What’s New in Medication Management: Focus on Older Adults and Caregivers Tuesday, April 30, 2013 12:00 Noon CDT Mike Varnell, RPh, CSA (214)

Slides:



Advertisements
Similar presentations
System Changes and Interventions: Planned Care Mike Hindmarsh Improving Chronic Illness Care, a national program of the Robert Wood Johnson Foundation.
Advertisements

Medication Therapy Management The Patient and Provider Variables.
Introduction Medication safety is a critical aspect in improving the health of individuals and increasing their quality of life. When used in the proper.
Polypharmacy in the Elderly
Polypharmacy of Older Adults
Meredith Cook Mercer COPHS August, Beers Criteria AGS and interdisciplinary panel of 11 experts in geriatrics and pharmacotherapy 53 medications.
Copyright © 2015 Cengage Learning® Chapter 27 Drugs and Older Adults.
OPTIMISING MEDICINES USE GRAHAM DAVIES Professor of Clinical Pharmacy & Therapeutics Institute of Pharmaceutical Science King’s College London.
Best Practices for Safe Prescribing in Older ED Patients S. Nicole Hastings, M.D., M.H.S. 1.
Concerns in Medication Safety in Regards to the Older Adult Population Stephanie A. Ball, Taylor W. Brickley, Macey F. Davenport, Kelly L. Erexson, Emily.
Includes adults >65 years old Fastest growing population in US and in the majority of developed nations. 20% of hospitalizations for those >65 are due.
Clinical Training: Medication Reconciliation
Pharmacologic Principles Chapter 1, 2, 3. Understanding Nurses must understand both + and – effects of drugs Pharmacotherapeutics –u–use of drugs and.
Supported by DHHS/HRSA/BHPr/Division of Nursing Grant #D62HP06858 Best Nursing Practices in Care for Older Adults ELDER Project Fairfield University School.
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Chapter 11 Drug Therapy in Geriatric Patients.
Understanding Medicines Ch. 23 pp Lesson 1: The Role of Medicines Classification of Medicines A.Prevent disease B.Fight pathogens C.Relieve.
Chapter 35 Safe Medication Use. Drugs Commonly Used by Older Adults Cardiovascular agents Antihypertensives Analgesics Antiarthritic agents Sedatives.
Kirk Panneton, M.D., FACP George Giokas, M.D. Medical Director, Senior Services Director, Palliative Care CDPHP The Community Hospice September 8, 2012.
Polypharmacy and preventing hospital admissions
Background Collection of S & O Information Data: – CC, HPI, PMH, PSHx, Demographics – Medication history including compliance etc. – VS, ROS, Lab, other.
Introduction to Pharmacology PHARM TECH. Pharmacology  Pharmacology is the science that deals with the study of therapeutic (beneficial) agents.  Knowledge.
1 Arch Intern Med.2003;163: JAMA.2006;296: The Most Common Cause of Adverse Medication Events that Result in Emergency Department.
Problems of Polypharmacy
Introduction to Pharmacology. ORIENTATION TO PHARMACOLOGY Objectives: 1. Definition of the four basic terms (drug, pharmacology, clinical pharmacology,
Drug Therapy in the Elderly
INTRODUCTION CLINICAL PHARMACOKINETICS
Pharmacotherapy in older age. Changes in pharmacokinetics and pharmacodynamics Polymorbidity, risk of DRUG-DISEASE interactions Polypharmacy, risk of.
Impact of Multidisciplinary Team Care on Older People with Polypharmacy Liang-Kung Chen Center for Geriatrics and Gerontology Taipei Veterans General Hospital.
Old Peeps and Drugs- Just Say NO Elizabeth von Wellsheim, MA, MSN, GNP Co-owner and Medical Director, ElderHealth & Living.
Principles of Pharmacology Brenda Rowe, RN, MN, JD.
Medicines management in the elderly Trudi McIntosh and Kim Munro School of Pharmacy and Life Sciences RGU.
Medication Management in the Older Patient. Older adults are more likely to have an Adverse Drug Reaction More likely to be on 5 or more medications Hazzard,
Copyright © 2016 by Elsevier, Inc. All rights reserved. Geropharmacology.
Strategies to Reduce Hypoglycemia Presented by: Hennie Garza, M.S., R.Ph., C.D.E, Director of Pharmacy Utilization and Outcomes Senior Care Centers
EVALUATING THE EFFECTIVENESS OF THE AGS UPDATED 2012 BEERS CRITERIA AS AN EDUCATIONAL TOOL IN A FAMILY MEDICINE RESIDENCY TRAINING PROGRAM Eseoghene Abokede.
Meet & Greet. Welcome Objectives: 1. Review the core terminology used in pharmacology. 2. Discuss the features of the “perfect” drug. 3. Examine the.
Using an EHR Template and the Beer’s List to Address Geriatric Polypharmacy Rose Family Medicine Residency Emily Gutgsell, MD Emma Bjore, MD Anna Plunkett,
Grant Macdonald.  Appropriate polypharmacy describes treatment where a patient has multiple morbidities, and/or a complex condition, that is being managed.
Community Education Promoting Informed Medicine Use.
PHARMACEUTICAL GUIDELINES: BASIC PRINCIPLES AND STATUTES.
A Welsh Overview of Pharmacy and Falls Prevention
The challenge of medicines
Prescribing for the Oldest Old
Objective 2 Discuss recent data, guidelines, and counseling points pertaining to the older adults with diabetes.
Medication Management With Older Adults
Medication Reconciliation ROP Compliance
Drug Therapy in Geriatric Patients
Medication Reconciliation and Reducing Adverse Drug Events
POLYPHARMACY IN GERIATRIC PATIENTS Dr SHREYAS MISTRY MD, Dr MAYUR RALI MD HOFSTRA-North Shore LIJ School of Medicine Department of Family Medicine Southside.
Patient Safety in Transitions of Care
Medication Reconciliation in Continuing Care
Using Medicines Safely (2:50)
Polypharmacy In Adults: Small Test of Change
Sandeep Wadhwa, MD, MBA, Vice President, Care Management Services
Medication Errors & Risk Reduction Ch. 7
System Changes and Interventions: Planned Care
System Changes and Interventions: Planned Care
Pharmacology KNH 413 Most Americans are not meeting RDA. Nutrient deficiencies worsen when medication is taken.
Principles of Pharmacology
ROLE OF HEALTHCARE PROVIDER IN GERIATRIC COUNSELING
Copyright Notice This presentation is copyrighted by the Psychopharmacology Institute. Subscribers can download it and use it for professional use. The.
Application of Pharmacology in Nursing Practice
Preventing Medication-Related Falls: Helping the Elderly Find Balance
Skills Workshop M1 Aging Week November 2012
Using Medicines Safely (2:50)
Care of Elderly – and measuring renal function!
The Basics of Geriatric Pharmacology
Pharmaceutical care plans Ola Ali Nassr
The Good, the bad and the Ugly In-patient prescribing in Diabetes – a non medical perspective. Angela Murphy Diabetes Renal CNS Tuesday 4th October.
POLYPHARMACY.
Presentation transcript:

What’s New in Medication Management: Focus on Older Adults and Caregivers Tuesday, April 30, 2013 12:00 Noon CDT Mike Varnell, RPh, CSA (214) 215-1826 mikevarnell@gmail.com

Words to Live By… “Don’t run with scissors!” “Watch where you’re going!” “Beware of multiple medications!” “Start low and go slow”

Multiple Medications = Polypharmacy The excessive or unnecessary use of medication Using more than 5 medications at one time Taking a medication for no therapeutic reason Taking more than one medication for same condition Taking medication to treat side effects of another med

Terminology for Drug Related Problems ADE - Adverse Drug Events ARs - Adverse Reactions PIMs - Potentially Inappropriate Medications These challenges can directly contribute to: Falls - Hypotension Fractures - Cognitive dysfunction Electrolyte imbalances -  Hospitalizations Heart Failure Ex.)  response to beta agonists and beta blockers  response to opiates, benzodiazepines and warfarin

Medication Management – Nursing Perspective Numerous challenges  risk of ADRs: Use of multiple medications (RX and OTC) Coexisting illnesses (i.e. – COPD / CHF / Diabetes) Physiological changes from the aging process

Common myths about medications “If it is OTC, it must be safe for me to take” “If one tablet is good, two is better” “It works for Dad, so it will work for me”

Potential reasons for polypharmacy Failure to d/c medications as intended by prescriber Medication being prescribed by multiple providers Failure of provider to do regular DRRs (Drug Regimen Reviews) Utilizing multiple pharmacies Poor compliance with medication regimes

Beers List www.dcri.org/trial-participation/the-beers-list Best known list of medications deemed inappropriate for use in the elderly These medications have evidence to support they cause SEs due to physiological changes Two examples of anticholinergics on the list: - Diphenhydramine (Benadryl) - Amitriptyline (Elavil) These agents are known to cause cognitive problems, constipation, urinary retention and glaucoma interference

Nonlinear vs. Linear Pharmacokinetics Pharmacokinetics – what the body does to a drug: - Absorption / Distribution / Metabolism / Elimination Linear Pharmacokinetics – assumes doubling the dosage doubles the medication present in the blood Nonlinear Pharmacokinetics – assumes doubling the dosage may increase to a greater amount, depending on other meds the individual is taking Most guidelines for meds were developed using linear vs. non-linear Nurses need to take in account OTC meds also being taken including vitamins and herbals looking for drug interactions

LIGHT Approach Nurses can advocate for the use of LIGHT approach: Life Expectancy (LE) by estimating avg. LE of patient Impact of other conditions (aging process, chronic conditions) Goals of the patient and goals of care Helping patient develop care plan to meet their preferences Time required to determine if benefit from medication occurs

Brown Bag Medication Review Patients bring all medications, including RXs, OTCs, vitamins, herbals, supplements, et al for review and discussion Reviewing medications in this way assists with: - Answering questions and increasing compliance - Identify errors in administration / assess possible drug interactions Download Brown Bag Medication Review toolkit: www.ohiopatientsafety.org/meds/default.htm

Be a Patient Medication Advocate Encourage patients to consolidate care providers Ensure patients have a delivery system for managing meds Review all acute changes in each patient as a potential ADE Mike Varnell, RPh, CSA 3 Star Healthcare, Inc. Email: mikevarnell@gmail.com Phone : (214) 215-1826 (office & cell)