This research area aims to improve care and overall quality of life for older adults by optimizing medication effectiveness and patient safety. Seniors are particularly at risk for medication-related problems and issues can involve the under- or overuse of medications, inappropriate prescribing, adverse reactions, drug interactions and lack of adherence to drug therapy. Opportunities for optimizing medications in older adults are now being identified and developed into research projects to inform clinical practice.
- Identifying factors that contribute to the safe and effective use of medications among older adults.
- Evaluating the effects of medications on patient outcomes in the geriatric setting.
- Investigating the overuse, underuse and misuse of medications prescribed to older adults.
- Educating physicians and pharmacists about medication strategies for older adults.
- Increasing involvement of older adults and families in medication decisions.
- Investigating potential medication-related contributors to falls among residents living in congregate care settings.
- Assessment of current patterns in psychotropic drug use for the treatment of dementia.
- Identifying knowledge gaps in fall prevention, particularly related to medication use, where education and training can be enhanced.
Tom Smillie, PharmD (University of Waterloo)
Ramesh Zacharias, MD (Schlegel Villages)
The goal of this collaborative initiative is to improve care and overall quality of life for older adults. In keeping with this commitment, the School of Pharmacy was charged with the responsibility of hiring a geriatric pharmacotherapy specialist who would focus on optimizing medication effectiveness and patient safety.
Included in the mandate is the need to:
- Identify and evaluate patient, clinician, and system factors that contribute to the safe and effective use of medications among older adults.
- Evaluate the effects of medications on patient clinical, psycho-social, and economic outcomes in the geriatric setting.
- Develop and use data repositories and novel population-based methods to optimize the uses of medications and to identify or confirm adverse events.
- Characterize general patterns of medication use to determine their effect on clinical, humanistic, and economic outcomes.
In an eye-catching publication from the U.S. Institute of Medicine (‘To Err is Human’), the authors (Linda T. Kohn, Janet M. Corrigan, and Molla S. Donaldson, Editors) indicate that:
Seniors are particularly at risk for medication-related problems. While medications are probably the single most important factor in improving the quality of life for older Americans, the nation’s seniors remain especially susceptible to medication-related problems due to physiological changes, higher incidences of multiple chronic diseases and conditions, and greater consumption of prescription and over-the-counter medications. It’s estimated that medication-related problems are among the top five greatest health threats for older [adults]. For example, 28% of all hospitalizations among seniors are due to adverse drug reactions, and 32,000 seniors suffer hip fractures each year due to falls caused by medication-related problems. In addition to medication errors, other types of medication-related problems include:
- Underuse of medications
- Overuse of medications
- Use of inappropriate medications
- Adverse drug reactions, including drug interactions
- Lack of adherence to drug therapy (patient noncompliance)