Medication management is a big deal in the Older Adult community. It is the 5th leading cause of death for older adults; 7,000 deaths per year due to adverse drug events. It is pervasive: Studies estimate up to 48% among community-dwelling older adults mismanage their medication. And it is costly: The cost of drug-related morbidity and mortality for seniors exceeds $120 billion including hospital admissions and long-term care admissions.
- Twenty percent of the Medicare population have five or more chronic conditions treated by medication
- Older adults see 14 different physicians in a year, which offers 14 different opportunities for MD errors in prescribing
- 50 or more prescriptions are filled by an Older Adult annually
- Errors involving patient adherence are common (21%)
- Medication can and often does increase fall risk
- Home care recipients are at especially high risk for experiencing such events
- Older adults with 9 or more medications have a 2x greater odds of medication-related problems than those with fewer than 9 medications.
How do you identify a problem? The best first step is to involve your loved one. Partnering with them is important to their dignity and your relationship with them. Involve them in the process. Start by asking if they have a medication list to take to Dr.'s appointments. Offer to assist your parent to create one. There are several ways you can do this. Local Fire Stations or Police Departments offer "Vial(s) for Life" or a way to alert emergency responders to prescribed medications for residence or create a visual one with pictures of each pill from the internet. Next look at the prescription bottles. How long ago was it filled? How many are left in the bottle? A medication dispenser is an easy way to determine of your loved one is taking their medication as prescribed. There are several options for medication dispensers (search it on Amazon); with alarms, lockable and more basic ones. Ask your parent if they would be open to you assisting with a medication dispenser.
Once your list is created, take it to their next primary care Dr. appointment and ask the MD to take a look. The Dr. does this often to evaluate if there are medications that could be creating negative symptoms or unnecessary medication. If you are not available to be there in person, ask your parent to sign a Release of Information for you to speak to the Dr. and fax it to the office to discuss with the Dr. on the phone. Then repeat with each Dr. he/she sees. Often Dr's do not know what other Dr's are prescribing, and if your loved one has any memory issues they may not realize the complexities. The MD's will thank you because you just made their job safer and easier.
- Partner with your loved one to create a medication list. You can create a visual one with pictures off the internet.
- Review medications bottles for date of prescription, how many doses are left in the bottle and expiration date.
- Use a medication dispenser to check for compliance.
- Review medication list with each Dr. involved in their care.
- Read “Medicines and You: A Guide for Older Adults” by the FDA
For Drug Evaluation and Research, Center. "Resources for You - Medicines and You: A Guide for Older Adults." U S Food and Drug Administration Home Page. Center for Drug Evaluation and Research, 7 Oct. 2015. Web. 26 June 2017.
Information, National Council on Patient. "Medication Management for Older Adults." NCPIE BeMedWise. National Council on Patient Information and Education (NCPIE), 04 May 2017. Web. 26 June 2017.
NIDA. "Misuse of Prescription Drugs." National Institute on Drug Abuse, 1 Aug. 2016, https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs. Accessed 26 Jun. 2017.
Zhan C, Sangl J, Bierman AS et al. - Potentially inappropriate medication use in the community-dwelling elderly: findings from the 1996 Medical Expenditure Panel Survey.
Institute of Medicine. (1999)"To err is human: Building a safer health system." Kohn, L., Corrigan, J., Donaldson, M. (Eds.) National Academy Press, Washington D.C.