Article of the month March 2017

Medication Management – Practical Support Options for People Needing Polypharmacy

Dr Kevin Doughty

e-mail:  dr.k.doughty@btinternet.com

Summary

The role played by medication in helping people to recover from illness, injury or surgery is well-established. In the case of acute illnesses, the appropriate choice of medications can quickly overcome the symptoms and help to defeat the disease resulting in a cure. However, many chronic diseases from diabetes through to arthritis cannot yet be cured in most cases, and certainly not through medication alone. Medication is needed to manage the symptoms, but needs to be taken for many years. This raises the possibility (or perhaps probability) that adherence to the prescribed medication therapy will decline over time, limiting control of symptoms. Indeed, if the decline in health over subsequent years is slow, people may not associate cause with effect.

Today, about 10 million people in the UK are aged 65 or older. The number is likely to double within 35 years as the total population increases and as life expectancy continues to rise. However, because many types of chronic disease are the result of lifestyle choices, including the effects of smoking, alcohol, obesity and a lack of exercise, more than half this population will suffer from not a single disorder but from multiple comorbidities. Each disease may require specific medications, resulting in a need for polypharmacy as shown in Figure 1 with nearly 3 in 5 men and women aged over 85 requiring 5 or more different medications every day. Managing these prescriptions is a significant problem, and an issue that leads to poor outcomes, and health and social care system inefficiencies.

Poor concordance with physician instructions, and more general public health advice, are known to be the cause of many chronic diseases. This is particularly a problem in the developed world where the ability to make informed choices is high on the priorities for consumers who can be tempted by ease of access to fast foods and who have moved into sedentary occupations due to the decline in heavy industry and more labour-intensive jobs. But poor adherence to medication regimes is a problem throughout the world, and is linked to many social-economic and cultural factors. Technology and digital healthcare strategies can play a big role in improving adherence. The devices and systems that are available are described in this article.

Full article can be found here

TO VIEW PREVIOUS ARTICLES OF THE MONTH, PLEASE CLICK HERE

Article of the month February 2017

Helping People with Dementia and their Families  – Using the 3 Tier Technology Enabled Community Care Model

Dr Kevin Doughty  

It is generally accepted that the outcomes of health and social care interventions for people with any physical, cognitive, sensory or emotional deficit(s) can be improved if the process of assessment includes a profiling that extends considerably beyond the traditional approach of focusing on risks and unmet needs; a consideration of their life goals and ambitions, and the obstacles to them achieving an improved Quality of Life and well-being supports more innovative, unconventional, and sometimes unusual or surprising approaches and priorities. The role of technology in many of these new ways of overcoming barriers is increasingly recognised and can be included within Technology Enabled Community Care and Technology Enabled Care @ Home models, especially when they add higher wave applications (3rd to 7th wave) to the usual telecare alarms in the support package.

However, attempts to integrate health and social care provision can focus so much on trying to treat illness and improve health conditions (usually through medical interventions such as medication, surgery or therapy), that some long-term conditions and disabilities are not considered. This can become a concern for the support of older people who may now survive for many years through improved healthcare but with poor Quality of Life. The i-CUHTec 3-tier model can play an important role in ensuring that technology is considered at several points in working out the best support plan.

This model is entirely generic, and can be applied to any individual irrespective of their challenges, disabilities, social capital or health conditions; its application for helping people with dementia, and their carers, is the subject of this article.
Full article can be found here

TO VIEW PREVIOUS ARTICLES OF THE MONTH, PLEASE CLICK HERE