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EHLE PROJECT: USE OF DRUGS AMONG THE ELDERLY: THE ROLE OF PHARMACISTS PRACTICAL PART

EHLE PROJECT: USE OF DRUGS AMONG THE ELDERLY: THE ROLE OF PHARMACISTS PRACTICAL PART. 20% of older people in Europe receive at least one inappropriate drug (JAMA 2005). 30-60% of adverse effects of drugs are PREVENTABLE and AVOIDABLE (Ger et Soc, 2002). JUSTIFICATION.

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EHLE PROJECT: USE OF DRUGS AMONG THE ELDERLY: THE ROLE OF PHARMACISTS PRACTICAL PART

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  1. EHLE PROJECT: USE OF DRUGS AMONG THE ELDERLY: THE ROLE OF PHARMACISTS PRACTICAL PART

  2. 20%of older people in Europe receive at least one inappropriate drug (JAMA 2005) 30-60%of adverse effects of drugs arePREVENTABLEand AVOIDABLE (Ger et Soc, 2002). JUSTIFICATION 30% of hospital admissions among elderly people are caused by adverse effects of drugs, which is considered thefifth leading causeof death in hospitals (J Am Geriatr Soc, 2001)

  3. ESSENTIAL MESSAGES The potential interaction risk increases exponentially with age and with a higher drug consumption, which consequently leads to more problems related to medication. This module has as its aim to transmit the following messages in a practical way: • That drugs are dangerous. • That even those “not prescribed” are dangerous too. • That their prescription is personalised as is their use. • That there are interactions between drugs. • That you must follow the guidelines prescribed by the doctor if you want the drugs to fulfill their function properly. • That it is essential to understand the pattern (guideline) prescribed and before any doubts you must ask the doctor. • That the pharmacist is a professional at the service of your health and that if there are any doubts you can and must ask. • That there are methods to keep drug-taking under control and that we are going to learn them in this module.

  4. OBJECTIVES AND CONTENTS OBJECTIVES • The objective of the module is to see the pharmacist as a professional at the service of your health who is there to clarify any doubts that consumers may have about their medication. CONTENTS The drug Use of drugs and problems derived from that use Polymedication and polyprescription Methods for a good use of drugs

  5. THE DRUG The objective in this first part is to use a practical case to give some basic notions about… • what drugs are • how they act • the differences existing depending on the patient’s characteristics.

  6. Medicine HOW WE DEFINE DRUGS “drugs are substances used to prevent, cure, treat and/or diagnose illnesses/diseases”.

  7. PROCESS SUFFERED BY A DRUG AFTER BEING ADMINISTERED (FIGURE 1) ABSORPTION LIBERATION DISTRIBUTION THROUGH THE ORGANISM DRUG PHARMACOLOGICAL EFFECT ELIMINATION LOCUS OF ACTION

  8. DIFFERENT DRUGS AND PATIENT CHARACTERISTICS • It is worth highlighting the differences associated with the patient’s age and physiology.

  9. USE OF DRUGS AND PROBLEMS DERIVED FROM THAT USE • Adverse reactions, interactions and serious consequences result from the wrong use of drugs.

  10. USE OF DRUGS: ADVERSE REACTIONS, INTERACCIONS AND SERIOUS CONSEQUENCES • What are the possible problems that can derive from an incorrect use? Opinions and comments: AdvantagesDisadvantages • Worsening condition • Adverse reactions… • Serious interactions - treat

  11. POLYMEDICATION AND POLYPRESCRIPTION • There are some problems derived from… • polymedication • non-compliance with the doctor’s prescription, • the prescriptions coming from different prescribing doctors. It is very important for… consumers and patients to understand and know when and how they must take what has been prescribed. And the doctor must know if there are parallel prescriptions or some other drug is being taken. Here we emphasise the pharmacist’s advice-giving and clarifying role.

  12. METHODS TO COMPLY WITH AND ADHERE TO THE TREATMENT • Practical cases and use of organisation tools for compliance with the drug-taking guidelines. • Differents methods for drug-taking organisation and control to ensure that the polymedicated patient uses drugs correctly.

  13. METHODS TO COMPLY WITH AND ADHERE TO THE TREATMENT FIRST METHOD: Write (you or your pharmacist) on the box or packaging: how the doctor told you to take your medication, what it is useful for whether it must be taken with meals or not. In case of doubt ask your doctor or pharmacist. For: Pattern: 1/0/1 How?: Empty stomach or meals Until: (Figure No. 4)

  14. METHODS TO COMPLY WITH AND ADHERE TO THE TREATMENT • SECOND METHOD: • Write down in your diary the following data about each one of the drugs so that you can show the doctor in your next visit (and it is clear for us too): • Prescribing doctor. • Name of the drug. • How often it must be taken (Intervals) • How does it have to be taken? • End of the treatment

  15. METHODS TO COMPLY WITH AND ADHERE TO THE TREATMENT THIRD METHOD: Use of tables where we indicate when I must take each drug and where I would put a mark when I do so (showing that I have complied with the treatment). In that way, I will be able to forget takes or avoid wrong taking-patterns. CONTROL TABLE: PLANNING OF MY TREATMENT FIGURE 5

  16. COMPLIANCE WITH AND ADHERENCE TO THE TREATMENT (FIGURE 5 ) CONTROL TABLE: PLANNING OF MY TREATMENT

  17. METHODS TO COMPLY WITH AND ADHERE TO THE TREATMENT • If we use the diary, the table could be made on a daily basis. In this case, the sheet corresponding to each day would include the data shown in Figure No. 6. DIARY: PLANNING OF MY TREATMENT • In any case, we would have to make a mark each time we take a drug. In that way I will know that if no marks are there, that means I forgot to take it. And besides, I will not double doses.

  18. COMPLIANCE WITH AND ADHERENCE TO THE TREATMENT (FIGURE 6 ) DIARY: PLANNING OF MY TREATMENT

  19. METHODS TO COMPLY WITH AND ADHERE TO THE TREATMENT (figure No. 7) FOURTH METHOD: Use of a pillbox. Each Monday and according to what is written down in my diary about my medication and its pattern, I will fill the pillbox putting the corresponding medication in each space. If I am not sure about doing it correctly or doubts arise, I will go and see the pharmacist to seek advice.

  20. COMPLIANCE WITH AND ADHERENCE TO THE TREATMENT (FIGURE 7 )

  21. Pharmacist PERSONALISED DOSAGE SYSTEMS (PDS) Personalised Dosage Systems are a tool for which a great implementation growth is foreseen. Their purpose is to improve the patient’s therapeutical compliance level. They allow patients to take their daily medication safely, this type of administering systems being under the strict supervision and control of pharmacists.

  22. THANKS FOR YOURATTENTION

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