Multimorbidity in older patients creates a challenge because you're dealing with multiple diseases and multiple medications, explained Michael Steinman, MD, professor of medicine, University of California, San Diego.
Multimorbidity in older patients creates a challenge because you're dealing with multiple diseases and multiple medications, explained Michael Steinman, MD, professor of medicine, University of California, San Diego.
Transcript
Why are medication management strategies particularly important for older patients?
One of the issues with older patients is the presence of multimorbidity, so the challenge has become that much more complex because we’re not just dealing with a single disease, were dealing with multiple diseases and thinking about the interaction of all of those diseases, including the multiple medications a patient may be taking. They might make sense for one disease at a time, but when you add up all of the diseases and a patient ends up taking 18 medications, 9 of which are interacting with each other, and the patient can’t pay for their electric bill because they’re spending all their money on medications, that’s a problem.
So, being attentive the unique needs that arise from the presence of multimorbidity and thinking holistically about the patient and how to optimize their medication regimen in a way that makes sense for the person, not just the individual disease, is critical.
Are there challenges with trying to reach and engage these patients?
I think there’s a lot of variability in what strategies work for different patients. For example, if a strategy is just focused on getting patients to remember to take their medications more, that could be really useful for patients whose primary problem is just they forget to take their medications and having improved strategies for helping them, for example, with medication organizers or reminders. But, just to build on that example, a lot of nonadherence isn’t due to forgetting, it’s due to patients not thinking their medication is useful, not understanding why they’re taking it, or having real or perceived side effects and not wanting to take the medicine as a result.
Again, we need to be patient-centered on how we approach these things and really understanding what’s going on in the patient’s mind, why they’re acting or not acting a certain why, what’s going on in the prescriber’s mind, why they’re acting or not acting in a certain way, and addressing those levers accordingly.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Posters Characterize DMD Caregiver Experiences, Impact of Gene Therapy on Caregiving Demands
May 10th 2024Posters presented at the ISPOR—The Professional Society for Health Economics and Outcomes Research meeting explored Duchenne muscular dystrophy (DMD) caregiver experiences and gene therapy’s impact on work opportunities for caregivers.
Read More
A Focus on Women: AUA Best Posters Highlight Female Athletes, Prenatal Care, and Women in Urology
May 9th 2024Three posters from the American Urological Association (AUA) 2024 Annual Meeting focused on urinary incontinence in female athletes, prenatal care for fetuses with spina bifida in California, and the experiences of women residents at the Brady Urological Institute.
Read More