Medication management in older adults

Kim, Luke D.; Koncilja, Kenneth; Nielsen, Craig

doi:10.3949/ccjm.85a.16109

Cited by 12 publications

(10 citation statements)

References 58 publications

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“…Some studies focus only on ethnic groups—failing to recognize important age‐related differences that affect medication management 37,38 . Conversely, other studies explore how medication is managed in the general older population, failing to acknowledge important differences amongst minority groups 39 . Finally, other studies 40,41 concentrate on minority groups living in their country of origin (where the healthcare system is different from the United Kingdom), failing to consider factors associated with a changed environment and migration, both of which can impact on medication management.…”

Section: Discussionmentioning

confidence: 99%

Medication management in M inority, A sian and B lack ethnic older people in the United Kingdom: A mixed‐studies systematic review

Secchi

Maidment

Sud

et al. 2022

Clinical Pharmacy Therapeu

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What Is New and Objectives Older people from ethnic minorities experience the intersectionality of age and ethnicity in relation to complex medication management and polypharmacy. Minority ethnic groups in the United Kingdom are at risk of poor medication management because factors such as cultural beliefs, language barriers, lack of knowledge of how the healthcare system works may affect their ability to safely manage their medications. The aim of this systematic review was to review the literature focussing on medication management in the older population amongst ethnic minority communities in United Kingdom. Methods The review was conducted and reported according to methods in the Cochrane Handbook and in the PRISMA 2020 statement using databases such as EMBASE, ASSIA, MEDLINE, PsychINFO and others. Studies conducted in the United Kingdom on individuals over 60 years of age and from a minority ethnic background were included. A thematic analysis was used to synthesize the results. Results and Discussion Nine studies (eight from initial searches, one from a search update in 2021) met the inclusion criteria. Three main themes were identified: misbeliefs around medications, poor health literacy, communication and education as possible intervention to improve medication management. Misbeliefs around long‐term illnesses exert a negative impact on medication management. Poor health literacy around medications influences patients' adherence to treatments. Poor communication is perceived as barrier to successful medication management. Despite extensive searching, the team identified a limited number of studies and a lack of intersectional studies focussing on minority ethnic groups and the older population. What is New and Conclusion Our findings suggest tailored education as a possible intervention to improve medication management amongst these minority groups. Future research should look at recruiting participants from specific ethnic groups and from rural as well as urban areas to explore how medication management operates in different areas of the United Kingdom.

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Section: Discussionmentioning

confidence: 99%

Medication management in M inority, A sian and B lack ethnic older people in the United Kingdom: A mixed‐studies systematic review

Secchi

Maidment

Sud

et al. 2022

Clinical Pharmacy Therapeu

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“…As the world population is aging, with the expectance of people over 65 years old to reach 71 million by 2030, compared with 35 million in 2000; by 2050, the world average life expectancy is predicted to increase by 10 years compared with that in the 2000s. These statistics shows that there will be more medications to be used per person [2,3].…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Overview of Polypharmacy in Elderly Patients in Saudi Arabia

et al. 2019

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Background/Objectives: Saudi Arabia has a great percentage of geriatric patients associated with multiple chronic diseases who require close attention and monitoring for their medications. The purpose of this study is to develop a full-framed picture about the utilization of medications for geriatric patients and how to provide better health-care management. Methodology: A retrospective cross-sectional study targeting patients 65 years of age and older, who are taking multiple chronic medications for different indications. Descriptive analysis and frequency of the main variables were used as appropriate. Only qualified and professional candidates were chosen for data entry to present the quality and accuracy of data. Results: A total of 3009 patient profiles were analyzed, with the patients’ average age in years being 73.26 ± 6.6 (SD). It was found that 55% of the patients have polypharmacy. An average of 6.4 medications were prescribed for patients aged between 65 and 70 years compared with a significant difference for patients aged 71 years and above, while a linear correlation between age and comorbidity diseases associated with all elderly patients. Hypertension, hyperlipidemia, and diabetes mellitus are the most common comorbidity diseases for elderly patients aged 65 years and older. Conclusion: Polypharmacy in geriatrics is defined as a patient aged 65 years and older receiving five or more appropriate medications. It is the responsibility of health-care professionals to reduce the number of medications in elderly patients. Awareness of geriatric medications and diagnosed diseases will improve managing adverse drug reaction and other risk factors. Awareness of geriatric medications should elaborate on how to avoid adverse drug reaction and other risk factors. It is the responsibility of physicians and pharmacists to reduce the number of medications in elderly patients. We also prove that the number of medications will not necessarily increase with age. The main impact of this study is to follow the main recommendations to improve health care management in geriatrics.

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“…It's worth mentioning that GP should patiently check all the active substances in generic drugs taken but also ask about the over-the-counter (OTC) medications which the patients forget to report to the health professionals during the consultation. Finally, the GP might suggest nonpharmacologic therapy, instead of medication, such as diet modification or exercise, or when the medication seems to be clinically necessary, he can alter the dose, perhaps starting from lower doses, taking into account the patients pharmacokinetic, pharmacodynamic, and adverse-event profile and renal and hepatic function in order to prevent toxicity or drug-disease or drug-drug interactions [34][35][36].…”

Section: Preventionmentioning

confidence: 99%

Поліпрагмазія У Людей Похилого Віку: Поширеність, Наслідки Та Стратегія Профілактики

Kotsalou

2021

Mìžnarodnij endokrinologìčnij žurnal

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Aging is a status often associated with multiple comorbidities which require pharmacologic intervention and complex medication regimens. Aging population results to the increase of chronic diseases and subsequent comorbidities that require concomitant multiple medications. It is reported that about 80 % of elderly have at least one chronic condition, and about half of them have at least two (such as heart disease, hypertension, diabetes mellitus, arthritis, and cancer). According the literature the worldwide polypharmacy prevalence has a wide range (between 5 to 78 %) due to different definitions on the number of medications taken (ranging between 2 and 9) and the different samples studied. In most studies polypharmacy was more common between women and in more elderly people. Many multicenter studies have been performed to define the term of polypharmacy and its prevalence in the elderly population. Polypharmacy is of growing concern for the older adults, because it can be very dangerous for this population due to altered absorption, distribution, metabolism and excretion of the drugs within their body reflecting unexpected pharmacokinetics and pharmacodynamics of various medications. This fact can lead to adverse drug reactions (ADR), drug interactions, noncompliance and reduced adherence, reduced functional status, geriatric syndromes, high risk of hospitalization and possible death. Over the last decade, there are several evaluation tools which can help the General Practitioner prevent the polypharmacy in the elderly. As prescribing for this group of individuals is a very challenging procedure, the General Practitioner should balance between under-treatment, over-treatment and risks and benefits. This review concluded that we need more cross-sectional clinical studies on practical preventive interventions to be applied not only on the population which is already exposed to polypharmacy, but also to the general population.

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Medication management in older adults

Abstract: Managing medications is a major part of providing care to older adults. Polypharmacy is common in the elderly and is fraught with risks. A careful and systematic approach is needed for managing drug therapy in these patients, recognizing the patient's specific goals.

Cited by 12 publications

References 58 publications

Medication management in M inority, A sian and B lack ethnic older people in the United Kingdom: A mixed‐studies systematic review

Medication management in M inority, A sian and B lack ethnic older people in the United Kingdom: A mixed‐studies systematic review

A Comprehensive Overview of Polypharmacy in Elderly Patients in Saudi Arabia

Поліпрагмазія У Людей Похилого Віку: Поширеність, Наслідки Та Стратегія Профілактики

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