Medication Challenges In The Elderly

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Drug-related problems in the elderly is intended to serve as a source of information and clinical support in geriatric pharmacotherapy for students as well as all health care professionals, e.g. physicians, nurses and pharmacists. Pharmacotherapy is of great importance to all mankind. Drugs are however powerful and must be handled appropriately. This is especially important for elderly patients. Drug-related problem is not a major subject in most university programmes in medicine or pharmacy. When there is no speci c course, there is often no book covering the topic. In our view, as teachers at various university courses, there has been a shortage of literature that re ects the most important aspects of drug-related problems in the elderly. Medical practitioners, nurses and pharmacists, need to have this knowledge to be able to serve their patients in the best way. This book covers most aspects of drug-related problems in the elderly. With b- ter knowledge of drug-related dif culties and risks we hope that elderly will have fewer drug-related problems and bene t more from their pharmacotherapy.

Reports in the popular press about the increasing longevity of Americans and the aging of the baby boom generation are constant reminders that the American population is becoming older. Consequently, an issue of growing medical, health policy, and social concern is the appropriate and rational use of medications by the elderly. Although becoming older does not necessarily correlate with increasing illness, aging is associated with anatomical and physiological changes that affect how medications are metabolized by the body. Furthermore, aging is often related to an increased frequency of chronic illness (often combined with multiple health problems) and an increased use of medications. Thus, a better understanding of the absorption, distribution, metabolism, and excretion of drugs; of the physiologic responses to those medications; as well as of the interactions among multiple medications is crucial for improving the health of older people.

Part 1 covers absorption, metabolism and excretion of drugs, the extent of medication use by the elderly, the reasons for increased use of drugs, and the factors that increase adverse drug reactions. Part 2 discusses the pharmacokinetics and pharmacodynamics of drugs, with further explaination of the causes of adverse drug reactions in the elderly. Other topics include the underuse of medication and common drug-drug interactions.

Medication use is the predominant form of health intervention in our society. And as we age, the likelihood of medication use increases dramatically, with more than 80 percent of those over age 65 using one or more medications. Along with that, the potential for medication errors also increases. Indeed adverse drug reactions (ADRs) and adverse drug events (ADEs) are a significant problem in older adults. Written in a practical format by contributors from Australia and the United States, Medication Management in Older Adults: A Concise Guide for Clinicians presents the available evidence on research interventions designed to reduce the incidence of medication errors in older adults, with a focus on acute, subacute, and residential (long-term) care settings. Because medication errors can occur at all stages in the medication process, from prescription by physicians to delivery of medication to the patient by nurses, and in any site in the health system, it is essential that interventions be targeted at all aspects of medication delivery. Chapters cover the principles of medical ethics in relation to medication management; common medication errors in the acute care sector; medication management in long-term care settings; nutrition and medications; the outcomes of a systematic review; dose form alterations; Electronic Health Records (EHR), Computerized Order Entry (COE), Beers criteria; and pharmacokinetics and pharmacodynamics. For those clinicians especially concerned with providing the best possible outcomes for their older adult patients, Medication Management in Older Adults: A Concise Guide for Clinicians is an invaluable resource and a significant contribution to the burgeoning literature on medication errors.

This open access book provides a comprehensive perspective on the concept of ageism, its origins, the manifestation and consequences of ageism, as well as ways to respond to and research ageism. The book represents a collaborative effort of researchers from over 20 countries and a variety of disciplines, including, psychology, sociology, gerontology, geriatrics, pharmacology, law, geography, design, engineering, policy and media studies. The contributors have collaborated to produce a truly stimulating and educating book on ageism which brings a clear overview of the state of the art in the field. The book serves as a catalyst to generate research, policy and public interest in the field of ageism and to reconstruct the image of old age and will be of interest to researchers and students in gerontology and geriatrics.

Help stop the widespread problem of medication errors among the elderly The problem of medication errors among the elderly is widespread. Improving Medication Management in Home Care: Issues and Solutions tackles this tough issue by closely examining the challenges faced in preventing medication errors in home and community care program settings and putting forth effective solutions to better manage medication use. Respected experts discuss the unique role of the pharmacist in improving patient safety, presenting a comprehensive collection of evidence-based studies featuring national and international viewpoints, cutting-edge interventions, and cost-effective procedures that address medication problems in older adults. Polypharmacy is the term used for patients receiving too many medications for a specific treatment. The implications for drug-drug interactions can be dangerous for the unaware patient. Improving Medication Management in Home Care: Issues and Solutions focuses on several different effective management programs and examines each in detail, completely explaining the positive—and negative—results. This hands-on practical information is useful for all professionals and field providers working with older adults and their medication concerns. The book also provides valuable lessons through the experiences of national home health leaders in various settings—hospital-based, rural, large or small, etc., as well as community-based programs for dually eligable older adults. The book is extensively referenced and includes an abundance of clear, helpful tables, figures, and Web resources. Improving Medication Management in Home Care: Issues and Solutions explores: developing computerized risk assessment screenings implementing pharmacist-centered interventions improving transitional care from hospital to home the Prescription Intervention and Lifelong Learning (PILL) program Medication Therapy Management Services a quality-improvement project to reduce falls and improve medication management outcome-based quality improvement for patient safety intern programs that can provide cost-effective consultant services Improving Medication Management in Home Care: Issues and Solutions is essential reading for home health care administrators, clinicians, managers, pharmacists, physicians, educators, students, those professionals involved in the field of aging, and health practitioners world-wide.

Comprising a single repository of knowledge and scientific evidence in the field, this book provides strategies to mitigate fall risk by providing information on the complex interactions between aging processes, co-morbid conditions and prescribed medications in older patients. Geriatric health is becoming a more prominent issue as the population ages, and balancing the beneficial effects of medication against the potential and real side-effects in these patients involves a deliberate and thoughtful task: physiologic aging, the accumulation of co-morbidities, and the use of drugs to manage various conditions and symptoms generates a unique set of problems for each patient. Falls are a dreaded event in older people. The event can affect a person in a physical, and psychological manner, resulting in soft tissue and bony injury, fear of falling, and depression. The identification of and reduction in fall risks in older people is a worldwide concern, and reducing the incidence of falls is a ubiquitous quality measure of health care delivery. Heterogeneity amongst older people precludes a single solution. However, physicians and others involved in the care of geriatric patients will benefit from the presented insights into how medication use can be modified to limit its impact as a contributing factor.