Polypharmacy, the use of five or more medications, is a common reality for geriatric patients. While medications play a vital role in maintaining their health and well-being, navigating a complex regimen can be challenging, potentially leading to medication errors, adverse drug reactions, and decreased adherence.

This article dives into optimizing medication management within the framework of geriatric care management. We’ll explore key strategies, considerations, and resources to ensure your geriatric patients receive the most effective and safest medication regimens possible.

Understanding the Risks of Polypharmacy in Geriatric Patients

Several factors unique to geriatric patients contribute to the challenges of polypharmacy:

• Physiological Changes: Age-related changes in metabolism, excretion, and drug sensitivity can increase the risk of adverse drug reactions.
• Cognitive Decline: Memory problems and confusion can hinder medication adherence and understanding of instructions.
• Multimorbidity: The presence of multiple chronic conditions often necessitates multiple medications, raising the risk of interactions.
• Functional Limitations: Difficulty with tasks like opening pill bottles or administering medications can lead to non-adherence.

The Geriatrics 5Ms: A Framework for Optimization

The Geriatrics 5Ms framework provides a holistic approach to optimizing medication management in geriatric care management:

1. Medications: This includes reviewing all medications, considering effectiveness, potential interactions, and dosage adjustments based on changing conditions or kidney/liver function. Utilize resources like the American Geriatrics Society Beers Criteria to identify potentially inappropriate medications for older adults.
2. Mobility: Assess a patient’s ability to manage their medication regimen. Can they open pill bottles? Do they require assistance with injections or inhalers? Consider simplifying regimens or using assistive devices to improve adherence.
3. Mind: Evaluate cognitive function and identify any potential impairments that could impact medication management. Implement strategies like pill organizers, medication calendars, and clear written instructions to enhance understanding.
4. Multimorbidity: Address the complex interplay of multiple chronic conditions and their associated medications. Prioritize medications for the most critical conditions and consider deprescribing, the process of tapering or stopping medications that are no longer necessary or beneficial.
5. What Matters Most: Focus on the patient’s goals and priorities. Involve them in medication discussions and tailor the regimen to their desired quality of life. Consider factors like treatment burden and potential side effects when making decisions.

Strategies for Effective Medication Management

• Medication Reconciliation: Regularly perform medication reconciliation at every patient encounter, especially during transitions of care, to identify and address discrepancies.
• Communication and Collaboration: Maintain open communication with patients and caregivers about their medications. Encourage them to ask questions and report any concerns. Collaborate with the patient’s family or caregivers to ensure everyone is on the same page regarding medication administration and potential side effects.
• Patient Education: Provide clear and concise education about medications, including administration instructions, potential side effects, and storage information. Utilize teach-back methods, where you ask patients to explain the instructions back to you, to verify understanding.
• Simplify Regimens: When possible, simplify medication regimens by minimizing the number of medications, using single-dose formulations, and considering long-acting medications.
• Leverage Technology: Explore medication adherence aids such as automated dispensing systems or medication reminder apps to provide additional support to patients.

In addition, there are tools you can integrate right into your EHR to streamline medication management. For example, integrating a robust e-prescribe solution would provide clinical decision support to help you stay informed of critical medication information for each patient; including allergy alerts, interaction checking, full medication history, and more. With this information readily accessible at the touch of a button, it can save you a significant amount of time while adding an extra layer of protection.

Take Away

By implementing a multifaceted approach that considers the Geriatrics 5Ms framework, you can optimize medication management for your geriatric patients. While each patient has unique requirements, challenges, and risks to remain mindful of, implementing these strategies and technological recommendations can help alleviate some of these risks.

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Integrating E-prescribe with your existing EHR grants you access to built-in clinical decision support like allergy alerts, drug interactions, and full medication history – making it significantly easier and safer to keep up with medication management for each patient. To learn more about how e-prescribe software can improve geriatric care management, schedule a demo of NewCrop’s leading e-prescribe software.