Preventing Polypharmacy in the Elderly - Paper Example

Polypharmacy involves the inappropriate use of different medications. In the United States, it accounts for up to 27 percent of annual hospitalizations (Lees & Chan, 2011). This is because the use of various medications often increases the risk of adverse medication reactions as a result of age-related changes in the medication, clearance, and delivery of multiple medications. For this reason, medication should avoid in older adults have been compiled into the Beers Criteria list. Despite this list and others similar to it, prevention of polypharmacy in the elderly through staff education is essential for the safety of older adults.

Background

Most older adults take between one and six prescription medications. The ideal older woman takes almost six precipitation education and three over-the-counter (OTC) medications concurrently. Even though most authors have written about polypharmacy, not everybody agrees on exactly how many medications being consumed polypharmacy; some consider it anything more than a single drug (Heuberger & Caudell, 2011). Be so as it may, polypharmacy can lead to unnecessary expenses for older adults because most health plans do not pay for the cost of medications. This costs can result in medication being used intermittently rather as scheduled. Other risks of polypharmacy include increased depression, decreased mental status and decreased social activity.

Significance

The importance of this study is based on the fact that physicians, nurses, and staff should recognize the unique problems that elderly patients present, particularly polypharmacy. While planned, rational polypharmacy can be quite helpful to patients; there are different situations which result in inadvertent, non-therapeutic polypharmacy.

Problem Statement

The causes of polypharmacy are multifactorial and complex. In countries without a centralized health-care provision, older people may go to various clinicians, who may be unaware of medications prescribed by others, but even where clinicians are fully informed of the patient's current medications, polypharmacy is still common. Educating the staff about polypharmacy is the first step to ensuring proper medication is prescribed to older patients.

Purpose Statement

The purpose of this study is to educate staff members about polypharmacy among the elderly to prevent implications for older people. In addition, polypharmacy may affect the quality of life of other vulnerable individuals.

Project Objective

Educating staff members about polypharmacy and its implications

Teaching older adults to self-manage medications

Preventing adverse drug reactions

Learning about the risks of polypharmacy and how to minimize them

Review of Literature

For many years, efficient geriatric and geriatrician nurses have made it a practice to review medications at every visit. These clinicians often require older adults to bring the actual pill bottlers for every medication that they take. In 2009, the Joint Commission for Hospital Accommodation in the USA began to require medication reconciliation at both inpatient and outpatient visits (Garfinkel & Mangin, 2010). Most are hopeful that the electronic medical record will help to prevent polypharmacy; however, until different systems can interface, these records will be less supportive.

It is challenging for practicing clinicians to know the effects and dosage of every possible medication. There are different electronic geriatric formularies which help in drug dosage for older individuals. Again, differed research grounds all over the world have observed the medical evidence and offer guidelines that help clinicians. Older people normally have different medical conditions which require complicated medical regimens. Some older people even take different complementary or alternative medications which may interact with prescribed medications.

According to Woodruff, (2010), a wide range of drugs are associated with depressive mood, even though it has to be mentioned that the mechanism where some classes of drugs appear to affect mood is not known. Polypharmacy is widely accepted as a bad practice in the elderly and leads to increased frequency of side-effects, drug interactions and poor compliance in addition to the effects on mood.

Even so, preventing polypharmacy can be challenging, especially given the range of pathologies which can be encountered in an individual. As a result, the best way to prevent polypharmacy is to educate the staff members about its consequences. Periodic medical interventions such as hospital admissions or over 75s check by general practitioners can be usefully occasioned to keep medication in check and also prescribe only the required drugs (Planton, & Edlund, 2010).

Theoretical Model

Since polypharmacy is known as a serious issue and one which will draw considerable attention in coming years, educating staff about polypharmacy is an essential step to ensuring the safety of the elderly. To do so, this project will involve requirements within a skilled nursing facility. A review will be conducted with the PubMed, PsycINFO, EMBASE, and AgeLine bibliographic databases in older adults to define polypharmacy and consider the comprehensive and the applicable definition. The data retrieved will be used in educating the staff based on the type of study, participants, study design and setting.

Project and Study Design

Training the staff about polypharmacy will involve observational study which includes report, cross sectional, case-sectional, etc, and interventional study such as quasi-experimental studies, randomised controlled trials, field trials etc, in which polypharmacy is regarded as one of the primary dependent and independent variables, and where a clear and practical definition is provided.

The study will targets studies where groups or subgroups of participants involve males or females with 65 years and older. The setting will be within a skilled nursing facility and the time frame will be set. Every study including those conducted within clinical settings, hospitals and nursing centers and those in a community setting will be looked into. Also, the source of information for the study will be PubMed, PsycINFO, EMBASE, and AgeLine bibliographic databases (Patterson et al., 2014).

Implementation

To complete the project, different nurses will be required to attend a particular nursing facility where different teaching tools will be presented, and questionnaires will also be available to ensure nurses have grasped the requiems adequately in this case. However, the study can also involve interviews in ensuring the project effectively

Evaluation

This step will be used for assessing the training to identify whether the required objectives are met. A learning criterion will be used to ensure whether or not participants were able to acquire the knowledge necessary to the training process. This will be addressed through interview and questionnaires. Necessary feedback can be obtained through dialogues with participants.

Conclusion

The role of nurses on polypharmacy prescription is quite essential. Their belief that polypharmacy is necessary for patients, their perception of overwhelming work and lead as well as time pressure are all associated with the increased administration of polypharmacy. In a few years, older adults will make up to 20 percent of the U.S population, and a higher number of polypharmacy prescriptions will be evident.

Excessive medication means costs for every patient concerned regarding health, time, money, and additional medical protocols to find the cause of polypharmacy. Therefore, this project will hopefully help increase awareness of the problems associated with multiple prescriptions of drugs and will encourage patients to conduct their learning and become responsible for safely taking their medicine.

References

Patterson, S. M., Cadogan, C. A., Kerse, N., Cardwell, C. R., Bradley, M. C., Ryan, C., & Hughes, C. (2014). Interventions to improve the appropriate use of polypharmacy for older people. The Cochrane Library.

Woodruff, K. (2010). Preventing polypharmacy in older adults. American Nurse Today, 5(10), 1-8.

Garfinkel, D., & Mangin, D. (2010). Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Archives of internal medicine, 170(18), 1648-1654.

Lees, J., & Chan, A. (2011). Polypharmacy in elderly patients with cancer: clinical implications and management. The lancet oncology, 12(13), 1249-1257.

Heuberger, R. A., & Caudell, K. (2011). Polypharmacy and nutritional status in older adults. Drugs & aging, 28(4), 315-323.

Planton, J., & Edlund, B. J. (2010). Strategies for reducing polypharmacy in older adults. Journal of gerontological nursing, 36(1), 8-12.