Abstract
Most clinicians recognize that the elderly take a disproportionately large number of medications compared to younger people and, as a result, they are two to three times more likely to experience adverse drug events (ADEs) [1]. Since pharmacologic therapy for chronic disease treatment is an essential component of the care of geriatric patients, optimization of their drug regimen is an important public health issue in the United States. The geriatric population is the fastest growing segment in the United States in that by 2030, 20% of the US population will be 65 or older. Appropriate prescribing, especially for frail residents of long-term care facilities (LTCF), is challenging due to multiple chronic diseases, limited physiologic reserves, changes in pharmacokinetics and pharmocodynamics, and impaired immune and inflammatory mechanisms. The physical disabilities of these frail elders can be significant. According to the Agency for Healthcare Research and Quality, 83% of nursing home residents receive assistance with three or more activities of daily living (ADL) that include bathing, dressing, toileting, transferring from bed or chair, feeding, and walking. Therefore, these frail elders with their disabilities are highly susceptible to the serious consequences of ADEs, such as hip fractures, weight loss, cognitive, and functional decline. As 27% of LTCF patients take 9 or more prescription medications daily, it should not be surprising that over 65% have ADEs over a 4-year period, while 1 in 7 of these ADEs results in a hospital transfer [2]. Therefore, the prevention and recognition of medication-related problems in patients is a principal healthcare quality and safety issue for LTC facilities, hospitals, and the ambulatory care settings.
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Marcolina, S.T., Swanson, K. (2011). Medication Management in Long-Term Care. In: Fenstemacher, P., Winn, P. (eds) Long-Term Care Medicine. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-60761-142-4_15
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