Medication Safety for Older Adults Learning Objectives Why is medication safety important? What is a medication-related problem? Are you at risk for a medication-related problem? How can you avoid medication-related problems? How to read prescription and nonprescription labels What you need to know about nonprescription medications and dietary supplements Tips for medication safety Why is Medication Safety Important? Older adults use more medications than the general population About one third of people over age 75 take five or more different prescription medications daily1 Older adults are at an increased risk One in 25 older adults who regularly use prescription medication are at risk of having a serious drug-drug interaction2 Older adults are seven times more likely to be hospitalized due to an adverse drug reaction compared to younger people2 What is a Medication-Related Problem (MRP)? A medication-related problem is an event or situation involving drug therapy that negatively interferes with a patient’s health.3 Are You At Risk? 4 Do you take five or more medications? Do you take medication that requires frequent blood tests or monitoring? Do you see more than one physician who prescribes medication for you? Do you get prescriptions at more than one pharmacy? These questions show some of the conditions that may put people over 65 at risk for a medication-related problem. 5,6 Avoiding Medication-Related Problems If you experience one or more of the following: Confusion Falls Drowsiness Dizziness Hallucinations Slurred Speech Incontinence/Difficulty Urinating Diarrhea/Constipation Bruising/Bleeding Have your doctor evaluate symptoms to determine if they are related to any of your medications Avoiding Medication-Related Problems (cont’d) Create a Personal Medication Record (PMR) A PMR is an up-to-date list of ALL your prescription and nonprescription medications, including the dosing schedule Keep your PMR with you at all times Bring PMR whenever you visit the doctor, hospital, or pharmacy Avoiding Medication-Related Problems (cont’d) Visit http://www.hqsi.org and look under Medicare Consumers, Resources for links to PMRs or call 1-732-238-5570, ext. 2019, for a free copy Avoiding Medication-Related Problems (cont’d) Make sure you can read and understand all information on the medication bottle There are different kinds of medication labels Prescription medication labels Nonprescription (over the counter – OTC) medication labels Dietary/herbal supplement labels They contain different kinds of information Avoiding Medication-Related Problems (cont’d) ■ Prescription Drug Label Local Pharmacy 123 MAIN STREET ANYTOWN, USA 11111 (800)-555-5555 Directions Dr. John Smith NO 0060023-08291 Date: 01/01/10 about how Jane Smith and when 456 Main Street, Anytown, USA 11111 to take TAKE ONE CAPSULE BY MOUTH THREE TIMES drug DAILY FOR 10 DAYS UNTIL COMPLETED AMOXICILLIN 500MG CAPSULES QTY #30 MRG Drug name NO REFILLS and strength USE BEFORE 10/10/10 SLF/SLF Avoiding Medication-Related Problems (cont’d) Reading prescription label directions Directions on label What it means Two tablets twice a day Take two tablets in the morning and two in the evening (Four tablets a day total) Take 5 mL three times a Take one teaspoonful day for seven days three times a day for a total of seven days – use a medication spoon or cup Avoiding Medication-Related Problems (cont’d) Teaspoon and Tablespoon are NOT the same! Always use medication measuring spoon Teaspoonful Tablespoonful Avoiding Medication-Related Problems (cont’d) 5 Additional Labels Additional labels provide important information about your medication Reading and understanding these labels can help prevent medication errors Avoiding Medication-Related Problems (cont’d) OTC Medication Label 6 Drug name and strength Warnings and side effects Directions about how often to take/maxi- mum dose Avoiding Medication-Related Problems (cont’d) Ask questions and share information about your medications with your doctor and pharmacist Examples of questions to ask What is the brand and generic name? What is it for? How will I know if the medication is working? What are possible side effects and drug interactions I should know about? ■ Examples of information to share with doctor/pharmacist Any changes in the drugs you take (new drugs you have started or others that have changed or stopped) Any symptoms you are experiencing Any nonprescription medications, vitamins, or supplements you take Avoiding Medication-Related Problems (cont’d) Medication Tips - Simple Steps for Medication Safety Visit http://www.hqsi.org and look under Medicare Consumers, Resources or call 1-732-238-5570, ext. 2019, for a free copy Nonprescription Medications and Dietary Supplements Common Nonprescription Common Supplements Medications Ginkgo Biloba Cold/Cough Remedies Garlic Glucosamine Allergy Medicines Co-Q-10 Heartburn/Ulcer Treatments Niacin Pain Medications Omega-3 (Fish Oils) – Tylenol® Saw Palmetto – Advil® Vitamins – Aleve® Herbs Digestive Aids Nonprescription Medications and Dietary Supplements (cont’d) Read warnings and directions carefully Ask pharmacist/doctor for assistance Know the potential side effects and drug interactions of supplements you take Visit http://medlineplus.gov and click on “drugs and supplements” for information on specific products Visit http://www.hqsi.org or call 1-732-238-5570, ext. 2019, for a copy of the newsletter, Medication Safety You: Understanding Dietary Supplements Tips for Medication Safety Tell your doctor about any possible medication- related problems Keep an updated PMR at all times and bring it with you to the doctor, hospital, or pharmacy Use a calendar or medication organizer to help you remember what you need to take and when Know how to read prescription and OTC labels Tips for Medication Safety (cont’d) Make sure you can read and understand the directions on prescription and OTC labels and bottles Read additional labels and other drug information provided Know the possible side effects of your prescription medications and supplements Ask your doctor and pharmacist about how you can safely take OTC drugs and dietary supplements Conclusion It is important to know your risks and share information about possible medication-related problems with your doctor A PMR can help you manage your medications better Understanding how to read labels can help prevent medication errors and problems It is important to understand your prescription and nonprescription medications and dietary supplements Questions? References 1. Qato DM, Alexander GC, Conti RM, Johnson M, Schumm P, Lindau ST. Use of prescription and over- the-counter medications and dietary supplements among older adults in the United States. The Journal of the American Medical Association [Internet]. 2008 Dec 24 [cited 2010 Jan 7]; 300(24):2867-2878. Available from: http://jama.ama-assn.org/cgi/content/full/300/24/2867. 2. Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL. National surveillance of emergency department visits for outpatient adverse drug events. The Journal of the American Medical Association [Internet]. 2006 Oct 18 [cited 2010 Jan 7];296(15):1858-1866. Available from: http://jama.ama-assn.org/cgi/content/full/296/15/1858. 3. SeniorCarePharmacist.com. What is a Medication Related Problem? [Internet]. Alexandria, VA: American Society of Consultant Pharmacists. [date unknown] [cited 2009 Jun 1]. Available from: http://www.seniorcarepharmacist.com/mrp/. 4. SeniorCarePharmacist.com. Do You Need a Senior Care Pharmacist? [Internet]. Alexandria, VA: American Society of Consultant Pharmacists. [date unknown] [cited 2009 Aug 31]. Available: http://www.seniorcarepharmacist.com/1.html. References (cont’d) 5. SeniorCarePharmacist.com. How are Seniors Affected by Medication Related Problems? [Internet]. Alexandria, VA: American Society of Consultant Pharmacists. [date unknown] [cited 2009 Jan 31]. Available from: http://www.seniorcarepharmacist.com/toll/. 6. Gurwitz JH, Field TS, Harrold LR, Rothschild J, DeBellis K, Seger AC, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. Journal of the American Medical Association. 2003 Mar 5;289(9):1107-1116. Available from: http://jama.ama-assn.org/cgi/content/full/289/9/1107.
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