is imperative to address individual needs for improved outcomes and preventative care ● Age : A person’s age impacts treatment approach. It is important for healthcare professionals to recognize that age-related conditions impacting older adults occur within a vast expanse of time impacting patients between 65 and 100, which each patient’s condition impaired by the lifetime of the effects of social determinants of health. Medication reconciliation conducted with the understanding of the patient’s social determinants of health is important to addressing the challenges of polypharmacy. For some patients with specific conditions polypharmacy may not be avoided to accomplish effective treatment. Drug reconciliation is necessary to ensure patient safety: ● It helps identify and minimize potential risks of polypharmacy. ● Can reduce the chance of drug duplication. ● Streamlines medication regimen. ● Prevents drug-drug interactions. ● Limits potential for harmful drug combinations. ● Lowers the chance of drug toxicity. ● Ensures medication doses are appropriate. ● Helps to minimize opportunities for adverse effects. ● Identifies potentially unsuitable medications for certain conditions, relative to changing health and/or modified treatment goals. ● Provides a clear opportunity to deprescribe inappropriate medications, potentially improving patient outcomes. can have direct impact on both quality of life and mortality (Table 13.) Common forms of intervention include: ● Education ● Patient support ● Shared decision making ● Problem solving ● Medication reviews ● Motivational interviewing ● Cognitive behavioral therapy ● Pharmacist consultation ● Peer support groups
Figure 1:
Other aspects of social determinants of health impact: ● Health behaviors : Personal lifestyle choices that include food choices, exercise and movement, smoking, and mood or mind-altering substance abuse ● Biology and genetics : These contribute to an individual’s susceptibility to certain diseases, as well as response to treatments, including medication ● Culture : Cultural identity, race, and ethnic background can impact access to healthcare, treatment, and other health outcomes. Providing culturally sensitive treatment
Addressing and resolving polypharmacy with intervention Integrating medication reconciliation into all treatment plans is an imperative in addressing and resolving polypharmacy and hyperpolypharmacy. Sheils et al. (2024) asserts that it is necessary to reconcile patient medication-related beliefs, as discussed earlier, when evaluating current medications as well as those needed for outcomes relative to future effects of disease. Consideration of shared patient insights and concerns are integral for effectively utilizing medication to achieve better outcomes. At times, providers may have to address patient concerns and medication-related beliefs to redirect patient behavior and self-care, recognizing that this
Table 13: Polypharmacy Interventions Intervention Description
Example of Respondent Feedback ● Patients received assistance to identify obstacles to taking their medications ● Guided to create strategies to overcome obstacles and barriers ● Received support to build self-efficacy ● Guided counseling that focused on addressing lack of motivation, patient concerns, and limiting beliefs ● Motivational interviewing ● Patient received information pertaining to their respective challenges with medication management and polypharmacy from researchers and healthcare providers ● Opportunity to develop social connection and education
Problem solving
● Analyze or prompt patient to identify factors impacting their choices ● Identify strategies to address barriers and increase opportunity to achieve goal ● Developed steps to arrange or provide social support from friends, relatives, colleagues, or other forms of social support ● Social support can include praise, positive feedback, or a reward for making change ● Promotion of educational information relative to health consequences to poor medication choices ● Educational information distributed via different channels—verbal, written, individual meetings
Varied social support
Education and information about health consequences
(Sheils et al., 2024)
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