the rise of polypharmacy
Marie Germain
With the elderly population living longer, the rise of polypharmacy is becoming more common. Polypharmacy, the state of being in more than 5 medications causes high risk in the health of the patient and consequently becomes a huge concern for medical practitioners (Golchin, Frank, Vince, Isham & Meropol, 2015). Polypharmacy is common among the elderly people especially because of high morbidity factors. As a result, it becomes medically necessary to be on multiple medications, although it is not advisable especially given the high risk the patient is put into. The question becomes does the benefits outweigh the consequences? It is important to understand these risks and possible interventions to prevent, treat and respond to polypharmacy risks in order to improve patient outcomes.
Among the risk associated with polypharmacy are reactions between drug to drug reactions and increased risk of morbidity. Approximately 40% of the older adults are on multiple prescription drugs, while half of these are at a high risk of experiencing the risks associated with polypharmacy (Rossi, Feske, Shaffer & Kreutzer, 2017). Reaction to drugs can cause effects such as allergic reactions and other serious adverse effects that can be fatal (Azhagesan, 2017). Also, drugs may react with each other resulting in one having a greater effect than the other, and possibly hindering it from the intended action. Morbidity is the ultimate and most unprecedented risk as death may occur on the patient following immunity weakening.
As a health concern, practitioners need to respond to this issue. The first response is to examine the patient’s accurate medical history upon any given discharge. This is important in examining previous medications and how they fared well with the particular patient. This also helps to inspire the most accurate medication (Rossi, Feske, Shaffer & Kreutzer, 2017). Secondly, the medical practitioners need to reconcile medications given to the patient (Azhagesan, 2017). This helps to prevent the risk of drug to drug interactions, while adhering to early intervention to help to prevent or deal with medical issues.
Maritza Cosme
Risk Factors for Polypharmacy
Polypharmacy entails taking of 5 or more medicines. Generally, polypharmacy in the elderly occurs because of three factors: demographic factors, health factors, and access to healthcare. It is more common among older patients and has potential harms such as drug interactions and drug toxicity. Polypharmacy is an area of concern for elderly because of several reasons. Elderly people are at a greater risk for adverse drug reactions (ADRs) because of the metabolic changes and reduced drug clearance associated with ageing; this risk is furthermore exacerbated by increasing the number of drugs used. Polypharmacy is linked to increased risk of adverse drug events in older people due to increased risk of drug interactions, lack of adherence to medication regimes, susceptibility of older people to side effects of medications, and physical changes related to ageing causing difficulties in taking medications as prescribed. One of the risk factors is frailty. Patients who are frail are more likely to be having many health conditions that can contribute to excessive polypharmacy. Another risk factor is multimorbidity (Card, 2016; Ersoy, 2018). Patients who have many chronic conditions may be have to take 5 or more medicines to manage their conditions. Obesity is another risk factor. Obese people may have risk factors for many health conditions such as diabetes, heart disease, and high blood pressure, among others (Ersoy, 2018). These conditions may make them to take many medicines to manage them, therefore resulting to polypharmacy. In the elderly, disorders that occur as a result of ageing, frequently require treatment, resulting in increased use of medications. Polypharmacy is common among the elderly and although it can be therapeutic in nature, is linked to adverse events such as falls.
Interventions to prevent polypharmacy and its complications
A nurse practitioner is central to the administration of healthcare services. The nurse can play certain roles to prevent polypharmacy and its complications. One intervention may entail assessing for drug-drug interactions. If there are interactions, there may be a need to eliminate some medicines. Another intervention may include reviewing dosages. The effects of the medicines may be due to excess dosages. The reviewing of dosages can lead to a reduction in the number of medicines that one takes. Another intervention is eliminating duplicate medications (Johansson, 2017). Some medications may serve the same purpose; and therefore, it is necessary to eliminate some to reduce the burden on the patient. Exploring non-pharmacological approaches may also be necessary. For instance, if a patient has depression or anxiety, use of psychotherapy and exercise may be a useful alternative to medicines and therefore reduce the number of medicines that one takes.
Guillermo
Polypharmacy
Indeed, polypharmacy in which patients take several medicines to an extent that they result in complexities is a common experience among the old people. Such a situation is as a result of particular aspects which is discovered can solve the issue. The common risk factors for polypharmacy among the older individuals are gastric disturbances as well as gastrointestinal diseases that induce a lot of adverse reactions which make patients opt to taking gastrointestinal drugs. The intake of such drugs them result in cascading of treatments and increment in DDC. Additionally, painful conditions which the older adults suffer including arthropathic, chronic, and neuropathic pain. According to Word Health Organization (2019) chronic pain is related with behavioral and somatic comorbidities encourages the old adults to consume excess analgesic. Indeed, risk factors such
