Proper medication management among older adults can be challenging. Older persons may not fully understand the purpose of the medication and the importance of following the prescription as directed. Over the counter medication, herbs and supplements may not be considered medication; therefore, they do not inform their health care provider that they are taking them. Multiple health care providers can result in duplication of orders or adverse drug reactions. Improper management of medication may lead to adverse drug events ultimately extending a hospitalization or decreasing an older adult’s ability to function safely. Obtaining an accurate record of medications at all points of care promotes safer medication administration and prevents adverse events.
Zwicker D., Fulmer T. (2012) Reducing adverse drug events (ADE) in older adults focuses on drug-drug interactions, drug-disease interactions, iatrogenic ADE’s, poor medication adherence, pharmacodynamics and polypharmacy. According to Zwicker D, Fulmer T. (2012) “Around 31% of all adverse events in hospitals are caused by medication-related problems.” This guideline is developed to promote safety in the hospital and after discharge. It is comprehensive in providing assessment tools to promote medication safety such as Beers Criteria and the Cockcroft Gualt formula to determine renal failure. The guideline assesses functional capacity in both independent activities of daily living and functional activities of daily living as well as cognitive capacity. Zwicker D, Fulmer T. (2012) advised completing a brown bag method of reviewing all medication as part of the assessment in order to include all medication an older adult has at home including over the counter medication herbs, and supplements. Assessment occurs on admission, at discharge and at intervals throughout the hospital stay.
In addition to assessment Zwicker D, Fulmer T.(2012) provide a framework for reducing adverse drug reactions through patient empowerment, interdisciplinary collaboration and following safe prescribing principles. To prevent iatrogenic ADE’s Zwicker D, Fulmer, T.(2012) looks at new symptoms, monitoring of medication orders offers suggestions for improving prescribing practices and documentation. Patient and caregiver education is central to preventing ADE’s, along with follow up and monitoring.
Zwicker D, Fulmer T. (2012) guideline on preventing adverse drug reactions is comprehensive, and I did not identify any missing topic.
The research method for Zwicker D, Fulmer T. (2012) is a meta-analysis with systematic review. This was completed by doing a hand search of published literature using Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Medline or PubMed. In med-line the researcher is able to tag articles specifically for meta-analysis and in CINAHL specifically for systematic review.
The panel used to develop Zwicker D, Fulmer T....