2.50
Hdl Handle:
http://hdl.handle.net/10755/158127
Type:
Presentation
Title:
Patient Risk Factors Associated With Medication Irregularities
Abstract:
Patient Risk Factors Associated With Medication Irregularities
Conference Sponsor:Western Institute of Nursing
Conference Year:2004
Author:Zulkowski, Karen, DNS, RN, CWS
P.I. Institution Name:Montana State University - Billings Campus
Contact Address:, Billings, MT, USA
Problem: While medication under-adherence is far more common than over-adherence in elderly populations, both have been associated with cognitive problems. This is especially troubling as cognitive impairment, particularly mild cognitive impairment is common among the elderly. One person in three over 60 years of age has bee reported to have at least mild cognitive impairment and one in six may have moderate to severe impairment. Psycho/social factors such as depression and ability to take medication unaided are also related to medication issues in the elderly person. The purpose of this study was to examine the association risk factors (i.e. depression, ADL ability, cognitive status and executive functions) and medication irregularities in elderly persons. Framework: See overview. Sample: Presently there are 149 subjects over 65 years age, with a hospital stay >72 hours that have completed study interviews and medical records review. Mean age was 80 + 8 years, 71% were female, and 58% lived with a spouse, or family member. Methods: The MMSE, and Barthel Index were administered by a study nurse to patients at hospital admission and discharge. Executive functioning (Behavioral Dyscontrol Scale), symptom severity scale and depression scale (CES-D) were administered on discharge and 2 weeks post discharge. Results were correlated to number and type of medication error. Findings: Seventy-nine percent of participants had no cognitive impairment and 21% had mild impairment on admission. While patients cognitive and functional status decreased during hospitalization it returned to baseline levels within two weeks post-discharge (>.05). Patients executive functioning improved post discharge, they reported a lower severity of physical symptoms, and were slightly less depressed. There was no clear correlation between any cognitive score and the number of medications taken. However, data trends did suggest that lower cognitive ratings may be associated with increased medication irregularities in a larger sample. Conclusions: At the time of discharge patients exhibited lower cognitive and executive functioning. This transition point is a time of frequent changes occurring in amount and type of medication they are prescribed. This combined with the fact that the majority of patients self-reported taking their medications without help means there is an increased likelihood of medication problems occurring at discharge. Nurses and case managers need referrals for medication assistance and increased family caregiver education especially during the first two weeks following hospitalization.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePatient Risk Factors Associated With Medication Irregularitiesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158127-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patient Risk Factors Associated With Medication Irregularities</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Zulkowski, Karen, DNS, RN, CWS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Montana State University - Billings Campus</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Billings, MT, USA</td></tr><tr><td colspan="2" class="item-abstract">Problem: While medication under-adherence is far more common than over-adherence in elderly populations, both have been associated with cognitive problems. This is especially troubling as cognitive impairment, particularly mild cognitive impairment is common among the elderly. One person in three over 60 years of age has bee reported to have at least mild cognitive impairment and one in six may have moderate to severe impairment. Psycho/social factors such as depression and ability to take medication unaided are also related to medication issues in the elderly person. The purpose of this study was to examine the association risk factors (i.e. depression, ADL ability, cognitive status and executive functions) and medication irregularities in elderly persons. Framework: See overview. Sample: Presently there are 149 subjects over 65 years age, with a hospital stay &gt;72 hours that have completed study interviews and medical records review. Mean age was 80 + 8 years, 71% were female, and 58% lived with a spouse, or family member. Methods: The MMSE, and Barthel Index were administered by a study nurse to patients at hospital admission and discharge. Executive functioning (Behavioral Dyscontrol Scale), symptom severity scale and depression scale (CES-D) were administered on discharge and 2 weeks post discharge. Results were correlated to number and type of medication error. Findings: Seventy-nine percent of participants had no cognitive impairment and 21% had mild impairment on admission. While patients cognitive and functional status decreased during hospitalization it returned to baseline levels within two weeks post-discharge (&gt;.05). Patients executive functioning improved post discharge, they reported a lower severity of physical symptoms, and were slightly less depressed. There was no clear correlation between any cognitive score and the number of medications taken. However, data trends did suggest that lower cognitive ratings may be associated with increased medication irregularities in a larger sample. Conclusions: At the time of discharge patients exhibited lower cognitive and executive functioning. This transition point is a time of frequent changes occurring in amount and type of medication they are prescribed. This combined with the fact that the majority of patients self-reported taking their medications without help means there is an increased likelihood of medication problems occurring at discharge. Nurses and case managers need referrals for medication assistance and increased family caregiver education especially during the first two weeks following hospitalization.</td></tr></table>en_GB
dc.date.available2011-10-26T20:32:11Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:32:11Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.