Abstract
The high prevalence of multiple comorbidities poses unique medication-related challenges for geriatric patients. Polypharmacy is a particular concern since taking several medications simultaneously increases the likelihood of adverse drug events and the risk of drug interactions while decreasing patient adherence. These factors are associated with suboptimal health outcomes and a heightened burden on the healthcare system (insurance claims) and the patient (out-of-pocket expenses). These challenges can significantly affect the quality of life of geriatric patients. This chapter critically examines the impact of medication use and polypharmacy on the quality of life of older patients. In addition, the authors discuss how artificial intelligence-based digital tools and precision medicine can address these issues by streamlining medical decision-making, improving the patient experience, and allowing remote monitoring. Finally, they interpret the findings from the lens of ethical considerations associated with the adoption and implementation of digital applications and gadgets.
TopIntroduction
The geriatric population experiences several medication-related concerns due to the higher prevalence of chronic diseases in this group, particularly in the context of polypharmacy, which is defined by Borodo et al (2022) and Nobili et al (2011) as the simultaneous use of more than five different types of drugs. According to Aiezza et al (2021) and Dagli & Sharma (2014), taking several medications raised the risk of adverse drug reactions (ADRs), drug-drug interactions, prescription errors, lowers medication adherence, while increasing healthcare expenses. Fauziyah et al (2017) found that these difficulties can strongly influence patients' physical, mental, and social well-being, thereby, lowering the overall quality of life.
According to Frishammar et al (2023), the advent of digital technology has resulted in innovative techniques to improve medication management in geriatric patient. Electronic medication dispensers, for example, help to coordinate medication schedules, distribute the correct dosage at the scheduled time, and provide medication reminders, according to Shahani et al (2022). Dayer et al (2013) stated that patients and caregivers can benefit from mobile applications and gadgets that track medication compliance, send notifications, and provide medication-related content, and Marien et al (2017) stated that the deployment of medication reconciliation procedures and decision support tools has also been aided by digital transformation.
As per Wheatley (2013), medication reconciliation includes a renview of patient's drug regimen to confirm that it is correct and acceptable. Healthcare practitioners can use digital tools to collect comprehensive treatment histories, detect potential drug interactions, and make informed decisions about prescription modifications. As stated by Angelopoulou et al (2022), these technologies increase pharmaceutical safety, eliminate risks related to polypharmacy polypharmacy-related risks, and optimize treatment programs, thereby improving geriatric patients' quality of life. Furthermore, telemedicine has developed as an essential tool for geriatric patients, notably in the treatment of medication-related difficulties. Kuwabara et al (2020) discovered that healthcare providers can remotely examine prescription regimens, evaluate drug effectiveness, give education and medication literacy to the patients, and track patient response to therapy through virtual consultations.
According to Ma et al (2020) and Ienca et al (2021), it is critical to explore the ethical implications and address the digital divide among older patients while digital transformation provides promising solutions and it is essential since it serves as the most important factor underlying geriatric patients’ acceptance to digital technology. The answer, according to Kärnä et al (2022), is to prioritize careful handling and processing of sensitive health information, respecting privacy, and maintaining data security. Adequate training and assistance should be provided to promote equal utilization and digital literacy among geriatric patients, eliminating the digital age gap and ensuring that all geriatric patients can reap the perks of digital transformation. Hence, in the present chapter, we aimed to discuss medication use and polypharmacy in geriatric patients, its impact on the clinical and quality of life aspects, and the role of digital transformation in addressing these issues.
Key Terms in this Chapter
Geriatric: A medical discipline specialty focused on providing care for the older adults population due to their unique health requirements.
Healthcare: The systematic delivery of medical care to a population or a person, either in private or public instances.
Pharmacokinetic: A branch of pharmacology, focusing on the dynamic movements of the consumed drugs within the body of a living organism.
Aging: Time-related decline of physiological capabilities required for life and fertility as a result of the buildup of an extensive variety of molecular and cellular damage.
Polypharmacy: A practice of multiple medicines prescription (>5 drugs) for a patient due to their illnesses.
Pharmacodynamic: A branch of pharmacology, focusing on the assessment of the biochemical and physiological impacts of drugs.
Digital Health: A comprehensive, multidimensional paradigm for managing illnesses and health hazards that integrates ideas from the convergence of information and communication technology and healthcare.
Medication Adherence: The extent to which a patient correctly follows drug use advice given by the healthcare practitioners.