Transcript PowerPoint 프레젠테이션 - Georgia Institute of

Emergency Room of the Future
Improving Geriatric Medication Compliance
through Doctor/Patient Communication
Laura Salisbury, MID
Ben Cleveland, MSHS
Lee Sanghun, MSIE
Problem Statement
Geriatric patients make up a large percentage of the Emergency
Department population. Many take multiple prescription medications
that could result in noncompliance, taking the form of underusing or
overusing/altering prescribed dosage. Due to mental or physical
disability, many geriatric patients are at risk for medical
noncompliance during their dosage period after visiting an
emergency room because they may be unable to fully communicate
their current medicinal use to the prescribing doctor and
understand or recall his/her prescribed medication information.
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Related Literature& Research
• 25% of all ER visits are geriatric
- Average 4.2 prescriptions per person
- Many patients cannot recall accurately current medications
and dosages
• Current methods of communicating &
recording directions are not effective
• Elderly patients find medication adherence difficult
- Cognitive & Physical impairment
- Multiple prescriptions
Possible Scenarios
• Overuse/Altering Dosage
Patient falls
Dr. makes diagnosis,
prescribes dosage and
discharges patient
Taken to ED with
care-giver
Forgets dosage info.
Attempt to describe
current medication use
Take medication whenever
they feel urge
Possible Scenarios
• Forgetfullness
Patient w/ mild dementia
goes to ER for heart
palpations
Attempt to describe
current medication use
After a long day, doesn’t
remember to put the pills
into daily pill container
Dr. makes diagnosis,
prescribes beta blockers,
discharges patient
Forgets to take medication
Prospective Solutions
• Physical Reminder System
Packaging design, digital display reminder
• Medication Communication (between home & ED)
Automated telephone reminder, digital device
• Medication Communication (within ED)
Type of paperwork given to elderly, digital passport of
health history, physicians seen, and medication list
References
• Adherence to emergency department discharge prescriptions
By: Corinne M. Hohl, MD, MHSc; Riyad B. Abu-Laban, MD, MHSc; Jeffrey R. Brubacher, MD, MSc; Peter J. Zed, PharmD; Boris Sobolev, PhD
• Medication compliance in elderly people: influencing variables and
interventions
By: Cargill, Julie M. Journal of Advanced Nursing. Apr92, Vol. 17 Issue 4, p422-426. 5p. DOI: 10.1111/1365-2648.ep8530400
• Adherence Issues in Elderly Patients
By: Jeannette Y. Wick, RPh, MBA, FASC, Published Online: Thursday, January 13, 2011
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