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04/02/2014

Medication Adherence in the Elderly Population

Which population do you see most at your local pharmacy? It is the elderly population (ages >65), that are usually at the pharmacy trying to fill multiple prescriptions. There are many areas that the elderly population needs assistance with, in order to achieve optimal medication therapy and prolong life. Barriers such as polypharmacy, comorbidities, and growing disabilities can be analyzed to provide better treatment outcomes.

Barriers: The elderly population struggles with an increasing number of medications or polypharmacy as they age. Italian researchers concluded that number of drugs prescribed at hospital discharge and minimal comprehension about the purpose of each medication contributed to overall non-adherence. The average patient in the study had a total of 9 drugs to take on a regular basis. It is this pill burden that the elderly population needs help managing. Because of multiple medications, patients may feel overwhelmed and even stop taking their medication accurately according to schedule. Patients are taking multiple medications for hypertension, diabetes, cholesterol and other comorbidities.

Comorbidities, if not managed properly can lead to future complications and decrease patients’ life expectancy. Schuz and colleagues concluded that if older people with multiple illnesses are convinced that their medication serves their specific needs, the more likely they will stay adherent. Elderly patients may not see a purpose in taking so many medications and may even consider one disease state more important the other. Thus, it is important to explain the use of each medication in treating a specific illness.

Additionally, growing disabilities such as vision loss can contribute to a patient’s overall adherence. It is common for elderly patients to lose their eye sight as they age and therefore contribute to unwanted difficulties. Patients will have trouble reading medicine labels or treatment directions. With this inconvenience, patients may even ignore the direction on the prescription bottle and start taking the medication on their own terms. It is these arising issues with age that may result in poor adherence and unsuccessful disease management.

Hypertension: Most elderly patients are on antihypertensive agents to prevent future cardiac issues. Although patients may not see physical changes, it is important for them to be adherent for long term results. Multiple questionnaires showed that illness perception and beliefs about antihypertensive medications played a role in patients’ adherence. It was more likely that patients followed a drug regimen if they knew that the long-term health consequences of cardiac complications, stroke, and mortality can be decreased. Elderly patients tend to take antihypertensive medication if they know that it is purposeful and efficacious for their health.

Barriers such polypharmacy, comorbidities and other disabilities should be resolved so that the elderly can better manage their health. Pharmacists can work one-on-one with these patients so that they can provide better resources for these patients. Resources such as pill kits, large font instructions or even a counseling session can go a long way in assisting elderly patients. The pharmacy has a lot of valuable information that patients can use in order to improve their overall medication adherence.

Sheenu Joseph, PharmD '15

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