DRP in Elderly Flashcards
Criterias in MAI
- Indication: Need/Want
- Efficacy: Hx of use, how efficacious
- CI, DDI, DFI, DLI
- Dose appropriate? Practical Dosing and Administration?
- Duplication of therapy?
- Duration of treatment
- Cost effectiveness
Does not include:
- untreated indications
- failure to adhere to treatment
- ADR
Types of DRPs
- Indication
- ADR
- Dosage: Over or under dosed
- Failure to adhere: non compliance
- Interactions: DDI, DFI, DLI
Pharmaceutical Care Framework
- What matters most to patient
- Explicit: HAM, WANTED list drugs
- Implicit: clinical judgement + adherence issues
- Successful delivery: monitor adr, adherence, what matters most
Basic ADLs
DEATH —> frail if cannot do
Dressing
Eating
Ambulating
Toileting
Hygiene
IADLs
SHAFTTT —> Mild frail if cannot do
Shopping
Housekeeping
Accounting
Food Prep
Telephone, Take Meds, Travelling
ABCDEF Framework
Accurate diagnosis of dementia
BPSD
Caregiver Stress
Drugs & Disabilities
End of life or Equipment
Financial
CGA (5 Domains)
- Functional Status
- ADL, IADLs —> maintain/improve - Medical Review (CAIT)
- conduct, assess, address, identify and tailor - Mood
- cognitive impairment (cause)
- mood issues (depression, anxiety) - Nutrition and Med
- malnourished, lack essential nutrients?
- med: DDI, ADR, prescribing cascade - Socioeconomic
- support system
- finances
- living conditions: safe space
Who would not benefit from CGA?
- CFS 8/9
- Very fit elderly
Only benefit those CFS 4-7
CFS Staging
1-3: non frail
4: pre frail (vulnerable: symptoms limit activities)
5: mild frail (need help with IADLs)
6: Moderate frail (need help with BADLs)
- Severe frail: dependent for personal care but stable and not high risk of dying
8: Very severe frail: dependent on personal care and cannot recover from minor illness
9: Terminally Ill: <6 mths to live
