Optimization of Drug Prescription and Medication Management in Older Adults with Cardiovascular Disease

Abstract

Cardiovascular disease increases incrementally with age and elderly patients concomitantly sustain multimorbidities, with resultant prescription of multiple medications. Despite conforming with disease-specific cardiovascular clinical practice guidelines, this polypharmacy predisposes many elderly individuals with cardiovascular disease to adverse drug events and non-adherence. Patient-centered care requires that the clinician explore with each patient his or her goals of care and that this shared decision-making constitutes the basis for optimization of medication management. This approach to aligning therapies with patient preferences is likely to promote patient satisfaction, to limit morbidity, and to favorably affect healthcare costs.

Is Prescription Nonredemption a Source of Poor Health Among the Roma? Cross-Sectional Analysis of Drug Consumption Data From the National Health Insurance Fund of Hungary

“…The positive effect of female sex on redemption in Hungary was found to be weak but statistically significant, which is consistent with observations from the United Kingdom, the United States and South Korea (Hagström et al, 2004;Farris et al, 2018;Lee et al, 2018). The relatively low redemption ratio among young and middle-aged Hungarian adults also fits the reported age dependency from other countries (Cooper et al, 1982;Mansur et al, 2009;Wenger et al, 2017).…”

<p>Simplifying Medication Regimens for People Receiving Community-Based Home Care Services: Outcomes of a Non-Randomized Pilot and Feasibility Study</p>

“…2 Managing multiple medications can be complex, time-consuming and stressful for older people and caregivers. [3][4][5][6] Impaired cognition, dexterity, mobility, hearing and/or vision, and frailty contribute to reduced ability to manage a complex regimen. 4,7,8 Complexity arises due to multiple formulations (eg, inhalers, patches), a greater number of administration times and special administration instructions (eg, crushing).…”

Multimorbidity in cardiovascular disease and association with life satisfaction: a Chinese national cross-sectional study

“…7 Except for coexisting multiple CVDs, CVD coexisting with non-CVD morbidities can substantially impact the clinical features, diagnosis, management and outcome of most older patients. 8 The WHO has pointed out that approximately 13% of CVD deaths are associated with diabetes, 9 hypertension 10 and dyslipidaemia, 11 which are recognised as the most common occurrences of multimorbidity with CVD.…”