Emergency Room of the FutureImproving Geriatric Medication Compliance

through Doctor/Patient Commu-nication

Laura Salisbury, MID Ben Cleveland, MSHS Lee Sanghun, MSIE

Problem Statement

2

Geriatric patients make up a large percentage of the Emer-

gency 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 pe-

riod 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 pre-

scribed medication information.

• 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 dif-ficult

- Cognitive & Physical impairment- Multiple prescriptions

Related Literature& Re-search

Possible Scenarios • Overuse/Altering Dosage

Patient fallsTaken to ED with care-giver

Attempt to describe current medication use

Dr. makes diagnosis, pre-scribes dosage and dis-charges patient

Forgets dosage info. Take medication when-ever they feel urge

Possible Scenarios • Forgetfullness

Patient w/ mild demen-tia goes to ER for heart palpations

Forgets to take medication After a long day, doesn’t remember to put the pills into daily pill container

Dr. makes diagnosis, prescribes beta block-ers, discharges patient

Attempt to describe current medication use

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

• Adherence to emergency department discharge prescriptionsBy: 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 in-terventions

By: 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

References

Thank You !