Patient sheet: tips for avoiding problems with polypharmacy

[A Prediction Model of Drug Misuse Behaviors in Community-Dwelling Older Adults]

PURPOSE

This study was designed to construct a model which explains drug misuse behaviors in community-dwelling older adults.

METHODS

The design of this research is a cross-sectional study using structure equation modeling. The hypothetical model consisted of two types of variables: the exogenous variables of health status, cognitive ability, and negative emotion, and the endogenous variables of number of drugs, and drug misuse behaviors. The data collection was conducted from September 2 to September 21, 2013 through self-report questionnaires. Participants were 320 community-dwelling adults over the age of 65 living in J city. Data were analyzed with SPSS 21.0 program and Amos 18.0 program.

RESULTS

The results of the model fitness analysis were satisfied. The predictor variables for the hypothetical model explained 62.3% of variance regarding drug misuse behaviors. Drug misuse behaviors were directly affected by health status, cognitive ability, negative emotion and number of drugs and indirectly affected by health status, and negative emotion through number of drugs.

CONCLUSION

These findings indicate factors that should be used in developing effective nursing interventions for safe and proper drug use and the prevention of drug misuse behaviors in community-dwelling older adults.

[Evaluation of a medication self-management education program for elders with hypertension living in the community]

PURPOSE

The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension.

METHODS

The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program.

RESULTS

There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure.

CONCLUSION

The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.

Drug-nutrient interactions in elderly people

PURPOSE OF REVIEW

The presence of multiple diseases, polypharmacy, malnutrition, and impaired metabolism in elderly individuals increases the risks of adverse events related to drug-food interactions. Some considerations for elderly people influenced by drug-food interactions are reviewed.

RECENT FINDINGS

When investigating pharmacokinetic and pharmacodynamic modifications in the elderly, other factors have to be considered, such as anorexia, dementia, depression, intolerance, gastrointestinal-tract disorders, social and economic factors, reduced abilities (visual and manual) and difficulties in chewing or swallowing. Specific reference is made herein to the health status of the elderly Brazilian population based on the observations of our research group. In addition, the most common diseases (such as cancer, coronary heart disease, dementia, diabetes mellitus, hypertension and osteoporosis), the drugs usually prescribed to treat them, and the adverse nutritional reactions that occur in older patients are summarized.

SUMMARY

In order to develop a correct drug prescription plan and nutritional intervention to avoid any kind of undesirable drug-food interaction effect, it is necessary to adequately diagnose the disease and often re-evaluate the chosen treatment, identify disease stages and the necessary therapies to minimize the number of drugs administered, and select a reasonable nutritional assessment.