Key Considerations for Pharmacists on Medication Management for Geriatric Patients

Ginah Nightingale, PharmD, BCOP, associate professor of pharmacy practice at the Jefferson College of Pharmacy at Jefferson University, discusses how pharmacists can counsel geriatric patients who may be taking multiple medications for chronic illnesses during the American Society of Clinical Oncology Annual Meeting in Chicago, IL.

Transcript

So I think there are a couple of things to actually take into consideration. I think pharmacists are trained to, again, not just look at number of medications but to also identify those medications that are considered to be high risk. Another thing that pharmacists should consider is the patient’s underlying organ function. So we do know as we get older there are changes in terms of pharmacokinetic and pharmacodynamic changes that impact organ function, so that’s something that a pharmacist would want to take a look at. Pharmacists are also uniquely trained to assess more pharmacokinetic drug-drug interactions, even outside of drug-drug interactions looking at drug-food interactions and drug-herbal interactions. So there’s quite a bit of resources to assist pharmacists to be able to perform that task.

And I think the other component is really drilling down and looking at medication adherence because what we find is that certain patients may be adherent to 1 medication, but that adherence doesn’t necessarily transfer over to other medications that they’re taking. So really trying to assess how well a patient is taking their medications and making sure that the instructions are written in large font, making sure that they’re able to read it, and also I think one of the areas that’s currently emerging is assessing the patient’s cognitive function. Because what we’re finding is that a lot of these older adults may have underlying cognitive impairment and that actually can potentially get worse after exposure to cancer treatment. So we want to make sure that patients are able to manage their medications safely and effectively because in terms of the fact that they would have to self-monitor for side effects and identify whether or not they should manage those side effects themselves, contact a physician, or actually seek medical attention. So that is something that must be considered as well.