#408 COPD in Older Adults with Leah Witt, MD & Amber Lanae Martirosov, PharmD
Sep 18, 2023
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Learn about COPD in older adults with expert guests Dr. Leah Witt and Dr. Amber Lanae Martirosov. Topics covered include COPD diagnosis and classification, inhaler misuse and cost, and the impact of COVID-19 on pulmonary care. They also discuss the challenges of medication cost and coverage, and the need for standardized use of maintenance inhalers.
Medication management and cost of inhalers are crucial aspects of caring for older adults with COPD.
Cognitive decline and social isolation are prevalent in older adults with COPD and should be addressed in their care.
Mobility, gait impairment, and falls are common concerns in older adults with COPD, and addressing these issues is important for their overall well-being.
Deep dives
Medications: Exploring the challenges of medication management in older adults with COPD
Medication management is a key aspect of caring for older adults with COPD. Polypharmacy and medication side effects are common concerns, as older adults may be taking multiple medications for various comorbidities. The high cost of inhalers can also pose financial burdens for patients, leading to non-adherence. It's crucial for healthcare providers to carefully evaluate a patient's medication regimen, consider the cost and potential side effects, and provide education and support to ensure proper use of inhalers.
Mentations: Addressing cognitive impairment and social isolation in older adults with COPD
Cognitive impairment and social isolation are prevalent among older adults with COPD. Providers should be attentive to signs of cognitive decline, mood disorders, and delirium, as this can impact disease management and medication adherence. Loneliness and social isolation can contribute to worsened quality of life and increased risk of falls in this population. Incorporating mental health screening and interventions, as well as addressing social isolation through support networks and community resources, can greatly enhance the overall care of older adults with COPD.
Mobility: Enhancing mobility and reducing disability for older adults with COPD
Mobility issues, gait impairment, and falls are common concerns for older adults with COPD. Pulmonary rehabilitation programs have shown significant benefits in improving exercise capacity, reducing frailty, and enhancing overall quality of life. However, limited access to such programs remains a challenge. Providing education on fall prevention strategies, optimizing assistive devices, and addressing environmental barriers can help improve mobility and reduce disability in this population.
What Matters: Aligning COPD care with individual goals and preferences
Taking into account an older adult's individual values and preferences is essential in providing person-centered care for COPD. Engaging in conversations about advanced care planning, treatment goals, and shared decision-making can help ensure that the patient's healthcare decisions align with their overall well-being and personal values. This approach promotes a patient's sense of autonomy and ensures that their care is tailored to their specific needs and priorities.
Importance of Understanding Inhaler Devices
Understanding the different types of inhaler devices is crucial for prescribing appropriate treatments for patients. The cost of inhaler drugs is high, particularly due to the lifelong patent on the devices compared to the shortened patent on the drugs. This significant cost impacts patients' ability to afford and use inhalers effectively. Additionally, aging lungs may lead to a decline in inspiratory effort, making it difficult for patients to use dry powdered inhalers. In such cases, nebulized solutions may be a more suitable alternative.
Challenges with Inhaler Use and Costs
Inhalers present challenges in terms of patient education and technique. Many patients struggle with correct inhaler use, even after years of using them. Coordinating the breathing and actuating the canister correctly can be difficult, especially for elderly patients with arthritic hands or tremors. Moreover, the high costs of inhalers, particularly for Medicare patients, pose significant barriers. Insufficient knowledge of insurance plans and formularies can result in patients choosing plans with high deductibles and copays. However, there are programs available through drug manufacturers and resources like the Medicare Plan Compare website that can help patients reduce out-of-pocket costs and find more affordable coverage options.
Level up COPD management in older adults. Start with learning the latest in COPD diagnosis and classification, then stay for the mind-blowing inhaler misuse & cost discussion. We’re joined by a dynamic (and interprofessional) duo: Dr. Leah Witt (@leahjwitt) and Dr. Amber Lanae Martirosov, PharmD (@AmberMartirosov).
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