Medicine(s) Matter(s) in the Older Patient: Understanding, Counselling and Health Literacy (#27)
Patients who are older than ever before are now being given chemotherapy - which was once restricted to under-60s. Many have challenges relating to cognitive impairment (e.g. delirium and early dementia), and the burden of medication-related problems renders these issues more complex. This interactive presentation will discuss challenges facing the pharmacist counselling an older patient who is receiving chemotherapy and supportive care medications.
Mr AS is a 79 year old man with newly diagnosed Non-Hodgkin’s lymphoma, receiving R-CHOP chemotherapy and associated supportive care medications. He is on four regular medications which his wife usually packs in a dosette. On the day he receives his first cycle of chemotherapy the pharmacist who counsels him about chemotherapy side effects realises that he has been given a bag of new medications which he does not know what to do with. How do you ensure that he understands about his chemotherapy and takes his medications safely?
Numerous papers regarding patient health literacy and comprehension of medical/pharmaceutical information have been published over the years. Up to 80% of information provided is not retained by patients; assessing their comprehension of that which is retained is not straightforward. Some patients display little interest in receiving further information about their condition, possibly because they are overwhelmed. Other patients may have well-meaning family and friends who perform an internet search but don’t fully comprehend the information they have retrieved.
Various educative and recall strategies will be discussed. A ‘triage’ approach can determine the information patients have already received from other sources and their retention of this. Current medications should be reviewed and the pharmacist can use this information to pitch counselling at an appropriate level. Medicines lists produced by commercially available software may prove to be too detailed - a written medication card and numerical labelling of supportive care medications can be the simplest and most effective approach