Cost: seniors do not fill or refill medications because they can not afford the enormous cost. Some stretch their medications by splitting pills or taking half doses. Fear: Seniors may be afraid to take their medications because of potential side effects.
Increased Sensitivity to Many Drugs: The problems of decreased body size, altered body composition (more fat, less water), and decreased liver and kidney function cause many drugs to accumulate in older people’s bodies at dangerously higher levels and for longer times than in younger people.
The most common reasons for patient non-compliance to medications are intentional and include: high drug costs, fear of adverse events, being prescribed multiple medications, and experiencing either instant relief or medication ineffectiveness leading to self-discontinuation of medications.
Drug-related problems are common in older adults and include drug ineffectiveness, adverse drug effects, overdosage, underdosage, inappropriate treatment, inadequate monitoring, nonadherence, and drug interactions. (See also Overview of Drug Therapy in Older Adults.
Behavioral factors: These include social isolation, social and health beliefs, and economic condition. Many elderly people live alone. Studies have shown that people who live alone more often fail to comply with medication regimens.
Alcohol Use Despite increasing rates of illicit and prescription drug misuse among adults older than 65 years,5,6,10 alcohol remains the most commonly used substance among older adults.
Elderly people are at a greater risk for adverse drug reactions (ADRs) because of the metabolic changes and reduced drug clearance associated with ageing; this risk is furthermore exacerbated by increasing the number of drugs used. Potential of drug-drug interactions is further increased by use of multiple drugs.
Their function is to persuade physicians and surgeons to increase sales volume by persuading the medical profession to prescribe newer and more expensive drugs to patients, even though most of these drugs are variations that offer little more than older medications.
Because a client legally has the right to refuse medication, the nurse can only recommend, advise, suggest, or urge the patient to comply. Consequently, it is important to understand the nurse’s response to patient refusal of medication. 2.
Lack of trust: If for whatever reason, you don’t believe your treatment is going to make a difference in your health, you may not be motivated to comply. Apathy: When you don’t realize the importance of the treatment, or you don’t care if the treatment works or not, you are less likely to comply.
Confusion in the elderly patient is usually a symptom of delirium or dementia, but it may also occur in major depression and psychoses. Until another cause is identified, the confused patient should be assumed to have delirium, which is often reversible with treatment of the underlying disorder.
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Medication nonadherence is widespread among seniors. According to the Department of Health and Human Services: Fifty-five percent of the elderly are non-compliant with their prescription drug orders, meaning they don’t take their medication according to the doctor’s instructions.
Not taking medications properly leads to unnecessary hospital admissions, illness, and even deaths. It also costs the health care system billions of dollars every year, in costs both direct (e.g., hospitalizations) and indirect (e.g., lost productivity).