Policies and Procedures for Patient Education & Inappropriate Medications for Elderly

1. By Asad Khan
PhD Pharmacy Practice
assad.pharmacist@gmail.com
Policies and Procedures
for Patient Education &
Inappropriate Medications
for Elderly

2. “50% of the Patients Walk out of Healthcare Provider Office not
knowing What they were told and or are suppose to do.”

3. Agenda
Patient Education
•Purpose of Patient Education
• Patient Education Models
01
Roles of Pharmacists02
Patient Education Rationale
•Policies and Procedures
03
Documentation and Benefits of
Patient Education
04

4. Patient Education
Patient education is a planned
learning experience using a
combination of methods such as
teaching counseling and behavior
modification techniques that
influence patients knowledge and
health behavior.

5. The five main aims of educating patients
are
1.To maintain and promote health.
2.Prevent illness and restore patient's
health.
3.To teach the patient how to cope with
their condition.
4.To help decrease the noxious affects of
drugs.
5.To decrease the overall cost of therapy
by improving medicine compliance and
adherence.
Purpose of Patient Education

6. Patient Education Models
Discharge
Instructions
given to Patients
List of
Dos and
DONTs
Medication
Reminders
Instructions to
see Physician
after some weeks
Old
Patient assessment
begins upon
admitting and Collect
relevant Information
Assessment
and Planning
Executed
Implementation
of
Pharmaceutical
Care Plan
Follow Up:
Monitoring and
Evaluation
carried out
New
Conclusion
Pharmaceutical Care Plan being an important component of Patient
Education was lacking in older model thus lesser reliable and
effective as compare to the new patient education model.

7. Pharmacists’ Roles in Educating Patients
1 2 3 4
Prescription
Monitoring
Medications
History Taking
Patient
Counseling
Antibiotic
Stewardship
8 7 6 5
Pharmacoeconomics
Hospital
Discharge
Management
Disease State
Management
Medication
Reconciliation

8. Patient Education Rationale
Knowledge and Attitude Changes of Patients
• Increase understanding
• Increase Confidence
• Increase Satisfaction
• Improved emotional state
• Leading to change in Behavioral Changes
thus physical health and well being will
elevate decreasing symptoms and
complications
Which will eventually
Decrease length of stay and
decreases burden on healthcare
system
Patient Education
• Print
• Verbal
• Multimedia
• Combination

9. PatientEducationSteps Introduce yourself as a pharmacist Explain the purpose and
expected length of the sessions Obtain the patient’s agreement
to participate.
1
2
3
4
Ask open-ended questions about each medication’s purpose and
what the patient expects Ask the patient to describe or show how
he or she will use the medication.
Provide information orally and use visual aids or demonstrations
to fill patients’ gaps in knowledge and understanding. Open the
medication containers to show patients the colors, sizes, shapes,
and markings on oral solids.
Demonstrate the assembly and use of administration devices
such as nasal and oral inhalers. For oral liquids and injectables,
show patients the dosage marks on measuring devices.

10. PatientsEducationSteps As a supplement to face-to-face oral communication,
provide written handouts to help the patient recall the
information.
5
6
7
Then adjust the pharmacotherapeutic regimens according to
protocols. If a patient is experiencing problems with his or her
medications, gather appropriate data and assess the issues.
Verify patients’ knowledge and understanding of
medication use by asking patients to carry the procedures.

11. Documentation of Patient Education Process
1
Pharmacists should document education and counseling of patients.
2
Education and counseling may be documented On a specially designed counseling
record.. All documentation should be safeguarded to respect patient confidentiality and
privacy.
3
The Pharmacist Should Record That counseling was offered and was accepted and
provided or refused The pharmacist’s perceived level of the patient’s understanding As
appropriate, the content should be documented (for example, counseling about food–drug
interactions.

12. • Improved health outcomes
• Improved understanding of condition
• Improved quality of life
• Improved long-term outcomes
• Improved feelings of well-being
• Empowers patients to take an active role
• Increased self-efficacy
• Increased self-management
• Increased life-expectancy
• Reduces complications
• Fewer hospital admissions
• Overall better healthcare experience
• Decreased tiredness, stress, anxiety and depression
Benefits of Patient Education

13. “Medicines are only fit for OLD PEOPLE”.
Napolean Bonaparte

14. Agenda
DRPs in Elderly01
Inappropriate Use of
Medications in Elderly
02
Inappropriate Medications
in Elderly (Examples)
03
Pharmacist Geriatrics
Pharmaceutical Care Plan
•Comprehensive Geriatric Assessment
04

15. Drug Related Problems in Elderly
Drug-related problems are common in older adults . Adverse drug
effects are effects that are unwanted, uncomfortable, or
dangerous.
Common examples are over sedation, confusion, hallucinations,
falls, and bleeding.
Among ambulatory people ≥ 65, adverse drug effects occur at a
rate of about 50 events per 1000 person-years. Hospitalization
rates due to adverse drug effects are 4 times higher in older
patients (about 17%) than in younger patients (4%). And 66% of
these hospitalizations in older patients are due to 4 drugs or drug
classes—warfarin, insulin, oral antiplatelet drugs, and oral
hypoglycemic drugs.

16. • Drug-disease interacti
ons
• Drug- Drug
Interactions
• Inadequate
Monitoring
• Inappropriate Drug
Selection
• Lack of Patients
Adherence
• Over dose
• Poor Communication
• Under prescribing
• Poly Pharmacy

17. The use of inappropriate medications in elderly
persons is an important issue because of the
increased vulnerability of this segment of the
population.
There is evidence that elderly patients often are
prescribed inappropriate medications and, as a
result, tend to have more frequent and often serious
adverse effects.
The choice of medications prescribed is based on
prescribers’ knowledge of various pharmaceutical
agents, including drugs that have increased
potential for harm.
Inappropriate use of Medication in Elderly

18. Inappropriate Medications in Elderly (Examples)
01
02
03
04
05
Barbiturates
Respiratory
Depression,
habituation, Hip
Fractures
Benzodiazepines
Sedation,
habituation, Hip
Fractures
Tricyclic
Antidepressants
Ant cholinergic, Cardiac
Toxicity Orthostatic
Hypotension
Anticholinergics
Cardiac
Arrhythmia, Dry
Mouth and Eyes,
Urinary Retention
Antihistamines
Falls, Sedation,
Impaired Driving,

19. Comprehensive Geriatric Assessment(CGA)
Social Issues
Medications
Affective Status
Functional Status and
Cognitive Status
Nutritional StatusMedical Problems and Co
morbidities
Common
issues during
Older Age

20. Pharmacist Geriatrics Pharmaceutical Care Plan
Monitoring
and
evaluation of
the
effectiveness
of the plan is
carried out
Patient
centered care
plan is
developed
The pharmacist
implement care plan
with collaboration
with other
healthcare
Professionals
Collected
information is
assessed and
analyzed to
achieve optimal
therapy goals
Collection of necessary
Subjective and
Objective information
about Patient
Collect Assess Plan Implement Follow
Up

21. Thank You