Question
Asked 30th Oct, 2012

What are the main factors for self-medication mistakes among the elderly?

Elderly living on their own.

Most recent answer

26th Jul, 2013
Sharon W Stark
Monmouth University
There are many factors that contribute to medication mistakes among the elderly. Inadequate or unclear instructions given by health care provider can be moderated by providing instructions in writing and explaining the reasons for taking particular medications and having patients repeat the instructions back to the provider. Prescribing medications that are inappropriate for the geriatric population is problematic when health care providers do not heed differences in prescribing between younger and geriatric patients. Fragmented medical care where elders have multiple health care providers for specific disease states is a problem when health care providers do not communicate and/or collaborate while caring for the elder, thus, prescribing similar medications that subjects patients to a high probability of consequences from overdose, toxicity and organ failure. Elders often overlook the fact that over-the-counter (OTC) medications and/or herbal preparations for ailments that are being treated with prescription medications can be dangerous because they do not see a connection between OTC, herbal preparations and prescription medications. Sharing mediations between friends with similar ailments potentiates misdosing, side effects, catalyzing and/or thwarting the effects of prescribed medications. . Elders often adjust medication dosing according to their perceived effects instead of following directions. For example: If one pill makes me feel 50% better, than two pills may make me feel 100% better. Other issues include taking medications only when symptoms are present , not taking them when they are not, stopping medications when they are perceived to not work quickly enough or when side effects are bothersome, instead of giving time for medications to reach therapeutic levels, rationing medications because of financial burden, and “forgetting” to take medication (especially when multiple daily dosing is required) because there is no routine or organized system for dispensing and taking medications or there is cognitive impairment (identified or nonidentified) that renders elders incapable of managing their medication regime and so facilitates mediation errors. There are a myriad of other reasons that I have not mentioned. The bottom line is that more research related to appropriate and safe medication use among the elderly is better understood so that medication errors are minimized.

Popular answers (1)

16th Nov, 2012
Ben Keet
Vrije Universiteit Amsterdam
Self medication assumes correct diagnosis and full knowledge of options available and side effects to be expected especially in relation to existing pathophysiology and interaction with other drugs already taken. The elderly would unlikely take full advantage of internet available information and even if they did would require significant medical knowledge and experience to correctly select the right medication and dose. So best advise is to consult a GP / family practitioner and use a pre-loaded dispensing box which gets filled up on a weekly or fortnightly basis by the area nurse.
6 Recommendations

All Answers (51)

31st Oct, 2012
Amir Haider
University of Karachi
Deniz Kaya,
Please follow the link may be its helpful for you http://www.bioline.org.br/pdf?am08027
1st Nov, 2012
Chandra Sekar
The University of Findlay
Deniz: It is possible some of the following factors are mentioned in the above mentioned link, but three major ones are - 1) memory loss 2) unable to remember correct instruction or whether they have taken the drug 3) deterioration of vision . Pill dispense that can electronically remind patient to take the drug may be one solution.
1 Recommendation
1st Nov, 2012
Krzysztof Sollohub
Medical University of Gdansk
It is also possible that:
1) due to different illnesses elderly patients can't swallow solid oral dosage form, what leads to dose skipping
2) there is lack of water to drink with solid oral dosage form, which also causes dose skipping or grug admission in wrong time
1 Recommendation
5th Nov, 2012
Mercedes Cócera
Bicosome Co.
The slow metabolism of elderly people requires sometimes the decrease the dosi
6th Nov, 2012
Barbara Małgorzata Kalenik
Nencki Institute of Experimental Biology PAS
Mercedes - Don't you think that age-related changes of metabolism should be taken into consideration by a doctor and have nothing in common with self-medication mistakes?
1 Recommendation
6th Nov, 2012
Dennis Enix
To help guide decision making you can find an updated version of the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (2012).
1 Recommendation
7th Nov, 2012
Esther Iecovich
Ben-Gurion University of the Negev
Cognitive impairment
7th Nov, 2012
Daniel S Sitar
University of Manitoba
Use of unit dose packaging is an important tool to minimize drug ingestion errors in those patients who have difficulty in remembering which drugs to take and when to take them. The packaging with which I am most familiar involves preparation of a week of medications into four daily bubbles than can be monitored to support appropriate administration of chronic therapies. This approach is quite useful when there are multiple and potentially confusing regimens among the prescribed drugs.
2 Recommendations
10th Nov, 2012
Senthil Kumar Kurunthachalam
Water Research Institute
The following factors are so common; over dosage, anxiety, fear, memory loss, etc.,
1 Recommendation
12th Nov, 2012
Munira Husain
MJB Govt. PG College, Moti Tabela, Indore
I need clarification regarding the word self -medication, whether it is regarding taking decision of medicines by their own or taking prescription of medicines by themselves? because we could find both practices in elderly and both have different implications and consequences.
1 Recommendation
13th Nov, 2012
Daniel S Sitar
University of Manitoba
Unfortunately, both situation identified by Munira Husain occur and complicate management stratgies as is already identified in that communication.
15th Nov, 2012
Munira Husain
MJB Govt. PG College, Moti Tabela, Indore
beside technical strategies for the prevention of medication accidents among elderly, it is also needed that we should identify common errors in taking medicines and methods of their simple rectification like some specified coloring of the drugs or packaging on the basis of their contraindications or precautions while taking them as Daniel has also suggested.
I am sharing my personal experience in this regard; my 90+ father who was quite an educated and sensible person took double dose of similar medicines which his Doctor gave him in two different packets asking him to take doses from one packet during 1st week and from another afterwords but my father forgot and took medicines from both packets together. this incidence caused severe consequences which could be fatal but he understood his mistake after taking the medicine and make us aware about the mistake so that it was managed safely.
hope that we could find some simple messages to make them alert or educate the elderly about the proper methods of taking medicines.
5 Recommendations
15th Nov, 2012
Syed Umer Jan
University of Balochistan
Although the unit dose packaging minimized the situation in developed countries but it is still a big problem in developing countries. The main factors in elderly are loss of memory and some time un-conciousness.
16th Nov, 2012
Anelia Stojczew
I think that main main factor for self-medication mistakes among the elderly is taking many medication at the same time, ignoring drug interactions that can be source of drug over- or underbioavailability of active substance. One drug can increase other drug adverse reaction or reduce its activity. I think that it is need to monitor drug taking by elderly.
16th Nov, 2012
Mercedes Cócera
Bicosome Co.
completely agree with Anelia
16th Nov, 2012
Ben Keet
Vrije Universiteit Amsterdam
Self medication assumes correct diagnosis and full knowledge of options available and side effects to be expected especially in relation to existing pathophysiology and interaction with other drugs already taken. The elderly would unlikely take full advantage of internet available information and even if they did would require significant medical knowledge and experience to correctly select the right medication and dose. So best advise is to consult a GP / family practitioner and use a pre-loaded dispensing box which gets filled up on a weekly or fortnightly basis by the area nurse.
6 Recommendations
17th Nov, 2012
Rita Kurdelas
National University of Patagonia San Juan Bosco
I agree with Anelia in the importance of interactions. In addition patients rarely inform their doctor what they are taking without prescription (including herbal remedies). Probably they believe this medication is absolutely innocuous. Education level may be a variable in this considerations.
19th Nov, 2012
Padmakar Pandit
B. J. Medical College & Sassoon Hospital
There are many factors that lead to medication errors and some of them are common to all patients. Discussing a few important ones below:
1. A patient would not take a particular dose if one feels it is not needed, say e.g. not taking a day's antihypertensive believing that my BP is ok today.
2. A patient would not take a particular dose if one feels that a particular drug has cause some adversity / side effect and that another dose shouldn't enhance it. say eg. nausea and vomiting may dictate skipping a dose of any drug that patient believes is causing the trouble.
3. Apart from the patient's idea about therapeutic efficacy or ADR induction, polypharmacy is a very major factor. Compliance would decrease in proportion to the number of drugs / doses prescribed.
4. Specific to the aged, it is comorbidities, that demand the use of many a drugs simultaneously.
5. So also the dementia, as the confusion and cognitive dysfunction will deteriorate the medication accuracy.
Of course such factors can to a large extent be negated by a sensible caretaker who looks after the old patient. Such system is commonly prevalent in the eastern countries, specially India, where the family members take the responsibility of giving medicines to the older in the family.
However this is an important issue and all efforts should be taken to ensure avoiding medication errors so as to yield therapy benefits without significant toxicity,
1 Recommendation
19th Nov, 2012
Ankush Madaan
Stanford University
Anxiety, forgetfulness, preemptive precautions, amnesia,
1 Recommendation
20th Nov, 2012
Nikhil K. Sachan
University Grants Commission, India
We should avoid, as far as possible, self medication especially in case of elderly because of their poor ability to recognize the right medication, forgeting to take the requisite dode in time, high risk involved due to reduced liver function, and associated anxiety in them.
7th Dec, 2012
Shanmugam Vippamakula
Sri Padmavathi School Of Pharmacy
Thank You Munira madam, you have given a nice answer for your own question.. but it is true...
7th Dec, 2012
Riette Broers
South African Nursing Council
I am a nurse at a retirement village. The major mistakes in self-medicating are usually due to loss of memory brought on by aging, Alzheimer's, dementia, major depression which could also include dementia and severe illness ( which could include hypertension) . Time unconciousness plays a lesser role. Polypharmacy is also a huge contributor. Some patients go to more than one physician and are then prescribed the same meds but in different generic forms and end up taking them all, for example hypertensives - this however is not common. The " I feel better today" factor also comes into play but actually most of the elderly take their meds religiously. Financial reasons can also play a role and that together with the " I feel better today" can lead to them not taking their chronic meds every day.
1 Recommendation
20th Feb, 2013
Mohd Shakrie Palan Abdullah
National Pharmaceutical Regulatory Agency
self-medication errors or mistakes might be due to as what most of my above fellow friends have mentioned. But as a pharmacist we have to play much more critical role during dispensing. Elderly people would like some doctors or pharmacist to have a listening ear. Then only the diagnosis would be correct and when dispensing any drug for the elderly, staff should be careful. That to is the responsibility of the younger generation. They have to take care of their medication when they are waded and thus would be able to play their part when they are back at home.
This would first help them from getting any other drug... Drug interaction would be the pharmacist and doctors responsibility and not the patients. I have the feeling the law in drug enforcement in every country are in place. Thus it is our responsibility being children and the younger generation. Also when the medication is dispensed it should be supplied according to visit. Any if there is a change of drug or addition of drug it should be detected by all parties such as pharmacist, doctors and nurses.
20th Feb, 2013
Syed Umer Jan
University of Balochistan
I agree with Anelia in the importance of interactions. I just gone through the medicines of a ralative (visited us just now) having eight medications at the same time. OMG. In addition, it is also true that patients rarely inform their doctor what they are taking without prescription at home which is other factor of interaction. This problem needs to be taken care of at every level espacialy by the Pharmacist.
21st Feb, 2013
Yahia Tamime
Université de Sherbrooke
The misunderstanding of the action of drugs. They might think that Natural remedies means SAVE. Which is not true. The other major concern is Dr google. Everyone has accept to tremendous number of informations in a blink of an eye. Elder people now '' google'' informations regarding their health concerns. They do self-diagnosis, self treatement. Internet and social media are making health information available to everyone.
Other causes could include bad doctors, low quality treatment. So people turns away from Doctor and see self medication as an alternative.
21st Feb, 2013
Alok Nahata
Dr. Harisingh Gour University
Many a times elderly people are pretty anxious about their health problems. It is in their mind that if we forget to take a particular medication, it can be very serious because of their age factor. Another thing is the ignorance about the medication. Most of them will remember the drugs by the color of the tablet, capsule or the packaging of the strip etc. If in case two similar packages are available, they incidently take the wrong medication. This is the scene about the doctor prescribed medication actually.
As the question says, self medication, it is very obvious in cases where elderly people come to know about certain drugs from their friends and relatives which might not be useful for them. But when a person of their same age is being benefited by that drug, they will give a try to that drug in most cases. This is one of the very big factors other than the stated causes by other experts. We can say it as oral popularization of a particular drug by friends or relatives of the same age. Many times it is also suggested by friends to take a particular drug for it has helped them in their health problems. In such cases chances of side effects are very high.
Another factor is the advertisements of the drugs on the television and social media which has a deep impact on the person who is in a deep suffering in his old age. He will try to get rid of the problem through any means regardless of the consequences.
One more reason I feel is the existence of many systems of healthcare. Allopathic, ayruvedic, homeopathic, Unani, Chinese systems exist together in our society. When there is a delay in response with any of the therapies, they are very prone to switch to other system which might cause severe problems because every system has its own way of treatment.
Thanks and regards
1 Recommendation
21st Feb, 2013
Syed Umer Jan
University of Balochistan
Very correctly elaborated Dr. Alok. Same is the situation with us here in our Country.
24th Feb, 2013
Kaye Ervin
University of Melbourne
There are many reasons for compliance and non compliance to prescribed therapeutic medicines in all age groups - the main one being able to feel the effects, ie, if a patient omits analgesics, they will feel pain, or if they omit their antihypertensive they may experience dizziness. Not so with drugs such as statins, and as such they have the lowest compliance,
In elderly populations compliance (or non compliance) is frequently linked to memory loss or purposeful exclusion due to adverse effects. Memory loss is very serious and there is much evidence that elderly people are frequently hospitalised from under/over administering prescribed medications.
There are screening tools available that can demonstrate whether an elderly person has the capacity to self medicate (including manual dexterity).
2 Recommendations
Deleted profile
It may depend on the population. If cognition is not impaired at least moderately, the main reasons seems to be anxiety or concerns about possible side effects, which is primarily driven by the media and the ‘’neighborhood’’, depression, and sometimes ''feeling well and thinking of going without pills anymore''.
6th Mar, 2013
Márcio Galvão Oliveira
Federal University of Bahia, Vitória da Conquista, Brazil
Can anyone point me to references of screening tools available that can demonstrate whether an elderly person has the capacity to self medicate?
7th Mar, 2013
Vasundhara Challapalli-Moses
Counties Manukau District Health Board
Dementia - Vascular, Alzheimer's or mixed, Delirium from a Chronic infection, Confusion, Depression, lack of education, polypharmacy. Medication review at every GP visit is essential for senior citizens to avoid accidents with over dosing. Blister packs are a solution but not always. Keep medication to a minimum for those over 65.
13th Mar, 2013
Kaye Ervin
University of Melbourne
In reference to Marcio Oliveira's question, here is a link to Psychometric Evaluation of a Self-Medication Assessment Tool in an Elderly Population.
There are many others, and all are useful and a good indicator of true capacity. Hope it helps.
16th Mar, 2013
Guillermo Acebedo
Columbia University
Most of the time the elderly do not remember the exact name of medications.
17th Mar, 2013
Lisa Hardee
Western Carolina University
Guillermo - precisely! It is not only the elderly who are confused about medication names, but the general population can be affected. Generic and trade name confusion is common with medical and nusring staff, hence the TaLLmAn lettering with drug names. If trained personnel cannot keep the drugs straight, why do we presume that patients are capable of doing a better job?
24th Mar, 2013
Michelle Mallett
University of Phoenix
Self medication can be defined in many ways and for many reasons. The elderly want to remain responsible for their care s long as they can. To self medicate via dr. google they are most likely trying to save money with prescriptions they get from pharmaceutical companies outside the U.S. in order to save money. Some try over the counter medications in place of the prescribed medications because they can not afford the prescription. Others simply do not like taking medication.
EXAMPPLE:
I accompany my mother to various doctors appointments so that I know what she is taking and when, they in turn call me if there is a change that I need to know about. This keeps her safe and me in the know, she is still responsible for her medications and we go over each of them briefly periodically to ensure she understands the neccessity of each. What everyone needs to remember is that many elderly today are set up better than those of 20 years ago but not so well that they are not going to need help periodically.
24th Mar, 2013
Diana Rodríguez Hurtado
Universidad Peruana de Ciencias Aplicadas (UPC)
The diagnosis and treatment by themselves (elderly people) is a big mistake..
However, after of the prescription by a Medical Doctor, the patients can make errors:
1.- Because they could have deterioration of functions of the organs of the senses: of sight and of hearing.
2.- Deterioration of the memory leads : to repeat the doses (unnecessary) or that they forget to take the medicines.
3.- it´s necessary the presence of caregivers that supervise the administration of the medicines .
The caregiver could be a relative or a technical assistant.
Sincerely.
Diana Rodríguez Hurtado M.D F.A.C.P
Internal Medicine - Geriatrics
"Universidad Peruana Cayetano Heredia" Lima, Perú.
1 Recommendation
30th Mar, 2013
Juan Carlos Morales Ruiz
Fundación Universitaria del Área Andina
Other possible errors in taking medications may be psychological or psychiatric disorders, loss of control  locus of control, polypharmacy and attention difficulties.
1st Apr, 2013
Michelle Mallett
University of Phoenix
I believe your answer is a valid one and should be considered by those providing care to the eldely. Periodically checking their self admistering of prescribed medication should be incorporated into their routines of daily living skills. Due to the immense number of mental disorders that go untreated due to lack of reporting and errors from pharmacists I encourage the occassional checking for correct self medicating seniors. I also encourage those I come in contact with to leave their medications in their original containers and not predeistribute them to other containers. This allows an accurate count of medications if the need should arrise. I am all in favor of blister packs for the elderly that do dispense their own medications.
3 Recommendations
4th Apr, 2013
Nichakarn Songthai
Naresuan University
Knowledge awareness and intension are factors that factors for self-medication.
If they do not have it They will self-medication mistakes. And,
Among the elderly who decline about cognition and physical change, They should have support for right drug, righ dose and right time.
6th Apr, 2013
Javier Galindo-Ocaña
Hospital Universitario Virgen del Rocío
It is well known that the first impaired instrumental ability among elder people is the management of medication. As it is the first one, many caregivers are not aware of his beloved one disability. This impairment may be quickly assessed by a Lawton-Brody index administration.
On the other hand, adherence to medication is multidimensional as reported by the WHO (Adherence to long-term therapies. Evidence for action. World
Health Organization; 2003). Involved factors are the disease by itself, healthcare model (continuity of care and proactive model vs. acute-process-oriented healthcare model, changes of family physician, community qualified pharmacist vs. drug shops), drug factors (adverse effects, availability, easy to take or not, complex posology, changes of box color after prescription by active ingredient, symptomatic treatments vs. pathophysiological one, etc.), culture and social factors (misbeliefs about medication, illiteracy, economical, etc.), availability of a caregiver, as current tendency is providing only short time visits and payed caregivers instead of old well-structured families with continuous support, disease factors (multimorbidity or franc polypathology with huge polymedication, dementia added to other diseases, cardiovascular diseases which associate to polypharmacy). All these interacting factors influence the active decision of taking one drug or not, or the provision of continuous feed-back between healthcare professionals or its absence.
When an old person has to copy with a 20 different drugs regime alone, he/she should be in a very fitted mind status or medication errors will be the rule. He/she will try to reduce medication doses, to prevent adverse effects, opting between drugs which probably he/she actually does not understand well. In my experience, many elders comply those oral cardiovascular drugs with less adverse effects, and they try to abandon those with potential severe adverse events as NSAIDs or opioids, those with intrinsic difficult to administer as inhaled drugs, but keep taking those subjectively important for their diseases (been evidence-based or not) as rheological drugs, citicoline, proton pump inhibitors (been needed or not) antihypertensive drugs or aspirin. They even would take two duplicated antihypertensive drugs if they are badly prescribed (i.e. two candesartan with different trade names).
Thus, disabled old persons will very often have any degree of cognitive impairment affecting drug adherence and medication errors. If a full-tiime caregiver is available, and the physician or pharmacist have provided enough medication knowledge to foster empowerment, these barriers would be mostly overcome. Any feed-back system (organizational, digitally or personal support) would help to detect medication errors and lack of adherence. Those models with effective interaction between physicians/nurse and pharmacists have shown much better results than pharmacists led programs with no physician or nurse participation, as social, disease-related, medical records, and personallly transmitted information are very important.
2 Recommendations
7th Apr, 2013
Gilles Berrut
Centre Hospitalier Universitaire de Nantes
The main factors for self-medication mistakes were related to neuropscyhological disorders and must be integrated in the adherence scale in the futur
1 Recommendation
12th Apr, 2013
Michael Puckett
Independent Researcher
From discussions with members of a health plan who are dual-eligible with Medicare and Medicaid, I have seen how the elderly are undermedicating. Beneficiaries (members) will sometimes only take a medication after experiencing physical manifestation of a condition. For example, a health plan member does not start taking her Lasix until she sees her feet with pitting edema. Another only takes 1/2 a pill to make medication last longer. Often I found cost to be the biggest barrier to medication adherence. Since HMOs, as a replacement for straight Medicare and/or Medicaid, can produce their own formulary and cost structure, the elderly simply cannot afford the costs. Pharmaceutical companies will assist people who have no insurance, but often exclude Medicare and Medicaid people from their cost-saving co-pay assistance programs. What most medical professionals fail to consider is the biopsychosocial aspects of holistic care. Maybe social workers and mental health workers should be part of a routine office visit. Most independent practices cannot afford this level of care. So, identification of the root cause of the elderly self-medicating and undermedicating is up to the medical community to identify the solution and not just concentrate on the desired outcome.
1 Recommendation
12th Apr, 2013
Michelle Mallett
University of Phoenix
Something else to consider as long as we are throwing these stone about self medication is this: My mother recently had emergency open heart tripple by-pass surgery. They discharged her two days early from the hospital, and changed or deleted several medications. Once discharged the floor nurse came in and ran through her instructions without the consideration that this was an eldrly individual that may not understand what was being said but too affraid to ask to needed questions. They were ready to send her home with no help once she got there. This is how errors, over medication and undermedication happen. If we are going to work in the field it needs to be done correctly and with compassion, care, and understanding.
1 Recommendation
17th Apr, 2013
Javier Galindo-Ocaña
Hospital Universitario Virgen del Rocío
Well, I forgot you were asking especifically about self-medication. In the US, 80% of drugs are self-prescribed. It is due to economical factors as there is no well structured public health system there (I think), and many elders try to save some money avoiding medical consults. Nevertheless, I don't think that one patient's relatives consider self-medication or not professional help to treat severe chronic conditions. So most of the problems would appear from heathcare. Transition gaps, multiple specialists after doctor shopping with lack of information sharing, and other factors are well known to be variables leading to a lack of continuity of care, in a reactive model which is not designed to attend the needs of elders with commonly more than 3 chronic conditions.
Although more and more old people get connected to internet every year, most of them are not able to do it, and their care is provided by younger caregivers, being their daughters the main character in the play.
I don't know if there is any evidence regarding your question, which occurs in a very complex reality by itself. However you can watch through the cracks and try to get answers from all the different answers together.
1 Recommendation
18th Apr, 2013
Michelle Mallett
University of Phoenix
Self-prescribing in the United States is not a factor and definately not at 80%. The considerations here are aimed at the elderly and disabled that do not have the capacity to understand, remember or know what medications they are to take at what time of the day. The transition gaps you bring up are generation centered. Older physicians practice medicine to keep people alive, younger physicians practice medicine to improve the quality of a healthier longer life. The generations need to merge and make special considerations for their elderly patients so these mistakes are fewer. We need to work as teams if we are to provide the health and wellness of our elderly, they will benefit from the exercise as will the rest of society. Understanding the issue is the largest part of the problem accross the board.
1 Recommendation
22nd Apr, 2013
Edward Russak
University at Buffalo, The State University of New York
As a pharmacist who reviews medication profiles, I see a lot of elderly patients who receive drug doses that are too high, especially the drugs that require normal kidney function. In terms of self medication, the elderly, with diminished vision, hearing, and possibly mental capacity may often forget to take their medications at the right time. Many will put pills in the same bottle and then get them mixed up. Also, they will often get confused when there is a change in manufacturer of their generic medication, where the medication no longer looks the same as it had in the past. They often get the pharmacists directions or advise confused due to hearing or vision impairment.
1 Recommendation
4th May, 2013
Michiel Versteeg
Maricopa Community College District
My aunt Gertha takes LSD twice weekly. She says that the LSD prevents depression and stabilizes her mood. She also says that LSD is much less toxic than Prozac, which she refers to as "a dangerous drug of modern day society".
23rd Jul, 2013
Satyaprasad Venkata
Manipal Hospital, KAYA
Minimum medications and maximum protection. polypharmacy should be avoided. the least one can do is to integrate nephrologists, diabetologist, cardialogist, neurologist, orthopedician, into one cluster so that these frail elderly people have minimum medication.
1 Recommendation
23rd Jul, 2013
Lalitha Kabilan
There are a number of factors which contribute to the self medication mistakes among the elderly. In developing countries, less affordability to physicians due to economic reasons drive the aged for self medication. In the absence of proper knoweledge on medication, leads to troubles. Anxiety, nervousness, and at times lonliness, desperation due to deprivation and psychological reasons are responsible for self medication mistakes among the elderly. lalitha kabilan
1 Recommendation
25th Jul, 2013
Francesca Sernissi
CAMLIN
Efficacy and safety of drugs on the market are mainly demonstrated through randomized and controlled clinical trials, in which compliance and persistence to the medication being investigated are by definition optimal, since otherwise patients are excluded from the study.
Nonetheless, achievement of optimal adherence in the clinical practice represents a real challenge for many physicians and caregivers, especially in the case of longterm treatment in chronic-degenerative diseases such as neurologic and rheumatic diseases, not to mention for asymptomatic diseases such as chronic hypertension, dislipedimia, diabetes, and osteoporosis.
The patient’s difficulty in adhering or continuing prescribed therapies can be caused by a number of factors, among which the lack of communication between patient and physician.
Here our work recently presented at Cyber18 Conference in Bruxelles.
2 Recommendations
26th Jul, 2013
Sharon W Stark
Monmouth University
There are many factors that contribute to medication mistakes among the elderly. Inadequate or unclear instructions given by health care provider can be moderated by providing instructions in writing and explaining the reasons for taking particular medications and having patients repeat the instructions back to the provider. Prescribing medications that are inappropriate for the geriatric population is problematic when health care providers do not heed differences in prescribing between younger and geriatric patients. Fragmented medical care where elders have multiple health care providers for specific disease states is a problem when health care providers do not communicate and/or collaborate while caring for the elder, thus, prescribing similar medications that subjects patients to a high probability of consequences from overdose, toxicity and organ failure. Elders often overlook the fact that over-the-counter (OTC) medications and/or herbal preparations for ailments that are being treated with prescription medications can be dangerous because they do not see a connection between OTC, herbal preparations and prescription medications. Sharing mediations between friends with similar ailments potentiates misdosing, side effects, catalyzing and/or thwarting the effects of prescribed medications. . Elders often adjust medication dosing according to their perceived effects instead of following directions. For example: If one pill makes me feel 50% better, than two pills may make me feel 100% better. Other issues include taking medications only when symptoms are present , not taking them when they are not, stopping medications when they are perceived to not work quickly enough or when side effects are bothersome, instead of giving time for medications to reach therapeutic levels, rationing medications because of financial burden, and “forgetting” to take medication (especially when multiple daily dosing is required) because there is no routine or organized system for dispensing and taking medications or there is cognitive impairment (identified or nonidentified) that renders elders incapable of managing their medication regime and so facilitates mediation errors. There are a myriad of other reasons that I have not mentioned. The bottom line is that more research related to appropriate and safe medication use among the elderly is better understood so that medication errors are minimized.

Similar questions and discussions

Delirium in older persons is serious and common. Why is it under-researched?
Question
13 answers
  • Daniel DavisDaniel Davis
I'm a geriatric medicine trainee in the UK and I am also doing a PhD on the epidemiological relationship between delirium and dementia risk.
Historically, delirium has been under-researched, certainly out of proportion to its prevalence and impact on clinical outcomes such as mortality, length of stay, insitutionalisation and dementia.
I am a member of the European Delirium Association:
We also have a Facebook page and group:
The Association aims to improve delirium care, research and policy by bringing together persons from a wide range of backgrounds that may not previously had the opportunity to share ideas.
There is an annual conference (the next one is in a couple of weeks in Sweden), but I'd be very interested to hear what your experiences of delirium practice where you work.
Best wishes,
Daniel

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