Population and Global Health Dissertation

Population and Global Health: Medication Adherence in Seniors

Assess the preventive and protective healthcare needs of a community of individuals, including emergency preparedness. Develop a plan for using behavioral change techniques to promote optimum health of a community, include culturally and spiritually sensitive care.

Describe the population/community you have chosen

The elderly are an incredibly high needs population when it comes to the field of professional medicine: they are consistently under-served and struggle very often to get even their most basic health needs met. One of the particular issues that prevents this population from staying healthy is the issue of medication adherence. A lack of proper medication adherence can cause a range of complicated issues and all of these issues are highly preventable: the individual just needs to stay on their medication. Medication adherence in seniors greater than 60 years of age is a primary factor for preventing serious complications from chronic conditions (Ruppar, Conn, & Russel, 2008). Cognitive and physical changes comingled with additional risk factors such as living alone, unable to drive and limited incomes all contribute to a negative outcome for medication compliance (Harkness & DeMarco, 2012).

Moreover, issues like cultural and spiritual beliefs perceived about healthcare can contribute to barriers to medication adherence. Many elderly lack education or and have multiple chronic conditions leading to higher rates of admissions and higher rates of death (Long, S.K., King, J., & Coughlin, T.A., 2006). This population deserves more attention because they’re so vulnerable: The elderly are disproportionately at risk for accidental drug overdoses, falls and readmission to the hospital. Furthermore, seniors are more likely to suffer from adverse drug responses from prescription medications complicated by complex drug regiments. With increasing age, many elderly have difficulty understanding due to hearing loss, seeing difficulties and knowledge deficits (Harkness & DeMarco, 2012). Thus, it is absolutely apparent that a strong system needs to be in place to ensure that the members of this population are able to feel comfortable staying on their medication and feel empowered to do so.

Assess preventative/protective health care needs of a population from different data sources and observations.

One of the obstacles in place that prevent many seniors from adhering to their medication is the fact that today many elderly are taking multiple medications for various chronic illnesses. However, the ability to modify this and other risk factors while providing a network of caring healthcare individuals and volunteers can help the elderly, allowing them to receive the medical care they need and to take their medications in a consistent manner. Adherence to medication is one major part of a multi-faceted plan of health that can allow individuals to receive the medical care and preventative care that they need, while nurses focus on disease prevention by showing elderly patients how to ascribe to better nutrition and through encourage them to join social events within the church or the community. Other studies have found that when pharmacies don’t have automatic refills of prescriptions, this can create a lack of adherence to medications in seniors (Krousel-Wood,, 2009). Other studies have indicated that inappropriateness of medication can also be a factor in a lack of adherence to prescriptions for seniors (Viks et al., 2004). All of these obstacles are largely preventable for healthcare professionals: they can be eliminated and a strong support structure can be ascribed in place.

Select one health care need of a population/community from your assessment, develop, and present a plan for meeting that need.

Seniors are in need of effective education about the medications they take and potential side effects to increase medication compliance. The World Health Organization defines adherence as “The extent to which a person’s behavior (taking medications, following a recommended diet and/or executing life-style changes) corresponds with the agreed recommendations of a health care provider” (Sabate, 2003, p. 13) (Ruppar et al., 2008, p. 115). Thus this problem is clearly the result of an epidemic of ignorance: one which causes a rush of readmissions to hospitals, with nurses needing to collaborate with other healthcare professionals and engage as liaisons for the doctors, caregivers, pharmacists, and other people. Nurses have so much potential for bridging this dangerous gap of ignorance as the power and wisdom of the nurse is so great: They can make home care visits and discuss medication regiments to the patient. They can screen and review medication management. Nurses can assess and educate the patient’s ability to administer medications, educate on dosages, purpose and side effects. They can also observe the medication effectiveness and monitor side effects.

Nurses collaborating with doctors and pharmacists could simplify the amount of medications needed by patients, address the possible need for puncture packs for the elderly, as well as assist patients with med lists for doctor’s appointments. This simplification could lower costs for the elderly and the community.

Describe theories of motivation and behavior change, which you are using.

The health belief model is one of the most consistent in the prediction of behaviors, particularly when it is used in conjunction with the ecological model that incorporates the individual, people and their environment, along with the developmental history and culture to change behavior. According to this model, behavior is linked to the knowledge, values, and beliefs of a person and can be used as a way to decrease barriers. By gaining a better understanding of a culture and its values, we can influence behaviors in a positive way. This would lead to better health outcomes for the Elderly whole. (Harkness & Demarco, 2012). By evaluating and educating elderly patients sent home from hospitals during the first 6 months of drug therapy, nurses can collaborate with other healthcare professionals and act as liaisons between doctors, caregivers and pharmacists. They can make home care visits, phone calls, and set up group education nights at clinics. All of these aspects can have a tremendously powerful impact on the overall health and wellness of the elderly patient.

Nurses can assess and educate the patient’s ability to administer medications, educate on dosages, purpose and side effects. They can also observe the medication effectiveness and monitor side effects.

Educating and monitoring patients over a period can lessen the high risks of drugs. This will create a healthier informed person and lower the costs of repeated hospital admissions as well as deaths resulting in a healthier community. Such observations and assessments can have a tremendous impact on how these individuals are cared for and the method that is taken with them.

Explain how you would evaluate the effectiveness of your plan/intervention.

To determine the effectiveness of the intervention, questionnaires will be given to all of the patients — questionnaires which contain short answers and multiple choice, along with phone calls and home visits. Permission to obtain information from the primary doctor would be beneficial to find out exact statistics for each patient, such as if readmission to hospitals had lessoned in the community after a 6-month teaching period.

Assess the preventive and protective healthcare needs of a community of individuals, including emergency preparedness. Develop a plan for using behavioral change techniques to promote optimum health of a community, include culturally and spiritually sensitive care.

Preventative care is absolutely and fundamentally key with this population. The key to successful preventative care generally revolves around delegating educational activities to midlevel practitioners, pharmacists and designated nurses. This form of delegation can prevent things like time restraints, health beliefs, cultural differences and comparable issues become too overwhelming during hospital stays. A higher level of organization, in conjunction with a higher level of cultural sensitivity, can help impact patient behavior and minimize readmissions to the hospital, particularly when used in conjunction with visits and phone calls (Umore, 2011). Spiritual health endeavors will need to be introduced to the community slowly over time and be treated as a serious pillar of health and wellness: meditation, yoga and aromatherapy are all essential to this cause.


Coughlin, T.A. (2006). The health care experiences of rural Medicaid beneficiaries. Journal of Health

Care for the Poor and Underserved, 17(3), 575-91.

Griffiths, R., Johnson, M., Piper, M., & Langdon, R. (2004). A nursing intervention for the quality use of medicines by the elderly clients. International Journal of Nursing Practice,

Griffiths, R., Johnson, M., Piper, M., & Langdon, R. (2004). A nursing intervention for the quality use of medicines by the elderly clients. International Journal of Nursing Practice,

166-176. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdf

Harkness, G.A., & DeMarco, R.F. (2012). Community and public health nursing Evidence for practice. Philadelphia, PA: Lippincott Williams & Wilkins.

Krousel-Wood,, M. (2009). New medication adherence scale vs. pharmacy fill rates in hypertensive seniors. American Journal of Managed Care,15(1), 59-66.

Vik, S.A. (2004). Measurement, correlates, and health outcomes of medication adherence among seniors. Annals Pharmacotherapy, 38(2), 303-312.

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