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Aging Wisely October 2009 - Aging Wisely

Medicare 2010


As 11/15 gets close, it’s time for open enrollment for Medicare prescription drug plans. The new #s and information for 2010 just came out as well. I’m doing a # of talks coming up to give people the “scoop” on all of this. In my talk last week, not surprisingly, there were lots of questions and confusion but hopefully we gave people some clarity about all the working parts of Medicare, what one has to do when turning 65 or retiring, and options. For upcoming talks check out the schedule:

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Medication Related Problems – Are You at Risk?


Americans increasingly come into contact with powerful medicines that possess great potential both to heal tend to harm. Used correctly, prescribed medications and those purchased by consumers directly can be the single best means of staying healthy, getting better, and controlling chronic health problems. The right medication, in the right amount, administered in the right way, to the right patient can produce a “medical miracle.” For older patients with multiple diseases, properly managed pharmacotherapy can help them live longer and live better.

More than 200,000 people die each year from a Medication Related Problem and another 2.2 million are injured each year. Adverse drug reactions alone are between the fourth and sixth leading cause of death. Because of this, it is now believed that we have a “Silent Epidemic” in America.

So, what is a Medication Related Problem (MRP)? A MRP is an event or situation involving drug therapy that actually or potentially interferes with an optimum outcome for a specific person.

Medication Related Problems occur most often in older people and are generally more severe. Primarily because the physiological changes of aging increase the risk in the elderly population. Secondly, as a group, older people are more likely to suffer from multiple chronic diseases, requiring several different medications at one time. Other factors that place the elderly at risk include cognitive impairments that make it difficult or impossible to follow appropriately prescribed medication regimens, lack of a primary care-giver to help with meds, financial issues, problems with vision and comprehension of medication information. If you factor in that older people are more likely to suffer from hospitalization, or psychiatric problems, memory loss, hip fractures, automobile related injuries, cognitive impairment, combined with psychological, social, and care-giving needs, this results in a recipe for disaster! The Journal for the American Medical Association has stated that adverse drug events are among the top five greatest and most preventable threats to the elderly.

What can cause a MRP?

Not receiving medication for a medical problem.
Taking the wrong medication.
Taking an inadequate dose – underdosing.
Unintentional, detrimental adverse drug effect.
Treated with too much or incorrect drug – overdosing.
Differences in generic drugs.
Taking a drug without a valid medical reason.

Situations that increase the risk of MRP’s

A new drug is added to the regime
A change in dosage (higher or lower)
A drug is discontinued
The senior uses alcohol or illicit drugs along with meds
The senior is taking multiple sedation or dizzying drugs
The senior adds OTC’s or herbal products which are unknown to the physician and/or the pharmacist
Food interactions

Conditions that Increase the Risk of MRP’s

Taking 5 or more medications
Taking 12 or more medication doses each day
The medication regime has changed 4 or more times in the past year
More than three diseases/conditions present
History of medication noncompliance
Using meds that require intense drug monitoring

Guidelines for Preventing MRP’s

Has the senior had a thorough physical examination in the past year?
Are non-pharmacological options possible in helping to treat this condition?
Does the senior understand potential drug and nutrient interactions with their meds?
Does the senior have any medical, cognitive, or psychological issues that could affect drug therapy?
What are any other barriers to compliance?
Are there physiologic parameters that are being monitored while taking meds?

What Can Be Done to Reduce Risk for MRP?

It is estimated that 50% of MRP related visits to the emergency room are related to mediation compliance issues.

Know the medication

What it is being used for
When to take it
How to take it
How to tell if it is working
What situations/effects require a call to the physician
What to do if a dose is missed
How to take it in relation to food/meals

Keep an up-to-date list of all meds, OTCs, vitamins and herbal products
Use only one pharmacy for all medications so that there is a central, complete record and make sure the pharmacy has a complete list of all meds, OTCs, vitamins and herbal products. Take the medication list to all doctors appt.’s and hospitalizations
Talk with the doctor AND pharmacist about medications
Take medications as directed
Be persistent with healthcare providers if something might be wrong

Lastly, Medicare is required by law to pay for Medication Therapy Management Reviews. How they pay for them though is undetermined. Each plan may have either a 1-800 number, a nurse, or allow a pharmacy to do the MTM review. Be aware of all the options that can keep each individual as healthy as possible. Take charge of your medications and take charge of your health!

Article provided by Laurie Hill, Lincourt Pharmacy,, (727) 447-4248.

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