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Medication: Management Matters A Toolkit to Promote Improved Medication Management for Community Dwelling Older Adults |
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Age Related Changes Medication
Adherence Care Transitions Intellectual/ Developmental Disabilities |
Introduction Adults aged 75 and older take an average of
7.9 prescription drugs every day. Twenty five percent of independent
community dwelling older adults take a daily average of 3 drugs, and seventy
one percent of community dwelling adults who receive help with activities of
daily living take 3 to 7 medications each day. Yet, the use of multiple
medications increases the risk of medication misuse related to poor health
outcomes. Error in drug use among older adults has been shown to increase the
frequency of: · visits
to outpatient settings and emergency rooms · hospitalization · lab
workups · medications
and medication side-effects · recurring
illness · early
death Medication management refers to an
individual’s ability to obtain, organize, and follow directions for taking
their medication. Older adults are at an increased risk of harm from poor
medication management which can result in relocation and potentially threaten
a community dwelling elder’s ability to remain in their home. Along with
increased risk to the individual, medication misuse increases the cost of
health care. It is estimated that the direct and indirect health care cost of
inadequate medication adherence alone is $177 billion annually. Given the serious impact on the quality of
life for older adults, and with the current crisis of escalating health care
costs, the issue of medication management is of critical interest to anyone
with an interest in serving older adults. There are a variety of programs and
resources available for medication administration in assisted care settings.
These programs typically train formal care providers how to administer
medication within legal parameters and how to document this care provision.
For many who assist older adults to remain in their home, medication
administration is not their proper or legal role. There is a need for a cohesive resource of
information on medication management for non-medical helping professionals
who assist community dwelling older adults. What
is this toolkit? This toolkit is a collection of evidence
based information and electronically available resources selected to: · Develop
your awareness of the importance of medication management and help you
understand why and how all professionals and care providers who serve older
adults play a critical role in the success of medication management. · Increase
your competence to support strategies for improved medication management for
community dwelling older adults and thereby assist them in their capacity to
age in place. Items selected for the toolkit can be adapted for use
by care professionals in a variety of settings. Many can be downloaded and
copied for use. Who
can use this toolkit? Anyone who is planning to work with or on
behalf of older adults, whether the services they plan to provide are in the
home, hospital, doctor’s office, skilled nursing or rehabilitation facility,
community program, or even in public policy. Medication management touches
every aspect of people’s lives and everyone is a stakeholder in this
important issue. How
is this toolkit organized? Along with this introduction, the toolkit
has four main sections, called modules.
Each module includes: learning objectives, definitions, activities,
self evaluation questions, and additional resources. · Module one
provides an introduction to the basic physiological changes associated with
aging that impact medication management in older adults. · Module two
explores the impact of medication adherence on the health and well being of
older adults. · Module three
explains the significance of care transitions in the medication management
process. · Module four
incorporates information about medication management for adults aging with
intellectual or developmental disabilities. Ready
to begin? While the modules and activities can be
utilized individually, to achieve the most benefit from the toolkit start
with module one and proceed in order through the other modules. Icons in each module will help identify
activities. Click on the link next to the icon to open an activity.
Read it
(it’s important!)
Watch
it
(the time is listed next to each video clip)
Check
it out (helpful tools, tips, & terms) References Bergman-Evans, B.
(2006). AIDES to improving medication adherence in older adults. Geriatric Nursing,
27(3), 174-182.
http://dx.doi.org/10.1016/j.gerinurse.2006.03.003 Enhancing
prescription medicine adherence: A national action plan
(Report). (2007). Retrieved from National Council on Patient Information and
Education website: http://www.talkaboutrx.org/index.jsp Steinman,
M.A., & Hanlon, J.T. (2010). Managing medications in clinically complex
elders: “There’s got to be a happy medium”. Journal of the American Medical Association, 304(14), 1592-1601. http://dx.doi.org/10.1001/jama.2010.1482 Gerontology graduate project
developed by: Felicia
Juntunen, BSW, MA California
State University, Sacramento 2012 |
Definitions Activities
of daily living (ADLs): Bathing, dressings, toileting, transferring, feeding Adherence: The degree to which a patient follows a prescribed
regimen Age in
place: Enabling people to stay in their homes/ preferred
place of residence and programs as they age Assisted
care setting: A housing option for older adults who do not have
severe medical issues but do need assistance with some ADLs. Community
dwelling: Residing in one’s own home, either with or without
assistance. Medication
management: The ability to obtain, organize, and follow
directions for taking medication |
