Doctors need to do a double-take when prescribing meds to seniors
By Kulbinder Saran Caldwell - Published on Monday, 29 June 2009 12:16
New research indicates that young doctors ought to ask more questions to help get a clearer picture before prescribing medication to their elderly patients.
Two new studies presented at the American Geriatrics Society's Annual Scientific Meeting in Chicago focused on challenges seniors face with their prescriptions.
Many of our most vulnerable citizens have multiple ailments that need to be treated at the same time and therefore, tend to take many different medications at the same time. This leads to seniors being more susceptible to side effects, having a higher risk of drug interactions; along with difficulty maintaining their dosing schedule due to possible physical, mental or financial obstacles.
One study had residents and medical students putting themselves through a similar complicated dosing schedule that many older patients go through in a regular week. The Medical College of Wisconsin program used candy "medications" to test the polypharmacy – the use of multiple drugs.
Very quickly the students found it difficult to maintain their schedule while dealing with problems of old age, such as poor memory or eyesight, arthritis and even psychological issues of feeling like they were taking too many meds and the medication wasn't working to help them feel better. The participants needed to find ways to help them keep on track – possibly asking to decrease the number of meds they were taking or getting their friends or family to help them stick to the schedule.
After participating in the program the students felt that they were much more aware the problems facing their older patients when they were prescribed multiple medications and said that they would endeavor to reduce the number and doses of prescriptions given to seniors.
Report lead author Dr. Kathryn Denson stated, "Walking in their patient's shoes helps them think practically about changes both the physician and patient can make to decrease medications, and to help patients take their medications correctly".
The other study was conducted in Maryland and it had internal medicine residents at Johns Hopkins Bayview Medical Center providing "thoughtful prescribing" for elderly patients. Over a four-week period, the students used special worksheets and classroom learning to review the older patients' use of over-the-counter and prescription meds.
The findings indicated that three-quarters of the patients had been prescribed medicines that potentially could interact with meds that they were already taking. Plus, the residents realized that about 22 percent of the elderly patients had been given an inappropriate prescription.
"Although fundamentals of pharmacology are taught in medical school, it is during residency that one's prescribing practices are developed. Our hope is that by using a more deliberate approach to prescribing, we can teach doctors habits that result in more safe and sensible care for their vulnerable patients," said Dr. Lynsey Brandt of Johns Hopkins and study lead author.
As our population continues to age, young doctors will be most effective by understanding the complexities of prescribing medication to their most vulnerable of patients.
Source: "Prescription Training Puts Docs in Shoes of Older Patients." Health Day News. 1 May 2009