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The Impact of Polypharmacy on Client Health and Adherence to Medications

Many people in the US, particularly the elderly, take more than one prescribed medication. CDC (2014) reported that between 2009 and 2012 nearly 48% of persons asked used at least one prescription drug, 22% used three or more prescription drugs, and nearly 11% used five or more.

In a recent study published by the Mayo Clinic, seven out of 10 Americans take at least one prescription drug. The most commonly prescribed drug is antibiotics — taken by 17 percent of Americans — followed by antidepressants and opioids — each taken by 13 percent of Americans. In addition, findings showed that:
o Even more staggering than the CDC findings, currently more than half of Americans take two prescription medications, and 20 percent of Americans are on at least five prescription medications.
o More women than men receive prescription medications.
o Antidepressant prescriptions are more common among women than men, and are most common among women ages 50 to 64.

When people take multiple medications, there is a greater risk for confusion about which medications are taken, when they are taken, and what they are being taken for. There is also a higher risk for drug interactions and increased side effects and adverse reactions.

Sometimes because of the sheer number of medications being prescribed, they may be forgotten, become too much of a bother, or a financial burden which can significantly impact client compliance and lead to poor health outcomes.
In this written assignment, you will be conducting an interview of a client who is taking multiple prescribed medications (three or more) and submitting a written paper describing the findings from the interview. You will then develop a Client Teaching Plan. Your instructor will assist you in the selection of the client. You must achieve a “pass” in this assignment to satisfactorily fulfill the requirements for the Pharmacology course.

The three parts of this assignment are:

Conduct an interview of a client who is taking multiple medications (polypharmacy). You must prepare the client before the interview by explaining why you are conducting the interview. You can say “my assignment is to find out about the medications you are taking so I can determine if you need more information about what you are taking”. You must always get permission from the client to conduct the interview and you must tell the client how the information will be used. You can say, “I will not be using your name in the information I share and I will be submitting it to my instructor only for this student assignment”. If there is important information that needs to be communicated to you, your doctor, family, or nurse, my instructor will assist me in following up on this”. Tell the client you will take no more than 30-45 minutes for the interview.

There may be a family member or significant other present during the interview. That is fine. Be sure to identify who answered a question and if possible always have the client answer first. Always thank the client (and others) when you complete the interview.

Do not use recording equipment for this interview. Have a notepad and pencil or pen and explain that you will be taking notes. When the interview is over, go to a quiet place and take some time to fill in any information you did not jot down. If you wait, you will not remember.

When setting the environment for the interview, make sure the client (and others) is comfortable and you are comfortably seated facing the client. If possible, do the interview in a quiet place. Ask questions slowly giving the client time to answer. Pay attention to the client’s hearing and ability to respond to the questions. Be sure your non-verbal communication demonstrates you are calm and relaxed.

Use the following interview question guidelines when conducting the interview. Be aware that the client may not be able to answer each of the questions with detailed information. Collect as much information as the client is able and willing to give you. Remember you are the interviewer so you will be collecting information and not making any comments about the information shared by the client except to ask for further clarification if you are not sure what was said or need more detail if it is available.

4. What medications are you taking?
5. Before the interview research each of the medications. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions.

For the following questions, paraphrase the client’s answers for your written paper.

6. How long have you taken each these medications?
7. Do you know why you are taking these medications?
8. Who told you about the medications and why you need to take them? Were you able to ask any questions about the medications and if so were they answered so you understood what was said?
9. How do you feel about taking these medications?
10. Are you taking other medication purchased “over the counter” such as in a drug store? If so, what is it and why are you taking it.
11. How and when do you take your medications?
12. Do you have any difficulty taking the medications? If so, what happens and how do you deal with any difficulties.
13. Have you ever felt any uncomfortable feelings and/or body reactions to taking these medications? If so, what were they and how were they handled?
14. If you had the above reaction, did they take you off the medication and/or replace it with another medication? Were you told why this happened?
15. Do you have any reason not to take the medications?
16. Have you ever not taken the medication? If so, what was the reason?

Ask a final question about whether the client would like to tell you anything further about their medications.
Write a paper describing your research and findings about the medications being taken and the results of the interview. Report your findings in a 3-5 page written paper. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions.
Use accurate and appropriate spelling and grammar and APA Editorial Format for sources used in your written paper.
Develop a teaching plan for this client based on your findings. Based on the findings from the interview, develop a 2-3 page teaching plan to include the following:

17. List one goal for this teaching plan
18. Describe two to three teaching resources that might be used
19. Identify two teaching strategies that can be used based on the client interviewed
20. List specific client instructions regarding the medications and what adverse reactions they should be aware of/and what to do
21. Identify at least one factor that may negatively influence adherence to the medications and how it can be overcome
22. If, appropriate, describe how the family might be involved in ensuring the client is on a proper and safe medication regime

Sample Answer

 

The Impact of Polypharmacy on Client Health and Adherence to Medications

In the United States, the prevalence of polypharmacy, defined as the concurrent use of multiple medications, is a growing concern, particularly among the elderly population. According to reports from the CDC and the Mayo Clinic, a significant percentage of Americans are taking three or more prescription medications, leading to potential risks such as medication confusion, drug interactions, and increased side effects. This written assignment aims to conduct an interview with a client who is taking multiple prescribed medications and develop a client teaching plan based on the findings.

Interview Findings:

During the interview with the client, the following information was gathered:

Medications Being Taken: The client provided a list of medications currently prescribed.
Duration of Medication Use: The client shared how long they have been taking each medication.
Understanding of Medications: The client’s knowledge about the purpose of each medication and who informed them about its usage.
Feelings About Medications: The client’s perspective on taking the medications and any concerns they may have.
Over-the-Counter Medications: Whether the client is taking any over-the-counter medications and the reasons for their use.
Medication Administration: How and when the client takes the prescribed medications.
Challenges with Medication: Any difficulties faced in taking the medications and how they are managed.
Adverse Reactions: Any uncomfortable feelings or body reactions experienced while on the medications.
Medication Adherence: Reasons for missing doses and any concerns about adherence.

Client Teaching Plan:

Goal:

To educate the client on the importance of medication adherence, understanding each medication’s purpose, and recognizing potential adverse reactions.

Teaching Resources:

Medication Information Sheets: Providing detailed information about each medication, including drug class, dosage, administration route, and potential side effects.
Pharmacist Consultation: Encouraging the client to consult with a pharmacist for in-depth explanations and clarifications regarding their medications.

Teaching Strategies:

Visual Aids: Using charts or diagrams to illustrate medication schedules and dosages for better understanding.
Role-Playing Scenarios: Practicing how to handle potential adverse reactions or medication challenges effectively.

Client Instructions:

Adherence Guidelines: Emphasizing the importance of taking medications as prescribed and explaining the consequences of non-adherence.
Adverse Reactions Awareness: Educating the client on common side effects and when to seek medical attention if experiencing adverse reactions.

Factors Influencing Adherence:

The complexity of managing multiple medications may negatively impact adherence. To overcome this, a pill organizer can be used to simplify dosing schedules and reduce confusion.

Involving the Family:

Family members can support medication adherence by helping organize medications, reminding the client to take doses on time, and monitoring for any adverse reactions or changes in health status.

In conclusion, by addressing the challenges associated with polypharmacy through effective education and support, clients can better manage their medications, improve adherence, and ultimately enhance their overall health outcomes.

 

 

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