The​ ​topic​ ​I​ ​chose​ ​was​ ​polypharmacy​ ​and​ ​its​ ​effectiveness​ ​in​ ​older​ ​patients,​ ​and​ ​I​ ​decided

to​ ​choose​ ​this​ ​topic​ ​because​ ​I​ ​was​ ​so​ ​shocked​ ​about​ ​the​ ​number​ ​of​ ​medications​ ​that​ ​all​ ​the
patients​ ​that​ ​I​ ​have​ ​worked​ ​with​ ​have​ ​to​ ​take​ ​on​ ​a​ ​daily​ ​basis.​ ​I​ ​think​ ​it​ ​just​ ​gets​ ​overwhelming​ ​to
the​ ​nurse​ ​and​ ​to​ ​the​ ​patient​ ​when​ ​having​ ​to​ ​worry​ ​about​ ​so​ ​many​ ​different​ ​medications,​ ​the
rationale,​ ​side​ ​effects,​ ​etc;​ ​consequently,​ ​ ​I​ ​wanted​ ​to​ ​see​ ​if​ ​using​ ​this​ ​many​ ​drugs​ ​was​ ​actually
effective​ ​for​ ​older​ ​patients.​ ​It’s​ ​also​ ​a​ ​concern​ ​for​ ​cost​ ​effectiveness​ ​and​ ​the​ ​ability​ ​for​ ​a​ ​patient
to​ ​pay​ ​for​ ​medications,​ ​because​ ​all​ ​the​ ​different​ ​medications​ ​especially​ ​over​ ​a​ ​long​ ​period​ ​of
time​ ​can​ ​add​ ​up.​ ​The​ ​first​ ​article​ ​I​ ​chose​ ​was​ ​called​ ​“Does​ ​polypharmacy​ ​in​ ​nursing​ ​homes​ ​affect
long-term​ ​mortality?”​ ​and​ ​it​ ​investigated​ ​the​ ​use​ ​of​ ​polypharmacy​ ​and​ ​an​ ​association​ ​with
two-year​ ​mortality​ ​while​ ​in​ ​a​ ​nursing​ ​home.​ ​The​ ​article​ ​was​ ​published​ ​in​ ​2016​ ​and​ ​published​ ​in
the​ ​Journal​ ​of​ ​the​ ​American​ ​Geriatrics​ ​Society.​ ​The​ ​population​ ​studied​ ​were​ ​residents​ ​in​ ​6
Nursing​ ​Homes​ ​in​ ​Israel,​ ​and​ ​the​ ​mean​ ​age​ ​was​ ​82.2.​ ​The​ ​results​ ​of​ ​the​ ​study​ ​concluded​ ​that
polypharmacy​ ​was​ ​not​ ​associated​ ​with​ ​mortality,​ ​so​ ​just​ ​because​ ​a​ ​patient​ ​takes​ ​more
medications,​ ​does​ ​not​ ​mean​ ​they​ ​are​ ​more​ ​likely​ ​to​ ​die.​ ​However,​ ​it​ ​was​ ​concluded​ ​that​ ​other
factors​ ​including​ ​being​ ​a​ ​male,​ ​being​ ​older,​ ​have​ ​a​ ​lower​ ​BMI​ ​was​ ​significantly​ ​associated​ ​with
higher​ ​mortality.​ ​It​ ​also​ ​depends​ ​on​ ​what​ ​medications​ ​the​ ​patient​ ​is​ ​taking​ ​as​ ​those​ ​who​ ​died
were​ ​significantly​ ​more​ ​likely​ ​to​ ​take​ ​antiarrhythmic,​ ​anticoagulant,​ ​and​ ​anti​ ​hyperglycemic
medications.​ ​The​ ​next​ ​article​ ​titled​ ​“Is​ ​Polypharmacy​ ​Associated​ ​with​ ​Frailty​ ​in​ ​Older​ ​People?:
Results​ ​From​ ​the​ ​ESTHER​ ​Cohort​ ​Study:​ ​published​ ​in​ ​2017.​ ​Frailty​ ​as​ ​defined​ ​in​ ​this​ ​study​ ​is
not​ ​be​ ​able​ ​to​ ​perform​ ​daily​ ​activities​ ​without​ ​risk​ ​of​ ​falls,​ ​injury,​ ​or​ ​even​ ​death.​ ​This​ ​journal
discusses​ ​the​ ​study​ ​that​ ​assess​ ​the​ ​associations​ ​between​ ​polypharmacy​ ​and​ ​prevalent​ ​and​ ​incident
frailty​ ​within​ ​3​ ​years​ ​of​ ​follow-up.​ ​The​ ​results​ ​of​ ​this​ ​study​ ​concluded​ ​that​ ​frail​ ​participants​ ​were
associated​ ​with​ ​polypharmacy.​ ​The​ ​last​ ​article​ ​is​ ​titled​ ​“Clinical​ ​Consequences​ ​of​ ​Polypharmacy
in​ ​the​ ​Elderly”​ ​published​ ​in​ ​2014.​ ​This​ ​article​ ​discusses​ ​the​ ​prevalence,​ ​negative​ ​consequences,
and​ ​interventions​ ​of​ ​polypharmacy.​ ​Many​ ​elderly​ ​patients​ ​take​ ​multiple​ ​medications​ ​for​ ​the​ ​same
morbidity,​ ​which​ ​can​ ​make​ ​it​ ​easy​ ​for​ ​these​ ​patients​ ​to​ ​be​ ​classified​ ​in​ ​the​ ​“polypharmacy”
category.​ ​However,​ ​there​ ​are​ ​many​ ​negative​ ​consequences​ ​of​ ​polypharmacy​ ​including​ ​adverse
effects,​ ​drug​ ​interactions,​ ​high​ ​medical​ ​costs,​ ​non-adherence,​ ​and​ ​risk​ ​of​ ​falls.​ ​Consequently,
there​ ​needs​ ​to​ ​be​ ​interventions,​ ​which​ ​can​ ​be​ ​studied​ ​with​ ​further​ ​medical​ ​studies.​ ​Implications
from​ ​these​ ​articles​ ​include​ ​the​ ​dangers​ ​of​ ​polypharmacy​ ​but​ ​also​ ​how​ ​it​ ​is​ ​needed​ ​in​ ​patients
especially​ ​those​ ​with​ ​comorbidities.​ ​Also,​ ​one​ ​can​ ​imply​ ​that​ ​these​ ​medications​ ​must​ ​be​ ​heavily
analyzed​ ​and​ ​assessed​ ​to​ ​see​ ​if​ ​it​ ​is​ ​the​ ​best​ ​for​ ​the​ ​patient​ ​and​ ​what​ ​consequences​ ​could​ ​happen.
Additionally,​ ​practitioners​ ​must​ ​really​ ​assess​ ​if​ ​a​ ​medication​ ​is​ ​needed​ ​or​ ​if​ ​there​ ​are​ ​other​ ​more
effective​ ​methods​ ​in​ ​curing​ ​a​ ​disease.​ ​I​ ​think​ ​the​ ​findings​ ​in​ ​these​ ​articles​ ​can​ ​be​ ​applied​ ​to​ ​my
career​ ​as​ ​a​ ​nurse,​ ​because​ ​it​ ​is​ ​my​ ​duty​ ​as​ ​a​ ​nurse​ ​to​ ​make​ ​sure​ ​that​ ​medications​ ​are​ ​suitable​ ​and
appropriate​ ​for​ ​the​ ​patient​ ​including​ ​any​ ​contraindications,​ ​drug​ ​interactions,​ ​adverse​ ​effects,​ ​etc.
and​ ​to​ ​evaluate​ ​before​ ​administering​ ​to​ ​the​ ​patient;​ ​furthermore,​ ​I​ ​am​ ​the​ ​last​ ​line​ ​of​ ​defense​ ​for
any​ ​possible​ ​mistakes​ ​made​ ​in​ ​medications​ ​before​ ​it​ ​actually​ ​gets​ ​to​ ​the​ ​patient.​ ​I​ ​also​ ​will​ ​want
to​ ​assess​ ​if​ ​a​ ​medication​ ​is​ ​actually​ ​worth​ ​giving​ ​because​ ​sometimes​ ​it​ ​can​ ​make​ ​a​ ​patient​ ​more
prone​ ​to​ ​other​ ​adverse​ ​effects​ ​that​ ​could​ ​have​ ​dire​ ​consequences.​ ​I​ ​think​ ​overall​ ​it​ ​is​ ​essential​ ​to
make​ ​sure​ ​that​ ​all​ ​medications​ ​are​ ​actually​ ​necessary​ ​before​ ​administering​ ​in​ ​order​ ​to​ ​make​ ​sure
that​ ​they​ ​are​ ​efficient​ ​as​ ​possible​ ​and​ ​will​ ​lead​ ​to​ ​the​ ​best​ ​results​ ​for​ ​my​ ​patients.