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Medication Related Problems

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  • 1. PREVENTING MEDICATION-RELATED PROBLEMS WEBINAR Dec 5, 2007 Featuring Patricia W. Slattum, PharmD, PhD, and moderated by Ayn Welleford, PhDPreventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 2. INTRODUCTION Medications are probably the single most important health care technology in preventing illness and disability in the older population. Avorn J., Health Affairs, Spring 1996Preventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 3. "Any symptom in an elderly patient should be considered a drug side effect until proven otherwise." J Gurwitz, M Monane, S Monane, J Avorn Brown University Long-term Care Quality Letter 1995Preventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 4. WHAT IS A MEDICATION-RELATED PROBLEM? Medication-Related Problem (MRP) An undesirable event experienced by a patient that involves or is suspected to involve drug therapy and actually or potentially interferes with a desired patient outcome.Preventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 5. “SYMPTOMS” of MRPs CHANGES IN SPEECH FALLS CONFUSION LOSS OF DEPRESSION APPETITE “SYMPTOMS” OF MRPs WEAKNESS OR DELIRIUM LETHARGY INCONTINENCE INSOMNIA PARKINSON’S-LIKE SYMPTOMSPreventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 6. TYPES OF MRPs Medical condition requires new or additional drug Correct drug, therapy that has not been dose too low. prescribed. Patient taking Correct drug, unnecessary drug given TYPES dose too high. present condition. OF MRPs Wrong drug for Adverse drug reaction patient’s medical or drug interaction. condition or age. Patient not taking drug correctly.Preventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 7. REASONS OLDER ADULTS ARE AT GREATER RISK FOR MRPs  Multiple chronic diseases  Multiple medications  Multiple prescribers  Physiologic changes associated with aging  Under-representation in clinical trials, particularly those over age 75  Shortage of professionals with specific training to work with older adultsPreventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 8. REASONS MRPs ARE NOT ADDRESSED  The patient has been taking this medication for many years without a problem.  One provider did not prescribe all of the medications the patient is taking.  Patients and prescribers are concerned that the risk of discontinuing the medication is greater than the benefit.  Patients often resist changes in their drug therapy (a stereotype).  The problems the patient is experiencing are not usually seen with this medication.Preventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 9. PREVENTING MRP 1 2 3 Communicate Designate a Keep a with health medication medication list care manager providers about medicationsPreventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 10. PREVENTING MRP 4 5 6 Consult with Use common Obtain refills a doctor or sense when in a timely pharmacist using manner before taking medications over-the- counter medication or herbal supplements .Preventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 11. TIPS FOR ADMINISTERING MEDICATIONS TO PATIENTS WITH DEMENTIA LANGUAGE Use clear and simple language. ROUTINE Develop a routine. Don’t assume the patient can manage MANAGEMENT medications on their own. ORGANIZATION Keep medications organized. Adapt medication administration to the ADMINISTRATION patient’s needs. STORAGE Store medications safely.Preventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative
  • 12. PANELISTS Dr. Patricia Slattum graduated with a B.S. and Pharm.D. in Pharmacy, a Ph.D. in Pharmaceutics, and a Certificate in Aging Studies from MCV/VCU. She received further training as a geriatric pharmacy fellow at McGuire Department of Veterans Affairs Medical Center in Richmond and as an NIH-funded postdoctoral fellow in aging and drug disposition at the University of North Carolina at Chapel Hill. Dr. Slattum joined the faculty at MCV/VCU School of Pharmacy in 1996, and is currently Associate Professor and Vice Chair for Graduate Studies in the Department of Pharmacy/ Department of Pharmaceutics at VCU. Her primary responsibilities include professional and graduate teaching, clerkship training and clinical program development in assisted-living and community pharmacy practice, and geriatric clinical pharmacology research focusing on central nervous system pharmacodynamics and medication- related problems in the elderly. She is a member of the American Society for Clinical Pharmacology and Therapeutics, the American Society of Consultant Pharmacists, the American College of Clinical Pharmacy, the Gerontological Society of America, and the American Geriatrics Society. Ayn Welleford, PhD, is Chair, VCU Department of Gerontology, Associate Professor,VCU Department of Gerontology, and Associate Director, Virginia Geriatric Education Center. Dr. Welleford received her B.A. in Management/ Psychology from Averett College, M.S. from the Department of Gerontology and Ph.D. in Developmental Psychology from VCU. She has taught extensively in the areas of Lifespan Development, and Adult Development and Aging. As an educator, researcher, and previously as a practitioner she has worked with a broad spectrum of individuals across the caregiving continuum. As a gerontologist she currently works extensively with formal and informal caregivers to improve elder care through education.Preventing Medication-Related Problems Virginia Alzheimer’s Commission AlzPossible Initiative