Cognitive Impairment and Medication Self-Management Errors in Older Adults Discharged Home from a Community Hospital

Hain, Debra; Tappen, Ruth M.; Díaz, Sanya; Ouslander, Joseph G.

doi:10.1097/nhh.0b013e31824c28bd

Cited by 23 publications

(16 citation statements)

References 27 publications

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“…While the rate of re-hospitalization was found to be lower in patients visited at their homes, it was higher in patients who had not given consent and those who could not be contacted (40). Moreover, the results indicate that rehospitalization is associated with previous re-hospitalization, low social support, depression, poor drug compliance, and late visit from the family physician (41,42).…”

Section: How Can High-risk Patients Be Detected?mentioning

confidence: 70%

Who is High Risk Elderly Patient?

Naharcı¹

2017

Istanbul Med J

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A 77-year-old male patient was brought to emergency services because he had fallen. It was learned from his history that he had been examined by cardiologists and orthopedists many times, and he had consulted a neurologist for gait difficulty approximately one month earlier. He had also fallen four times in the preceding month. He had comorbidities of coronary artery disease, type 2 diabetes mellitus, and lumbar disc herniation. He had undergone total right hip prosthesis replacement 3 years earlier. He was retired and lived with his wife. He had been having difficulty performing his activities of daily living due to gait difficulty for 6 months. The patient and his wife stated that he took 16 different medications. His physical examination revealed his arterial blood pressure while standing to be 86/62 mmHg, and his other vitals were normal. The movements of his right shoulder were restricted after he had fallen. Serious pain and restricted movement (probable effusion), accompanied by mild warmth and tenderness in the left knee, restricted left hip movements, and mild weakness in the left leg were detected. Apart from these, there were no other important findings. Detailed geriatric assessment revealed multiple factors that could lead to falls. These factors were evaluated to be postural hypotension, polypharmacy, degenerative joint disease in the left hip and knee, and spinal stenosis-induced neuropathy. Sample Case 2A 92-year-old female patient was brought to the hospital by her family because she had lost her appetite for 3 days. She had comorbidities of hypertension, congestive heart failure, urinary incontinence (overactive bladder), and depression. She used a walker. It was learned from her history that she had fallen because she had stepped on her urine in the restroom, broke her hip, and become dependent while walking. As a result of examination and analyses, she was hospitalized after having been diagnosed with malnutrition, dehydration, and a urinary tract infection. Because improvement was observed after treatment, the patient was discharged from the hospital on the fifth day of hospitalization. However, she was readmitted due to recurring urinary tract infection one week after being discharged. IntroductionAs in developed and developing countries, the proportion of the elderly population is increasing in Turkey, which is in a period of demographic change. According to the 2015 Who is High Risk Elderly Patient?The acute and post-acute care of the elderly is a process fraught with problems. Elderly patients at high risk are individuals who have to be admitted more frequently to a hospital due to developed complications, who are faced with a constant risk of hospitalization, and who have increased risks of functional decline, nursing home admittance, and death. These adverse outcomes cause discrepancies and problems in the implementation and regulation of treatment and coordination between health entities. Factors increasing these risks vary among these individuals, but existing chronic diseases and ge...

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Section: How Can High-risk Patients Be Detected?mentioning

confidence: 70%

Who is High Risk Elderly Patient?

Naharcı¹

2017

Istanbul Med J

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“…However, when patients report that they are not managing their medication correctly, there is good reason to believe this is true (Roth & Ivey, 2005). Hain et al (2012) reported that 13% of the participants responded they were having difficulty taking their medications during telephone interview; however, about 52% were found to have one or more medication discrepancies by home visit. It is well established that patient self-reporting of nonadherence lacks sensitivity but has high specificity; in other words, when patients report that they are not managing their medications correctly, there is good reason to believe this is true (Roth & Ivey, 2005).…”

Section: Medication-related Problems After Hospital Dischargementioning

confidence: 93%

“…Polypharmacy is a growing problem, often combined with complex instructions such as having to manage more than one medication (Hain et al, 2012) and taking medications more than once a day (Beckman et al, 2005), which increases the difficulty in mediation self-managing for older patients. Second, polypharmacy may increase the risk of adverse drug reactions and contribute to costs (Ballentine, 2008), which would lead to nonadherence (Ownby, 2006).…”

Section: Predictors Of Medication-related Problemsmentioning

confidence: 99%

“…Previous studies have suggested that the transition from hospital to home is a time of risk for medication-related problems (Garcia-Caballos, Ramos-Diaz, Jimenez-Moleon, & Bueno-Cavanillas, 2010;Midlöv et al, 2008). The first several days posthospitalization can be the most difficult period, as people attempt to incorporate medication regimens into a daily home routine (Hain, Tappen, Diaz, & Ouslander, 2012;Kripalani et al, 2008;Lam, Elliott, & George, 2011).…”

mentioning

confidence: 96%

“…Factors such as polypharmacy (Barat, Andreasen, & Damsgaard, 2001;Cárdenas-Valladolid et al, 2010;Mansur et al, 2008) and cognitive impairment (Barat et al, 2001;Hain et al, 2012;Mansur et al, 2008) may affect medication-related issues. Older adults take more prescribed medications (Stuart & Briesacher, 2002), are more likely to experience cognitive problems than other age groups (Ferrario, 2008), and are more vulnerable to adverse health outcomes because of altered pharmacokinetics and pharmacodynamics (Mangoni & Jackson, 2004).…”

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confidence: 99%

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Medication-Related Problems Among Community-Dwelling Older Adults After Recent Hospital Discharge in Mainland China

Xiong

Mao

2014

Nursing Research

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Medication management capacity in relation to cognition and self-management skills in older people on polypharmacy

Sino

Sietzema

Egberts

et al. 2014

The Journal of nutrition, health and aging

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A considerable proportion of independently living older people who receive home care and regularly use five or more medications lack the knowledge and skills needed to independently manage their own medications. Cognition and self management ability were related to medication management capacity. Self-management ability and medication management support were predictors of medication management capacity.

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Cognitive Impairment and Medication Self-Management Errors in Older Adults Discharged Home from a Community Hospital

Cited by 23 publications

References 27 publications

Who is High Risk Elderly Patient?

Who is High Risk Elderly Patient?

Medication-Related Problems Among Community-Dwelling Older Adults After Recent Hospital Discharge in Mainland China

Medication management capacity in relation to cognition and self-management skills in older people on polypharmacy

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