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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...

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Related Experiment Videos

Optimizing Medication Adherence in Older Patients: A Systematic Review.

Elizabeth A Schlenk1, Lisa Marie Bernardo, Linda A Organist

  • 1University of Pittsburgh School of Nursing (Drs. Schlenk, Bernardo, and Engberg), University of Pittsburgh Medical Center (Ms. Organist), and University of Pittsburgh Health Sciences Library System (Dr. Klem), Pittsburgh, PA.

Journal of Clinical Outcomes Management : JCOM
|May 9, 2009
PubMed
Summary

Optimizing medication adherence in older adults yielded mixed results. Educational interventions and memory aids showed some success, but no single strategy is clearly superior for improving medication adherence in the elderly.

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Area of Science:

  • Gerontology
  • Pharmacology
  • Evidence-Based Practice

Background:

  • Medication adherence is crucial for community-dwelling older adults.
  • Optimizing long-term medication regimens in the elderly presents unique challenges.

Purpose of the Study:

  • To systematically review literature on strategies for enhancing medication adherence in older adults.
  • To provide recommendations for clinical practice based on current evidence.

Main Methods:

  • Conducted a systematic literature search across multiple databases (MEDLINE, CINAHL, PsycINFO, IPA, EMBASE).
  • Included randomized controlled trials (RCTs) focusing on medication adherence in adults aged 65+.
  • Analyzed 34 papers reporting on 33 distinct studies.

Main Results:

  • Educational interventions showed mixed results, with 12 of 28 studies demonstrating improved adherence, often pharmacist-delivered.
  • Memory aids and cues, including technology-assisted approaches, improved adherence in 4 out of 5 interventions.
  • Effect sizes for significant educational interventions ranged from Cohen's d = 0.14 to 4.93; for memory aids, Cohen's d = 0.26 to 2.72.

Conclusions:

  • Current evidence does not support a single definitive intervention for optimizing medication adherence in older patients.
  • Future research should investigate tailored, ongoing contact strategies and address methodological limitations in existing studies.