Older adults need to take extra care with medications

Marcia Shade, Ph.D., is passionate about sounding the alarm on safe medication use and management in older adults.

Thirteen years of nursing practicing, personal experience and a study she did for her doctoral dissertation have shown her how dangerous over-the-counter and prescription medications can be if not monitored.

Dr. Shade, who recently earned her doctorate from the UNMC Graduate College, conducted a study that looked at medication use in older adults living in a small Nebraska town.

“I was really excited about it,” Dr. Shade said. “They were so generous with their time. My study focused on answering the question — ‘what are people really taking at home and is it appropriate?’ ”

Using the Beers Criteria, a resource for medications to avoid or use with caution in older adults, she evaluated prescription and non-prescription medications for 138 older adults living independently.

She did an extensive medication review with each individual, as well as assessed the use of vitamins, herbal supplements and alcohol and tobacco since they also affect how medications work in the body.

She found 49 percent were taking one or more medications on the Beers Criteria. The majority of the medications were over-the-counter such as non-steroidal pain relievers — ibuprofen and sleep aids.

“It wasn’t that a health provider was prescribing all of the medications. Many were acquired over-the-counter without a prescription, but that doesn’t mean they’re 100 percent safe. Individuals should always consult with a health professional before starting or stopping medications. They shouldn’t do it on their own.

“The more medications a person takes, the more likely they will be taking one that is inappropriate,” said Dr. Shade, a Jonas Nurse Leader Scholar.

More education and attention needs to be given to safer medication management both in the health care community and consumers, she said, and there needs to be a team approach including the physician, nurse, pharmacist and family.

Pharmacists are a good source to ask questions about medications. She recommends individuals take all their medication, vitamin and supplement bottles with them when having medications checked for interactions. She also encourages people to ask about signs regarding an adverse event.

“I’m passionate about this issue,” she said. “I can talk and talk all day. I just hope people hear me.”