Medication problems plague people of all ages as well as families, caregivers, and the entire health care system. Medication errors among older people cost about $177 billion each year. If such errors were counted as a disease, they would be the fifth leading cause of death for Americans over 65. The Framework Evidence Briefs were the first nationwide (U.S.) set of best practices for geriatric home care. 

The presentation takes 15 minutes. It is an audio presentation directed to nurses and health care providers in the community on the topic of geriatric medication management. 

This power point presentation is presented by Ontario’s Geriatric Steering Committee. Adverse drug event is described, along with common causes, assessments, factors of polypharmacy and "how to manage" events. 

The Canadian Institute for Health Information (CIHI) has projected that Canada will spend $211 billion on health this year, including $34.5 billion in drug expenditures alone. Deprescribing is the practice of stopping, reducing, or slowly withdrawing medications that are inappropriate, unsafe or ineffective. Pharmacists can play a key role in helping Canadians reduce the number of medications they are taking. In fact, an Ontario pharmacist has recently received government funding to develop and implement guidelines to assist prescribers with deprescribing medications. This issue of the Translator highlights the role of the pharmacist in deprescribing in an effort to both optimize the health of Canadian seniors and ensure the sustainability of the health care system:In Managing polypharmacy in a 77-year-old woman with multiple prescribers;  Discontinuing benzodiazepine therapy: An interdisciplinary approach at a geriatric day hospital; n Deprescribing medication in very elderly patients with multimorbidity: the view of Dutch GPs; Incidence and economic burden of adverse drug  reactions among elderly patients in Ontario emergency departments.

This article outlines the issue of polypharmacy among older adults and their increased risk for adverse drug reactions. The article describes:

  • Age-related changes,
  • The lack of evidence for medication use in the elderly, and
  • Strategies for reducing polypharmacy.

The Research for Aging Institute (RIA), a collaborative between The Univerity of Waterloo, Conestoga College, and Schlegel Villages include Optimizing Medications for Seniors as a theme for their research and education. Visit their website for a complete list of research projects.

The Collaboration for Homecare Advances in Management and Practice (CHAMP) selected and organized evidence-based tools from our Resource Library into this online Geriatric Medication Management Toolkit. This Toolkit contains:

  1. Clinically-focused and validated tools to help you, and patients and their caregivers, identify patients at increased risk of experiencing a medication-related problem;
  2. Intervention tools for homecare professionals, patients and their caregivers, to facilitate implementing proven strategies to manage medications;
  3. Tools to help you, patients, and caregivers communicate more effectively about medication risks with other providers;
  4. Guidelines and evidence-based best practices that provide an overview of the evidence for reducing medication-related problems and adverse drug events in older people. 

 

Key messages are:

  • As we age, physiological changes can affect the way our body metabolises drugs, causing adverse reactions.
  • Older people are more likely to be taking multiple medications (‘polypharmacy’), which increases the risk of medications being implicated in hospital admissions.
  • Up to 30 per cent of hospital admissions of people aged 65 years and over are medication-related, and approximately half of these could be prevented.
  • Medication-related admissions in older people can be caused by adverse drug reactions, failure to take a prescribed medication and errors with taking medications.

It has been reported that up to one-quarter of patients who visit emergency departments (ED) due to adverse drug reactions (ADRs) are admitted to hospital. ADRs resulting in hospital admission generally represent more severe reactions and require more resources to treat. One recent study found that ED visits and hospital admissions due to ADRs among seniors in Canada cost an estimated $35.7 million, with more than 80% of those costs arising from hospitalization. 

Statistics show around one in three unplanned hospital admissions for older Australians are related to issues with their medicines – and half are preventable. A new educational program targeting health professionals, particularly nurses and pharmacists, aims to reduce the rate of adverse medicine events in patients aged 75 and over. “NPS MedicineWise is encouraging all health professionals, including pharmacists and nurses, to adopt a coordinated approach to medicines management as an important aspect of a care plan for an older person, and to engage older people, their family and carers as active partners in health decisions."

Pages