Nurse’s Roles in Caring for Older Persons with Polypharmacy: A Case Study
Keywords:
Polypharmacy, Nurse’s roles, Older personsAbstract
Polypharmacy is common among older persons due to chronic illness and comorbidity. The use of multiple drugs is thus required for illness treatment and prevention. Polypharmacy may lead to problems such as drug interaction, adverse drug reactions, poor medication adherence, and inappropriate medication use. These problems cause ineffective treatment outcomes and harm to older persons, which may result in severe morbidity requiring hospital admission, mortality, and increased healthcare costs. The situation from polypharmacy worsens among older persons because of physical changes from age-related degeneration that brings pharmacologic change including 1) pharmacokinetics change in terms of drug absorption, drug distribution, drug metabolism, and renal drug clearance, and 2) pharmacodynamics change. Moreover, chronic illness is another significant factor contributing to greater physical degeneration that causes pharmacologic change and increases the problems of polypharmacy.
Nurses who provide care for older persons with polypharmacy need to perform appropriate roles as follows: 1) assessment by using comprehensive geriatric assessment to gather holistic data in physical, psychosocial, and environmental aspects, reviewing the use of medication, food supplements, and herbs, and analyzing data based on understanding about age-related pharmacologic change and chronic illness; 2) coordination with healthcare teams to provide timely and proper support for older persons; and 3) counselors by giving advice consistent with the context of older persons and involving older persons and caregivers in decision-making.
This article reviewed the literature and used a case study of an older person with polypharmacy in a community to present the issue and apply knowledge for management according to the roles of nurses in providing appropriate and effective care for older persons with polypharmacy.
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