Research Paper Example: Educating Nurses on Polypharmacy

Introduction

Over the ages, polypharmacy has been defined as the use of multiple medications by a single individual. A standardized threshold has not been developed as to what can constitute the definition of numerous medications. Despite the vague definition of multiple medications, clinicians widely accept a threshold of at least five medications. This has had a positive association with individuals with advanced age. The use of multiple medications has been seen to lead to a high number of admissions to hospitals, placement in nursing homes, mortality, and difficulty with ambulation. There is an advantage in using many medications by the patients since they help them keep their diseases in check, enabling them to live a better life.

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Despite the advantage that it holds, polypharmacy exhibits more risks because when a person consumes more drugs, there tends to be an increased drug interaction. These interactions may reduce or increase the effects that the individual drug possesses on the disease it was supposed to cure or suppress. Taking off the different types of drugs by an individual may cause side effects, which may include the reduction of the effectiveness of the drug. The risk factor that may lead to the contribution of polypharmacy includes seeing multiple medications prescribed by different pharmacists. This paper seeks to review various publications by different authors on the topic of polypharmacy, and it will further tackle how the literature review can be applied to the learning plan.

Literature Review

“Interventions to improve the appropriate use of polypharmacy for older people” by Rankin et al. (2018)

The article "Interventions to Improve the appropriate use of Polypharmacy for older people" by Rankin et al. (2018) agrees with the fact that there is complexity in finding the balance between avoiding medication-related harm and the aggressive treatment of diseases. The authors analyze the challenges that clinicians go through to offer proper treatment and provide treatment for the patient's ailments. The authors further explain that despite physicians' ability to reduce inappropriate prescriptions, it was still unclear whether the efforts to ensure proper polypharmacy amongst the elderly would result in improved quality of life or a reduction in hospital admissions. The authors' research used participants dealing with more than one medical condition who were aged 65 years and above. According to the authors, this sample was the most perfect since polypharmacy is most common among the elderly. The article concludes with the authors noting that the interventions to be made on which approach to be used in selecting suitable medicine for older people are based on the drugs taken to significantly reduce the effects of diseases.

“An update on the clinical consequences of polypharmacy in older adults: a narrative review” by Wastesson et al. (2018)

The article “An update on the clinical consequences of polypharmacy in older adults: a narrative review” by Wastesson et al. (2018) acknowledges the use of multiple medications by the elderly. The author further explains that the older generation's care with multimorbidity will cause a huge challenge soon. This is because as the years go by, diseases and complications keep mutating, and this will make it difficult for clinicians to use little medicine to deal with the ailments of the elderly. The article reviews the international news covering the prevalence of polypharmacy and the negative outcomes documented in various studies. The authors further review the clinical consequences polypharmacy holds concerning the interactions between the drugs and the disease, adverse drug-related events, physical functions, hospitalization, and even death. The authors further seek to develop a clinically meaningful definition of polypharmacy addressing the promising initiatives set to combine the clinical judgment approach and the cut-off approaches in a meaningful way. The article concludes by addressing the fact that there is a need for more scalable interventions to reduce the increasing levels of polypharmacy.

“Is polypharmacy associated with frailty in older people? Results from the ESTHER cohort study” by Saum et al. (2017)

The article "Is polypharmacy associated with frailty in older people? Results from the ESTHER cohort study" by Saum et al. (2017) investigates the relationship between frailty and polypharmacy. The authors classify frailty as diminished endurance, strength, and an increased risk of adverse outcomes, including disability, sudden falls, or even death. Additionally, polypharmacy also has the same almost similar characteristics as the ones exhibited by individuals experiencing frailty. The authors further review the cross-sectional associations that are caused by frailty and increased medication use. Higher rates of frailty were noticed among members of the sample who were exposed to frailty. The authors further explain that their study was based on a representative sample of community-dwelling older people compared to other studies and was mostly locked to specific groups. These groups were not representative of the older population, which happened to be the most affected group by polypharmacy. The author's study analysis was performed on an 11-year follow-up from the ESTHER cohort study. The study concludes by acknowledging the relationship between frailty and polypharmacy while suggesting a further review of whether a reduction in polypharmacy will also reduce frailty.

“Current and future perspectives on the management of polypharmacy” by Molokhia and Majeed (2017)

The article “Current and Future Perspectives on the Management of polypharmacy” by Molokhia and Majeed (2017), suggests the importance of having systems in place to ensure patients start medications only when there is an indication that they are aware of the complications and benefits that may arise from the treatment that they receive. The authors blame the rapid growth in polypharmacy to the inadequate up to evidence-based date guidelines. Many guidelines that existed before were single. The developers of the guidelines have recently recognized this. They are coming up with new guidelines catering to this shortfall. The article suggests the use of electronic patient records, particularly where prescription takes place. This will enable easier monitoring of patients; hence, subgrouping them will be much easier into subtle categories of complications. However, the authors address the fact that the randomized clinical trials meant for the creation of guidelines have rigorous selection processes, which in the end, lockout the frail and older patients with multimorbidity. The authors further suggest developing risk prediction tools to quantify the risk that may be involved with the adverse drug reaction. The article concludes with suggestions of using new technologies such as smartphone apps to keep track of patient prescriptions, enabling improved knowledge of their medication.

Application to Learning

Understanding of Polypharmacy

The literature review will be important in the proper understanding of all matters surrounding the polypharmacy topic. This will be essential in learning since it will bring a mastery of the topic, making colleagues' tutoring about the same to be a lot easier. It will also cover divergent views on the topic that would be essential in understanding the thoughts that other scholars had. Besides, it will help understand the evolution of polypharmacy and the measures that have always been undertaken to reduce its effects.

Developing of Findings

The literature review will help create a base of evidence sampled from the findings of the research. This will help create citations to be used in the demonstration of teachings as directed by the instructor. The literature review will help create a pool of knowledge from credible sources that can support arguments.

Understanding What Has Not Been Investigated

The literature review will help in the understanding of areas of polypharmacy that have not been investigated. This is essential in ensuring that more follow up is done on the topic to cover up on the weakness that the other research portrays. Various literature reviews highlight the gaps evident in the industry and suggestions on where the researchers should concentrate. The reviews will further explain the causes that make the researcher unable to address certain gaps.

Use of Information from The Literature Review in The Project

Creation of A Foundation of Knowledge

The project involves teaching fellow nurses, and the literature review will broaden the scope of knowledge already possessed. It will help in the tackling of questions that the other nurses will have concerning polypharmacy. The creations of presentation to be done quarterly will require a deep understanding of the matters concerning polypharmacy.

Referencing Own Research in The Context of Existing Literature

The literature review will assist in the use of the existing work to cross-reference against personal research. This will help make a case as to why further study is needed and address where own research was not explanatory enough. This will justify the facts that were stated in the teaching program of the project. Referenced material is efficient for the use in teaching since it covers all areas that need to be addressed and still shows the mastery that someone has on the polypharmacy topic.

Justification of The Project

The literature review will help justify the project since it will touch on the issues that are evident concerning the topic. A project that is backed with well-researched information promises confidence from the people that come across it. Fellow nurses will have a sense of confidence with the training that will be undertaken as planned. Furthermore, it will also address why the project is being done and the reasons for addressing the project proposal's thesis.

Strengthening of Argument

The information from the literature review can be used in the strengthening of arguments in the project. The information can be used in the strengthening of arguments developed by points addressed by the proposal. This is very important since it shows that sufficient research was done concerning polypharmacy before embarking on it.

Conclusion

Polypharmacy is a situation that has been around for a while but had not received recognition from the board that is responsible for the issue of guidelines. Although there is a vague explanation of multiple medications' meaning, polypharmacy can be understood as taking multiple medications by a single person. From the literature review, it can be concluded that polypharmacy is one area of study that has not been fully explored. The various studies that have been done have not addressed the methods to address and finish polypharmacy in the health industry fully. This paper has addressed various pieces of literature from the last five years that have been peer-reviewed to analyze further what researchers think about polypharmacy. The literature review is beneficial to the information to be included in the literature review. It will further help justify the project even as it is actualized.

References

Molokhia, M., & Majeed, A. (2017). Current and future perspectives on the management of polypharmacy. BMC family practice, 18(1), 1-9.https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-017-0642-0

Rankin, A., Cadogan, C. A., Patterson, S. M., Kerse, N., Cardwell, C. R., Bradley, M. C., ... & Hughes, C. (2018). Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database of Systematic Reviews, (9).https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008165.pub4/abstract