Many people in the US, particularly the elderly, take more than one prescribed medication. CDC (2014) reported that between 2009 and 2012 nearly 48% of persons asked used at least one prescription drug, 22% used three or more prescription drugs, and nearly 11% used five or more.

In a recent study published by the Mayo Clinic, seven out of 10 Americans take at least one prescription drug. The most commonly prescribed drug is antibiotics — taken by 17 percent of Americans — followed by antidepressants and opioids — each taken by 13 percent of Americans. In addition, findings showed that:

• Even more staggering than the CDC findings, currently more than half of Americans take two prescription medications, and 20 percent of Americans are on at least five prescription medications.
• More women than men receive prescription medications.
• Antidepressant prescriptions are more common among women than men, and are most common among women ages 50 to 64.

When people take multiple medications, there is a greater risk for confusion about which medications are taken, when they are taken, and what they are being taken for. There is also a higher risk for drug interactions and increased side effects and adverse reactions.

Sometimes because of the sheer number of medications being prescribed, they may be forgotten, become too much of a bother, or a financial burden which can significantly impact client compliance and lead to poor health outcomes.

In this written assignment, you will be conducting an interview of a client who is taking multiple prescribed medications (three or more) and submitting a written paper describing the findings from the interview. You will then develop a Client Teaching Plan. Your instructor will assist you in the selection of the client. You must achieve a “pass” in this assignment to satisfactorily fulfill the requirements for the Pharmacology course.

The three parts of this assignment are:

Conduct an interview of a client who is taking multiple medications (polypharmacy). You must prepare the client before the interview by explaining why you are conducting the interview. You can say “my assignment is to find out about the medications you are taking so I can determine if you need more information about what you are taking”. You must always get permission from the client to conduct the interview and you must tell the client how the information will be used. You can say, “I will not be using your name in the information I share and I will be submitting it to my instructor only for this student assignment”. If there is important information that needs to be communicated to you, your doctor, family, or nurse, my instructor will assist me in following up on this”. Tell the client you will take no more than 30-45 minutes for the interview.

There may be a family member or significant other present during the interview. That is fine. Be sure to identify who answered a question and if possible always have the client answer first. Always thank the client (and others) when you complete the interview.

Do not use recording equipment for this interview. Have a notepad and pencil or pen and explain that you will be taking notes. When the interview is over, go to a quiet place and take some time to fill in any information you did not jot down. If you wait, you will not remember.

When setting the environment for the interview, make sure the client (and others) is comfortable and you are comfortably seated facing the client. If possible, do the interview in a quiet place.

Ask questions slowly giving the client time to answer. Pay attention to the client’s hearing and ability to respond to the questions. Be sure your non-verbal communication demonstrates you are calm and relaxed.

Use the following interview question guidelines when conducting the interview. Be aware that the client may not be able to answer each of the questions with detailed information. Collect as much information as the client is able and willing to give you. Remember you are the interviewer so you will be collecting information and not making any comments about the information shared by the client except to ask for further clarification if you are not sure what was said or need more detail if it is available.

1. What medications are you taking?
   (Before the interview research each of the medications. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions).

   For the following questions, paraphrase the client’s answers for your written paper.

2. How long have you taken each these medications?
3. Do you know why you are taking these medications?
4. Who told you about the medications and why you need to take them? Were you able to ask any questions about the medications and if so were they answered so you understood what was said?
5. How do you feel about taking these medications?
6. Are you taking other medication purchased “over the counter” such as in a drug store? If so, what is it and why are you taking it.
7. How and when do you take your medications?
8. Do you have any difficulty taking the medications? If so, what happens and how do you deal with any difficulties.
9. Have you ever felt any uncomfortable feelings and/or body reactions to taking these medications? If so, what were they and how were they handled?
10. If you had the above reaction, did they take you off the medication and/or replace it with another medication? Were you told why this happened?
11. Do you have any reason not to take the medications?
12. Have you ever not taken the medication? If so, what was the reason?

Ask a final question about whether the client would like to tell you anything further about their medications.

Write a paper describing your research and findings about the medications being taken and the results of the interview. Report your findings in a 3-5 page written paper. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions.

Use accurate and appropriate spelling and grammar and APA Editorial Format for sources used in your written paper.

Develop a teaching plan for this client based on your findings. Based on the findings from the interview, develop a 2-3 page teaching plan to include the following:

1. List one goal for this teaching plan
2. Describe two to three teaching resources that might be used
3. Identify two teaching strategies that can be used based on the client interviewed
4. List specific client instructions regarding the medications and what adverse reactions they should be aware of/and what to do
5. Identify at least one factor that may negatively influence adherence to the medications and how it can be overcome
6. If, appropriate, describe how the family might be involved in ensuring the client is on a proper and safe medication regime

While there are many regimens for the treatment of H. pylori infection, significant efforts in research and innovation have been made as well. The latest research results indicate that  the new triple therapy comprising of amoxicillin, protein pump inhibitor (PPI) and levofloxacin has recorded the highest rate of eradication of this bacterial infection (Woo and Robinson, 2015). Alternatively known as hybrid therapy, it delays the overall duration of amoxicillin treatment for about 14 days (Woo and Robinson, 2015). Essentially, the prolonged treatment accounts for a significant percentage of H. pylori eradication by this hybrid therapy as well.

The prevalence resistance worldwide to the triple therapy has enhanced more effort on vonoprazan-based therapy, particularly in regions with a significantly limited rate of clarithromycin resistance. With the evolution of vonoprazan therapy, the treatment options and generally the eradication of helicobacter pylori problems are broadened (Chey et al, 2017). More profoundly, switching the vonoprazan as an acid blocker for H. pylori means that there is a chance for a further reassessment of the triple therapy. It equally improves the efficacy of triple therapy through a significant reduction to the resistance in clarithromycin as previously noted.      Additionally, concomitant therapy has also been introduced for the reduction of the metronidazole resistance estimated to be about 50% in Asian countries (Woo and Robinson, 2015). Concomitant therapy implies using conventional antibiotics to reduce resistance levels in triple therapy.

Patients should be advised against consuming contaminated food, water, and other consumables. Such factors exacerbate bacterial infection on the walls of the small intestine through releasing toxins and enzymes. Furthermore, it is imperative that the patient is advised to seek proper counseling. In addition, the interventions can be employed in the control, prevention, and management of H. pylori. Supporting and emphasizing programs on patient’s compliance with drugs, specifically, pharmacists will result in an increase in the number of patients who will be taking medication. While antibiotics are recommended, patients should be watchful of the side effects and report immediately to the healthcare facilities (Woo and Robinson, 2015). Patients are also encouraged to seek for medical checkups frequently. The earlier detection and treatment for this infection will result in a better positive result, unlike the late time action.

References

Chey, W. D., Leontiadis, G. I., Howden, C. W., & Moss, S. F. (2017). ACG clinical guideline: treatment of Helicobacter pylori infection. The American journal of gastroenterology, 112(2), 212.

Woo, T. M., & Robinson, M. V. (2015). Pharmacotherapeutics for advanced practice nurse prescribers. FA Davis.