Professional Documents
Culture Documents
Geriatric Patient PDF
Geriatric Patient PDF
A. F. M. Mahmudul Islam
Lecturer
Gono Bishwabidyalay
Lack of patient adherence
Drug effectiveness is often compromised by
lack of patient adherence among the
ambulatory elderly. Adherence is affected by
many factors but not by age per se. Up to
half of elderly patients do not take drugs as
directed, usually taking less than prescribed
(underadherence). Causes are similar to
those for younger adults. In addition, the
following contribute
• Financial and physical constraints, which may
make purchasing drugs difficult
• Cognitive problems, which may make taking
drugs as instructed difficult
• Use of multiple drugs
• Use of drugs that must be taken several times
a day or in a specific manner
• Lack of understanding about what a drug is
intended to do (benefits) or how to
• recognize and manage adverse effects (harms)
Resolutions
A regimen using too frequent or too infrequent dosing,
multiple drugs, or both may be too complicated for
patients to follow. Clinicians should assess patients’
health literacy and abilities to adhere to a drug regimen
(eg, dexterity, hand strength, cognition, vision) and try
to accommodate their limitations—eg, by arranging for
or recommending easy-access containers, drug labels
and instructions in large type, containers equipped with
reminder alarms, containers filled based on daily drug
needs, reminder telephone calls, or medication
assistance. Pharmacists and nurses can help by
providing education and reviewing prescription
instructions with elderly patients at each encounter.
Pharmacists may be able to identify a problem by
noting whether patients obtain refills on schedule or
whether a prescription seems illogical or incorrect.
Drug-Disease Interactions in the
Elderly
Drug-disease interactions
Common clinical disorders
Osteoporosis
Prevention
Prevention
Prevention
Role of pharmacists in geriatric care
Beers & STOPP/START Criteria
β-Adrenoceptors
Hypertension
Hypertension is an important risk factor for cardiovascular
and cerebrovascular disease in the elderly. The incidence
of myocardial infarction is 2.5 times higher, and that of
cerebrovascular accidents twice as high in elderly
hypertensive patients compared with non-hypertensive
subjects. Elevated systolic blood pressure is the single
most important risk factor for cardiovascular disease and
more predictive of stroke than diastolic blood pressure.
Blood pressure lowering has been shown to be beneficial
in those patients below and above the age of 65 years with
no substantial variation in reduction in major vascular
events with different drug classes. There is evidence that
treatment of both systolic and diastolic blood pressure in
the elderly is beneficial.
Treatment of hypertension
Principles and goals of drug
therapy in the elderly