TY  - CHAP
M1  - Book, Section
TI  - The Complicated Patient
A1  - Ogbonna, Kelechi C.
A1  - Donohoe, Krista L.
A1  - Clemons, Jenna S.
A1  - Delafuente, Jeffrey C.
A2  - Whalen, Karen
A2  - Hardin, Heather C.
Y1  - 2018
N1  - 
T2  - Medication Therapy Management: A Comprehensive Approach, 2e
AB  - KEY  POINTSMultiple  chronic  conditions  (MCCs)  present  challenges  to  older  adults  and  their  healthcare  providers.Geriatric  syndromes  are  not  specific  diseases  but  a  constellation  of  symptoms  common  in  older  adults.The  extensive  use  of  medications  by  the  geriatric  population  increases  the  risk  of  adverse  drug  events  (ADEs),  drug-drug  interactions,  disease-drug  interactions,  and  food-drug  interactions,  and  often  contributes  to  medication  nonadherence  among  patients.Poor  care  coordination  and  insufficient  communication  among  providers  caring  for  a  patient  is  a  cause  of  ADEs  in  older  adults.The  prescribing  cascade  commonly  contributes  to  what  is  referred  to  as  polymedicine  or  polypharmacy.Healthcare  delivery  for  people  with  MCCs  is  often  fragmented,  less  effective,  complex  as  well  as  confusing,  and  more  expensive.As  older  adults  move  from  one  healthcare  setting  to  another,  they  are  vulnerable  to  consequences  of  poor  communication  between  settings  and  between  providers.Many  of  the  existing  clinical  practice  guidelines  do  not  take  into  consideration  populations  with  physical  disability,  multiple  medications,  and  multiple  comorbidities,  all  of  which  are  commonly  seen  in  older  adults.Providing  care  to  older  adults  with  complex  conditions  requires  a  specific  skill  set  and  knowledge  about  geriatric  pharmacotherapy.The  Beers  criteria,  The  Screening  Tool  of  Older  Person’s  Prescriptions  (STOPP)  /  Screening  Tool  to  Alert  Doctors  to  Right  Treatment  (START),  and  the  Medication  Appropriateness  Index  (MAI)  provide  a  variety  of  methods  to  assess  medication  appropriateness.Little  research  exists  to  help  identify  the  most  effective  means  to  improve  health  outcomes  in  patients  with  MCCs.Patients  with  complex  multiple  conditions  need  a  team  approach  to  improve  and  coordinate  care.Caregiver  burden  describes  the  toll  on  people  providing  care  and  has  been  defined  as  “a  multidimensional  response  to  physical,  psychological,  emotional,  social,  and  financial  stressors  associated  with  the  caregiving  experience.”  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1150197887
ER  -