Magazine article Drug Topics

Seniors' Hypertension Therapy Hurt by Noncompliance

Magazine article Drug Topics

Seniors' Hypertension Therapy Hurt by Noncompliance

Article excerpt

As pharmacists are well aware, noncompliance is a widespread problem, significantly impacting patient outcome. Elderly patients, in particular, have a difficult time taking the right pill at the right dose at the right time for the right duration.

Senior citizens are medically challenged, economically and socially challenged, and in some cases physically challenged, William J. Elliot, M.D., Ph.D., told the audience at the recent meeting of the American Society of Hypertension (ASH), held in New York City. "Each of these factors," Elliot said, "has some importance in how we choose our medicines and particularly doses of medicine for elderly people."

In his presentation on the problem of noncompliance in the elderly, Elliot outlined specific obstacles that stand in the way of effective antihypertensive treatment for this graying patient population.

"Even though drug therapy is only 6% to 8% of the health-care budget in the United States, it's an out-of-pocket expense," he said. "Elderly patients on a fixed income are very nervous about their prescription drug costs, especially if they know that less expensive alternatives are available."

Concurrent medical conditions, whether attributable to disease or a natural part of aging, can be a major complicating factor when it comes to treating hypertension in the elderly, Elliot told the audience. Changes in the pharmacokinetic profile of some drugs may require that smaller doses of medication be used. Changes in cognitive abilities, hearing, or vision may impede the patients' understanding of how to take their medications.

Elliot told the audience that 82% of Medicare recipients in Illinois receive more than one drug per day, not including aspirin. He pointed out that increasing the number of medications a patient takes raises the likelihood of noncompliance and also the risk of drug-drug interactions, especially if the patient is under the care of several different doctors. …

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