Aging with Asthma Part I
Challenges Facing Older Adults with Asthma
Well, our recent move from one Georgia town to another has made me feel even older than my AARP-status proves, but luckily, my asthma has not flared. Moving dusty items, cleaning out storage unit corners and polishing our house to sell (pleeeaaase sell!) could have launched an asthma episode, but I have been lucky so far. I have not had to add to my usual daily medications.
Our daughter, Serena, who works for The National Council on the Aging which is located in Washington, D.C., reminded me that the majority of older adults use multiple medicines. In fact, according to the American Society of Health-System Pharmacists, 76% of older adults take at least three medications and 33% take eight or more.
The media frequently discusses the hazards of overprescribing, but a new study reveals that underprescribing may be an issue too. The October 2006 Journal of American Geriatrics Society provides the details of a study involving 196 patients, age 65 or older who were taking five or more prescribed drugs. More than 40% were taking at least one inappropriate medication while not taking one that could have helped them.
What makes a tough situation even more challenging? The results of “Prescription Drug Coverage and Seniors: Findings from a 2003 Survey” by D.G. Safran et al. reveal that 52% of older adults do not take their medications as prescribed and 54% take medicine prescribed by more than one physician. The issues with medications use and misuse in our homes are problematic; healthcare costs are staggering. The tab for medication-related problems was calculated at $100.6 billion (Bootman, L. et al, Archives of Internal Medicine, 1997.)
OK, OK, the statistics are hard and dry, but the implications are as binding and wet as the just-poured cement outside my window. But now…. you may be wondering what you can do to make a difference. The good news is you do have power. You can understand the full scope of challenges facing your healthcare professionals, grasp the details of seniors with asthma, maintain your personal medication record (PMR) and campaign for reform.
Scope of Challenges
Any medication therapy should be evaluated for appropriateness, effectiveness and safety, but healthcare professionals who treat older adults must consider a broad array of factors before prescribing, including a host of “multiples:”
- multiple diagnoses are likely
- multiple professionals are prescribing
- multiple pharmacies may be used, causing potential interactions to go unnoticed and
- multiple medications, including over-the-counter meds, vitamins and herbal supplements are being taken.
Additional considerations include:
- physical access to care
- declining senses, especially eyesight and hearing
- older adults metabolize, eliminate and therefore, respond to medications
differently from younger individuals.
No wonder only 9,000 physicians, less than 2% of the nation’s physicians, choose to specialize in geriatrics! At least 20,000 geriatricians are needed to care for America’s 35 million older citizens according to the Alliance for Aging Research. It will help any healthcare professional if you know the basics of your chronic condition(s) and asthma is certainly included.