ELDERLY CARE
he British Geriatrics Society was founded in 1947 and the first appointed consultant geriatricians came soon after the inception of the NHS in 1948. From the offset pharmacy played a vital role in the management of older patients, as part of an integrated team - recognised as early as 1771 when the New York Hospital Charter included an apothecary as one of the four salaried essential positions.1 Since then pharmacy has developed a unique array of skills, and has made been able to make positive contributions to overall patient care.
With advances in healthcare, progress soon disseminated from the hospital setting and into the everyday community environment. Contemporary thinking now suggests that such a move has and will continue to advance Healthcare standards and efficacy. The Scottish Government vision is for “supported care for people to live well at home
38 - SCOTTISH PHARMACIST
Pharmacy and older people T
for as long as possible and to have a positive experience of any care they receive”.2
The plain fact that such
experiences are both important, and difficult to achieve cannot be overlooked. Currently, 42% of the Scottish Government budget is set- aside for Health and Social Care.3
Full
integration of health care services into the community should cause some “constructive disruption”, and with an aging population such services will be in high demand. As such, the pharmacy can be a key player in the delivery and development of community based service.
An aging society brings with it some specific challenges for health services across the world, with the NHS being no exception.4
Increased frailty of
patients, increasing prevalence of diseases (including co-morbidities) and often vast number of medicines employed per patient, require each healthcare sector to work efficiently to maintain safe treatments to help
achieve patient goals, in terms of their chronic illness, their palliative care aims, and overall quality of life and wellbeing. This article will highlight some of the specific challenges surrounding pharmaceutical care of the elderly, and how pharmacy can provide effective resolutions.
Polypharmacy is a term that first appeared 150 years ago, used to describe cases where patients received multiple medicines simultaneously, and was initially frowned upon. Recently the term has been defined as patients receiving more than four medicines. 10 years ago this was considered a high quantity of medicines however, such regimens are now commonplace – prompting the debate to formally consider this definition. Patients are routinely prescribed complex drug regimens for prophylaxis and treatment of common disease states, resulting in many receiving greater than 10-20 medicines daily.5 prescribing has become regular
Such
POLYPHARMACY
IS A TERM THAT FIRST APPEARED 150 YEARS AGO, USED TO DESCRIBE CASES WHERE PATIENTS RECEIVED MULTIPLE MEDICINES SIMULTANEOUSLY, AND WAS INITIALLY FROWNED UPON. RECENTLY THE TERM HAS BEEN DEFINED AS PATIENTS RECEIVING MORE THAN FOUR MEDICINES.
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