Polypharmacy in the Elderly Population

Abstract

In this paper, the author has evaluated the issue of Polypharmacy in the Elderly Population. In this paper, the author has stated and described the clinical/client concern placing it within the context of a nursing practice area. Moreover, the author has also identified and described a nursing theory relevant to understanding and/or addressing the problem. The implications of the theories to practice; how specific practices are influenced by the theories, was also identified. Finally, the author has described three benefits gained from examining practice concerns using a model or theory.

Polypharmacy in the Elderly Population

Introduction

The purpose of this study is to expand the boundaries of the author's knowledge by exploring some relevant facts related to Polypharmacy in the Elderly Population. Polyphar-macy poses major challenges to optimal drug therapy because of age-related pharmacokinetics and pharmaco-dynamics, changes that occur when more than one drug is taken daily. The use of multiple medications for the management of multiple co-existing chronic health con-ditions is now understood as a major factor for prescription-related illness, with McGavock calling prescription-related illness a “scandalous pandemic” instigated by unnecessary prescribing, inappropriate diagnosis, lack of education in pharmacology and therapeutics, and the rapid development and promotion of new drugs (Zurakowski, 2009).

Frazier's literature review revealed an increased prevalence of polypharmacy among older persons; with this identified as a result of many co-existing chronic ill nesses, multiple prescribing providers over time and in multiple care settings, the use of more than one pharmacy to obtain medications through, and the shift of previously prescribed drugs to over-the counter availability. Few studies on the effectiveness of these admission medication reviews in continuing-care facilities have been conducted. No studies appear to have been specifically designed to compare the number and types of medications taken by community-dwelling older people before and after their nursing home entry. However, several studies from various countries have demonstrated that medication reviews in continuing care facilities are effective for identifying drug-related problems. A descriptive-comparative study of medications taken by older persons prior to and following admission to a large continuing-care facility in Western Canada was under-taken to address this knowledge gap (Wilson, 2004).

Discussion & Analysis

People who are aging with disabilities often experience a multitude of age-related functional, medical, and psychological problems that tend to occur earlier than in people without disabilities (Heller & Marks, 2006; Kemp & Mosqueda, 2004). Several chronic conditions seem to be more prevalent among individuals with disabilities than in the general population, including non-atherosclerotic heart disease, hypertension, hypercholesteremia, obesity, heart disease, diabetes, respiratory illness, osteoporosis, and pressure sores. Mobility impairment, thyroid disease, psychotropic drug polypharmacy, and deaths due to pneumonia, gastrointestinal cancer, bowel obstruction, and intestinal perforation also have a higher prevalence among groups of people with various disabilities (Tinetti, 2003).

Clinical/client concern within the context of a Nursing practice area

Polypharmacy refers to medical problems that can come about when a person takes more medications than they need. This is a significant concern for the elderly population in the United States, who some reports ...