Many older adults take 10 or more prescription drugs daily, often prescribed by several different doctors. Not only can all those pills be difficult to remember and afford, they can have unpleasant side effects and interactions that are magnified in the frail elderly. The most recent issue of the American Society on Aging’s journal, Generations, takes on the controversies surrounding medication use in older adults. One of the articles, “A Primer on Medication Use in Older Adults for the Non-Clinician,” is freely available here.
I urge you to read the article and to get a copy of the entire issue, entitled “Medications and Aging” (full disclosure: I am on the journal’s editorial board). The articles cover a broad range of topics, including discussions of how to balance clinical practice guidelines and a patient’s quality of life; the role of interdisciplinary teams in reducing medication problems; and the importance of eliminating prescribing errors during care transitions. The articles mention key topics we have covered in the past, such as the Beers criteria, ACOVE, and PACE, and also cite work by Hartford-funded researchers specializing in care transitions, such as Eric Coleman and Mary Naylor.
We have supported a few other medication management initiatives that do not appear in the journal. If you want to see additional examples of possible solutions to the complex problem of medication management in older adults, take a look at Partner’s in Care’s HomeMeds, also known as the Medication Management Improvement System. Or, consider CHAMP, a partnership with the Visiting Nurse Service of New York. This home care improvement program includes a geriatric medication management course designed to help managers in home health agencies improve their medication management skills.
The problem of medication misuse in older adults has been around too long. It’s high time we relegated it to the past. We have the knowledge and programs we need; we just need to figure out how to spread that knowledge throughout hospitals, pharmacies, and doctor’s offices. Read "Medications and Aging" and let us know what you think we and the broader health care community need to do next to ensure that older adults are getting the right medications.