Pharmacotherapy

Article submitted by Pharmacotherapy Consultant Services of Alabama.
For more information, they can be reached at 205-966-9464.

RxCS provides individual pharmacy consulting services. These services include education to the individual patient and/or caregiver pertaining to their medications and disease states. Through this education, this gives the patient and/or their caregiver the information needed to partner with their physician to manage their healthcare. The goal of these services is to improve overall healthcare and to promote safe and effective use of all medications, including, prescription, non-prescription, vitamins and herbal products. Medication regimens are reviewed for any medication-related problems. A report is provided to the patient and/or caregiver and physician, where appropriate.

With the healthcare system becoming more complicated, i.e. patients having several physicians and multiple disease states, it is very important for patients and/or their caregivers to be well-informed healthcare consumers. 25% of all nursing home admissions are due to the inability to manage medication therapy. The 85+ age group is the fastest growing population. We are all living longer thanks to the many advances in the medical field. Medication therapy is usually the central focus of one's healthcare. It is crucial that all patients become educated on these therapies in order to improve their outcomes.

Patients over the age of 65 make up about 13% of the overall population. Of these individuals, they consume about 42% of the total annual prescription spending. Medication-related problems result in 28% of hospitalizations in the elderly and is the fifth leading cause of death. Medication-related problems are defined as "any undesirable event(s) experienced by a patient that involves or is suspected to involve drug therapy and actually or potentially interferes with desired patient outcome". Any new symptom in an elderly patient should be considered a drug side effect until proven otherwise. Before a new drug is added to a regimen, the medication regimen should be reviewed for a possible discontinuation of another medication.

Some reasons seniors are at a greater risk for developing medication-related problems are:

• multiple chronic diseases
• multiple physicians
• multiple medications
• types of medications prescribed
• under-representation in clinical trials, particularly those over age 75
• a shortage of trained professionals in geriatric pharmacotherapy

Some possible symptoms of medication-related problems are:

• confusion
• depression
• insomnia
• Parkinson's-like symptoms
• incontinence
• weakness, fatigue, or drowsiness
• loss of appetite
• falls
• changes in speech

Another reason the elderly are at a greater risk for developing medication-related problems is that " a given dose of a given medication produces a different and sometimes unexpected response in an elderly patient compared to a younger patient of the same gender and similar body weight". As we age, many changes occur in our body that affect the way drugs are distributed throughout the body, how they perform their actions and how they are metabolized and removed from the body. There is an overall decline in body systems function. Body composition changes with an increase in body fat, decrease in water and decrease in muscle mass.