Question

Geriatric Pharmacology

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Please provide an example (based on life or clinical experience) of a geriatric patient's adherence or nonadherence to their medication regimen. Incorporate the reasons and types of non-adherence you experienced. (HINT: Utilize the article "Adherence Issues in Elderly Patients").  Explain how patient education could have improved their adherence.  Your example can be from life experience with a grandparent or friend, or it can be from a clinical experience. Please make your response HIPPA compliant.

Answer 1

Adherence to medication is defined as the extent to which a person's behavior(in) taking medication corresponds with agreed recommendations from a health care provider.

Non-Adherence can be defined as either intentional or unwitting failure to take medications as prescribed.

There could be certain reasons which could be the cause for different types of non-adherence exhibited by a certain Geriatric patient. Lets discuss a live experience of one such patient who had non-adherence to medication due to few certain reasons. A 75 year old female patient was admitted for difficulty in breathing, upon running few test it was found that the patient's heart functioning is been reduced and is recorded that the heart functioning was only 40% and also due to the accumulation of water in lungs patient has been experiencing shortness of breath. Patient was treated in emergency and after complete treatment was provided with a list of medications that are to be taken on a daily basis at regular intervals prescribed by the physician. On the day of discharge patient was advised by the consultant to maintain a proper diet and see that the fluid intake is not more than 2 ltr/day. However after a couple of months she was admitted again with the same symptoms. After followup and upon checking with the patient she stated that she has not been taking the prescribed medications and the fluid intake is not being maintained as instructed.

The reason for the non-adherence of medication stated by the patient was she was not able to be manage the daily routine all by herself and has been forgetful of taking medications on time as there were too many to be consumed every day and fear of side effects which she was told by a third person. Down the line the above reasons lead to complete stoppage of the medicine intake and increase in the fluid intake further leading to another episode of the difficulty in breathing.

Patient education should have been given-  If the patient was given a detailed description of her condition with a clear explanation of why too many medications need to be taken daily and the actual positive effects of the medications prescribed and their role in improving her health condition the patient would not have stopped taking the medication. Also, insight should have been provided on the effects of too much fluid intake. A check list would help the patient in a much better way.

As discussed above there could be different reasons for non-adherence of medication for which a proper education needs to be provided to the elderly.