gc08-4 - Compliance Enhancement Angel L. Wolf, M.B.A.,...

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1 Compliance Enhancement Angel L. Wolf, M.B.A., Pharm.D., BCPP Assistant Professor of Pharmacy Assistant Professor of Medicine/Clinical Pharmacist University of South Florida Department of Psychiatry and Behavioral Medicine “Medications only work if they are taken as prescribed”
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2 Objectives ± Interpret the definition and impact of medication adherence in the elderly ± Identify factors affecting medication adherence in the elderly ± Utilize helpful assessment tools for medication adherence ± Apply intervention strategies to enhance medication adherence Medication-Taking Behavior ± Compliance – passive following of doctors’ orders ± Adherence – the extent to which a person takes medications as prescribed ± Concordance – consultative and consensual partnership between the consumer and their doctor ± Persistence – a person’s ability to continue taking medications for the intended course of therapy
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3 Non-adherence ± Intentional or accidental – Failing to initially fill a prescription – Failing to refill a prescription as directed –Om i t t ing doses – Discontinuing therapy – Taking less or more of a medication than prescribed – Taking friend/family member’s medication – Taking outdated medications – Storing medications improperly – Improperly administering medications requiring devices Non-adherence ± 30-60% of consumers are nonadherent to their prescribed medications ±
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4 Medication Use ± 90% of Medicare beneficiaries report taking prescription medications ± Community dwelling elderly – Average 3.1-7.9 medications ± Nursing home residents – Average 7.2 medications Col N, Fanale JE, Kronholm P. The role of medication non-compliance and adverse drug reactions in the hospitalizations of the elderly. Arch Intern Med. 1990;150:841-845. Gurwitz JH, Field TS, Harrold LR, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA. 2003; 289:1107-16. Consequences of Non-adherence ± Increased use of medical resources – Physician and Emergency department visits – Hospital admissions ± 10 – 33% of elderly admitted had a history of nonadherence – Nursing home admission ± ~ 25% of admissions may be due to the inability to self-administer medication Col N et al. The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Strandberg LR. Drugs as a reason for nursing home admissions. J Am Health Care Assoc. 1984;10:20-23.
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5 Consequence of Non-adherence ± Increased use of medical resources – Unnecessary additional treatments – Additional laboratory testing – Preventable adverse drug reactions
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gc08-4 - Compliance Enhancement Angel L. Wolf, M.B.A.,...

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