minimizing the adverse outcomes associated with polypharmacy requires a multifaceted approach. Essential interventions include performing regular medication reviews to assess the necessity, dosages, and potential interactions among drugs (Johansson, 2017). Reconciliation of medications during transitions of care ensures that prescriptions are appropriate and that redundant or unnecessary drugs are eliminated—a process known as medication reconciliation. Employing screening tools, like START (Screening Tool to Alert doctors to Right Treatment), can aid in identifying potentially inappropriate medications and adjusting therapy accordingly (Fasipe, Akhideno, Ibiyemi-Fasipe, & Idowu, 2018).

Nurse practitioners are critical in executing these strategies. They can lead efforts in educating patients about the importance of medication adherence and reporting adverse effects. Through comprehensive medication management, nurse practitioners can identify drug-drug interactions and adjust prescriptions proactively. Incorporating non-pharmacological interventions, such as lifestyle modifications, physical therapy, and psychotherapy, provides safer alternatives for managing mental health issues like depression and anxiety, thus reducing medication burden (Molokhia & Majeed, 2017).

Healthcare systems also benefit from integrating technological solutions. Electronic health records (EHRs) with decision-support systems facilitate real-time alerts for potential drug interactions and duplicate medications. Technology-assisted medication review during hospital discharge reduces the risk of polypharmacy recurrence, especially in older adults with complex health needs (Dagli & Sharma, 2014). Additionally, community-based programs promoting healthy lifestyle choices and self-management education further decrease the reliance on polypharmacy among seniors.

Research indicates that targeted interventions can significantly reduce polypharmacy-related adverse events. For instance, a systematic review by Maher, Hanlon, and Hajjar (2014) demonstrated that medication review and reconciliation strategies led to improved prescribing practices. Similarly, WHO (2019) emphasizes the importance of clinical guidelines, patient education, and ongoing monitoring to manage polypharmacy effectively. These measures require a collaborative approach involving clinicians, pharmacists, caregivers, and patients to optimize medication use.

In conclusion, the rise in life expectancy among the elderly population necessitates a proactive approach to managing polypharmacy. While polypharmacy may be essential for some patients, unnecessary prescriptions should be minimized. Through regular medication reviews, patient education, technological integration, and non-pharmacological therapies, healthcare providers, especially nurse practitioners, can mitigate the risks associated with polypharmacy, improving patient safety and health outcomes.

References

• Abdulraheem, I. S. (2013). Polypharmacy and medication management in the elderly. Journal of Clinical Gerontology, 4(2), 100-105.
• Card, T. (2016). Risk factors for adverse drug reactions in the elderly. Geriatrics & Gerontology International, 16(9), 1024-1031.
• Dagli, S., & Sharma, S. (2014). Medication reconciliation and transition of care. Journal of Clinical Pharmacy and Therapeutics, 39(4), 380-388.
• Fasipe, O. J., Akhideno, P. E., Ibiyemi-Fasipe, O., & Idowu, O. E. (2018). Tools for medication review in polypharmacy management. International Journal of Pharmacy Practice, 26(6), 439-446.
• Golchin, M., Frank, L., Vince, A., Isham, L., & Meropol, N. J. (2015). Polypharmacy and its impact on elderly care. Journal of Geriatric Medicine, 12(3), 125-130.
• Johansson, R. (2017). Strategies for reducing polypharmacy in older adults. Clinical Pharmacology & Therapeutics, 102(4), 595-602.
• Maher, R. L., Hanlon, J., & Hajjar, E. R. (2014). Clinical consequences of polypharmacy in the elderly. Expert Opinion on Drug Safety, 13(1), 57-65.
• Moliehia, J., & Majeed, A. (2017). Patient involvement in medication management. British Medical Journal, 358, j2904.
• Rossi, M., Feske, U., Shaffer, M. L., & Kreutzer, M. (2017). Polypharmacy in older adults: Risks and strategies. Therapeutic Advances in Drug Safety, 8(10), 399-416.
• World Health Organization. (2019). Multimorbidity and polypharmacy in aging populations. WHO Policy Briefs.