One source of problems in polypharmacy is drug-drug interactions. The pharmacist monitors drug-drug interactions, but it is essential that he or she be informed about all the patient's medications. This includes all prescription and OTC medications, as well as herbal preparations and other related supplements.
Other issues complicate polypharmacy in older adults. For example, weakening vision and memory lead to mistakes and possible serious drug toxicities. In addition, medication adherence problems are more common in cases of polypharmacy, particularly with more complex regimens, and can lead to drug therapy failure. One focus of pharmaceutical care is patient-and caregiver-education and the application of systems designed to promote adherence.
A new study released in the Journal of the American Pharmaceutical Association estimates that drug misuse costs the economy more than $177 billion each year in hospital and long-term care admissions, physician and emergency department visits and added treatment costs, with an estimated 218,000 patient deaths in 2000. The study identified drug-related problems that include adverse drug reactions, drug interactions, improper dosage (either subtherapeutic or overdosage) and failure to receive drugs. Other problems included misuse due to improper drug selections, drug use without a need and no drug use when there were indicating symptoms.
Students at the UB School of Pharmacy and Pharmaceutical Sciences now receive the Doctor of Pharmacy (Pharm.D.) as the entry-level degree for pharmacy practice. The Pharm.D. provides advanced training in pharmaceutical care, in a range of clinical practices. During the final year of the four-year, graduate-professional Pharm.D. program, students receive advanced clinical experiential training in a variety of clinical environments including geriatric outpatient, in-patient and long-term care.
The new geriatric pharmacotherapy program at UB trains pharmacy students and postdoctoral residents in drug therapy management for older adults. Conditions that are more common in populations of older adults and medications that are inappropriate for this group are studied as well.
With the emphasis on recognition and resolution of medication-related problems in older persons, the aims of medication therapy can be achieved. Our goals are to improve the quality of life by curing disease, or slowing the disease process while reducing or eliminating symptoms.