Problems with Medication Use in the Elderly: An Australian Perspective

Elliott, Rohan A

doi:10.1002/j.2055-2335.2006.tb00889.x

Cited by 121 publications

(123 citation statements)

References 82 publications

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“…7 It was reported that approximately 70% of elderly women and 60% of elderly men take at least four medications (prescription and non-prescription) daily. 8 These statistics highlight the vulnerability of elderly patients to interruptions in continuity of care, and access to essential medications during a natural disaster. It is therefore imperative that healthcare policymakers develop adaptive, climate change-resilient, health care systems.…”

Section: Introductionmentioning

confidence: 99%

Burning questions: Exploring the impact of natural disasters on community pharmacies

Mak

Singleton

2017

Research in Social and Administrative Pharmacy

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BackgroundThe past decade has seen a rapid change in the climate system with an increased risk of extreme weather events. On and following the 3 rd of January 2013, Tasmania experienced three catastrophic bushfires, which led to the evacuation of several communities, the loss of many properties, and a financial cost of approximately AUD$80 million. ObjectiveTo explore the impacts of the 2012/2013 Tasmanian bushfires on community pharmacies. MethodQualitative research methods were undertaken, employing semi-structured telephone interviews with a purposive sample of seven Tasmanian pharmacists. The interviews were recorded and transcribed, and two different methods were used to analyse the text. The first method utilised Leximancer® text analytics software to provide a birds-eye view of the conceptual structure of the text. The second method involved manual, open and axial coding, conducted independently by the two researchers for inter-rater reliability, to identify key themes in the discourse. ResultsTwo main themes were identified -'people' and 'supply' -from which six key concepts were derived. The six concepts were 'patients', 'pharmacists', 'local doctor', 'pharmacy operations', 'disaster management planning', and 'emergency supply regulation'. ConclusionThis study identified challenges faced by community pharmacists during Tasmanian bushfires. Interviewees highlighted the need for both the Tasmanian State Government and the Australian Federal Government to recognise the important primary care role that community pharmacists play during natural disasters, and therefore involve pharmacists in disaster management planning. They called for greater support and guidance for community pharmacists from regulatory and other government bodies during these events. Their comments highlighted the need for a review of Tasmania's 3-day emergency supply regulation that allows pharmacists to provide a three-day supply of a patient's medication without a doctor's prescription in an emergency situation.

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Section: Introductionmentioning

confidence: 99%

Burning questions: Exploring the impact of natural disasters on community pharmacies

Mak

Singleton

2017

Research in Social and Administrative Pharmacy

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“…To treat these, many elderly people receive polypharmacy, with the attendant risk of drug/drug interactions that increases exponentially with the number of medications taken 83 . It has been shown that about two-thirds of communitydwelling people aged460 years take four or more medications daily, frail elderly people with multiple comorbidities take an average of nine 84 , and elderly hospital in-patients may be prescribed as many as fourteen 83 . The probability of interactions may be further increased by the consumption of over-the-counter (OTC) medications, which many patients perceive to be unimportant and do not disclose to their physician.…”

Section: Comorbidities and Polypharmacymentioning

confidence: 99%

Managing chronic pain in elderly patients requires a CHANGE of approach

Kress

Ahlbeck

Aldington

et al. 2014

Current Medical Research and Opinion

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In many countries, the number of elderly people has increased rapidly in recent years and this is expected to continue; it has been predicted that almost a quarter of the population in the European Union will be over 65 years of age in 2035. Many elderly people suffer from chronic pain but it is regularly under-treated, partly because managing these patients is often complex. This paper outlines the extent of untreated pain in this population and the consequent reduction in quality of life, before articulating the reasons why it is poorly or inaccurately diagnosed. These include the patient's unwillingness to complain, atypical pain presentations, multiple morbidities and cognitive decline. Successful pain management depends upon accurate diagnosis, which is based upon a complete history and thorough physical examination, as well as an assessment of psychosocial functioning. Poor physician/patient communication can be improved by using standardized instruments to establish individual treatment targets and measure progress towards them. User-friendly observational instruments may be valuable for patients with dementia. In line with the widely accepted biopsychosocial model of pain, a multidisciplinary approach to pain management is recommended, with pharmacotherapy, psychological support, physical rehabilitation and interventional procedures available if required. Declining organ function and other physiological changes require lower initial doses of analgesics and less frequent dosing intervals, and the physician must be aware of all medications that the patient is taking, in order to avoid drug/drug interactions. Non-adherence to treatment is common, and various strategies can be employed to improve it; involving the elderly patient's caregivers and family, using medication systems such as pill-boxes, or even sending text messages. In the long term, the teaching of pain medicine needs to be improved -particularly in the use of opioids -both at undergraduate level and after qualification.

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“…Jenis obat-obatan yang sering mengalami polifarmasi (12 yang melebihi indikasi klinis, pengobatan yang mencakup Terjadinya efek samping merupakan salah satu bagian paling tidak satu obat yang tidak perlu, dan penggunaan DRP yang penting. Pada penelitian ini didapatkan 14% empirik 5 obat atau lebih (8).…”

Section: Diskusiunclassified

Permasalahan Pemberian Obat pada Pasien Geriatri di Ruang Perawatan RSUD Saiful Anwar Malang

Rahmawati¹,

Sunarti²

2014

JKB

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ABSTRAKPermasalahan terkait pemberian obat sering terjadi pada pasien yang menjalani perawatan di rumah sakit, dengan faktor risiko yang tersering adalah polifarmasi dan peningkatan usia. Penelitian ditujukan untuk mengetahui deskripsi usia, jenis kelamin, jumlah obat dan prevalensi adanya Permasalahan terkait pemberian obat (Drug Related Problem=DRP) pada pasien geriatri yang menjalani perawatan di Rumah Sakit. Penelitian kohort retrospektif dengan pengambilan data sekunder pada pasien geriatri (≥ 60 thn) di Ruang Perawatan RSUD Saiful Anwar Malang selama Periode JanuariDesember 2011. Penelitian ini menunjukkan dari 150 subjek 55,3% adalah pria, rentang usia 60-65 tahun (28%), 66-70 tahun (36%), 71-75 tahun (19,3%), >75 tahun (16,7%). Polifarmasi terjadi pada 72% pasien geriatri dengan prevalensi kejadian DRP sebesar 72%. Penggunaan obat tersering yaitu antibiotik (73,3%), H2 antagonis (60,7%), antihipertensi (46 %), antiemetik (37,3%), NSAID ( 32%). Kejadian DRP tersering yaitu potensi interaksi obat (66%), dosis yang tidak tepat (17,3%) , pemakaian obat yang tidak perlu (16%), efek samping obat (14%), pemilihan jenis obat yang tidak tepat (8,7%). Potensi interaksi obat terbanyak yaitu pada obat ACE-inhibitor, diuretik dan antiplatelet. Duplikasi obat terjadi pada pemberian PPI dan H2 antagonis. Terdapat hubungan yang signifikan antara peningkatan jumlah obat yang diberikan dengan prevalensi terjadinya DRP (p=0,000). Tidak terdapat hubungan yang signifikan antara peningkatan usia subjek dengan prevalensi DRP (p=0,366). Risiko relatif pasien geriatri dengan polifarmasi mengalami DRP sebesar 1,822 (CI 95%: 1,291-2,569).Kata Kunci: Geriatri, permasalahan terkait pemberian obat, polifarmasi (≥ 60 years) ABSTRACT Drug-related problems often occur in hospitalized patients and the most common risk factors are the presence of polypharmacy and increasing of age. This research aims to determine the description of age, sex, number of drugs and the prevalence of Drug-Related Problems (DRP) in hospitalized geriatric patients. This research is a retrospective cohort study with a secondary data collection in geriatric patients

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Problems with Medication Use in the Elderly: An Australian Perspective

Cited by 121 publications

References 82 publications

Burning questions: Exploring the impact of natural disasters on community pharmacies

Burning questions: Exploring the impact of natural disasters on community pharmacies

Managing chronic pain in elderly patients requires a CHANGE of approach

Permasalahan Pemberian Obat pada Pasien Geriatri di Ruang Perawatan RSUD Saiful Anwar Malang

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