Emergency Room of the Future Improving Geriatric Medication Compliance through Doctor/Patient Communication Laura Salisbury, MID Ben Cleveland, MSHS Lee Sanghun, MSIE
Problem Statement Geriatric patients make up a large percentage of the Emergency Department population. Many take multiple prescription medications that could result in noncompliance, taking the form of underusing or overusing/altering prescribed dosage. Due to mental or physical disability, many geriatric patients are at risk for medical noncompliance during their dosage period after visiting an emergency room because they may be unable to fully communicate their current medicinal use to the prescribing doctor and understand or recall his/her prescribed medication information.
Related Literature& Research • 25% of all ER visits are geriatric • - Average 4.2 prescriptions per person • - Many patients cannot recall accurately current medications • and dosages • Current methods of communicating & • recording directions are not effective • Elderly patients find medication adherence difficult • - Cognitive & Physical impairment • - Multiple prescriptions
PossibleScenarios • Overuse/Altering Dosage Patient falls Attempt to describe current medication use Taken to ED with care-giver Forgets dosage info. Take medication whenever they feel urge Dr. makes diagnosis, prescribes dosage and discharges patient
PossibleScenarios • Forgetfullness Patient w/ mild dementia goes to ER for heart palpations Attempt to describe current medication use Dr. makes diagnosis, prescribes beta blockers, discharges patient After a long day, doesn’t remember to put the pills into daily pill container Forgets to take medication
Prospective Solutions • Physical Reminder System • Packaging design, digital display reminder • Medication Communication (between home & ED) • Automated telephone reminder, digital device • Medication Communication (within ED) • Type of paperwork given to elderly, digital passport of health history, physicians seen, and medication list
References • Adherence to emergency department discharge prescriptions • By: Corinne M. Hohl, MD, MHSc; Riyad B. Abu-Laban, MD, MHSc; Jeffrey R. Brubacher, MD, MSc; Peter J. Zed, PharmD; Boris Sobolev, PhD • Medication compliance in elderly people: influencing variables and interventionsBy: Cargill, Julie M. Journal of Advanced Nursing. Apr92, Vol. 17 Issue 4, p422-426. 5p. DOI: 10.1111/1365-2648.ep8530400 • Adherence Issues in Elderly Patients • By: Jeannette Y. Wick, RPh, MBA, FASC, Published Online: Thursday, January 13, 2011