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Medications and Physical Therapy Practice

Friday, April 19, 2019   (0 Comments)
Posted by: Sonja Hix
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Janes M, Adamski H, Strunk E, Kornetti D, Langham B, Walsh J 

The practice of physical therapy is comprised of many facets of care and oversight.  While the list of responsibilities and activities associated with physical therapy is lengthy, the first and foremost concern is to ensure the patient is safe and care that is provided does not jeopardize the health and well-being of the patient. 

Ensuring safety for patients is an elemental practice concern associated with providing a service to the public.  One element of safety pertains to the role of physical therapy when evaluating and examining a patient’s current condition and considering the potential impact of currently prescribed medications on the plan of care.  As physical therapy continues to be instrumental in fostering a patient’s ability to maintain and maximize functional capacity, considerations that may impact the overall outcome of care must be considered.  In the United States, the 65 and older population is expected to reach 73 million persons by the year 2030 representing 20% of the total US population.1  As our population continues to grow, many patients in this age group have multiple chronic conditions that may require several medications.  According to the National Center for Health Statistics, 92% of persons aged 65 and older have taken at least one prescription drug and 43% have taken at least 5 or more prescription drugs in the past 30 days.2  Polypharmacy, which is commonly defined as taking five or more drugs, increases the risk of drug interactions, adverse drug events, nonadherence, and reduced functional capacity.3 

Drug interactions and adverse drug events (ADEs) have been shown to be one of the most common types of adverse events after hospital discharge. Physical Therapy is often provided following hospital discharge in multiple Post-Acute Care (PAC) settings, out-patient based services and, in many instances, serving as the first provider following hospital discharge.  Ensuring safe care transitions includes performing a drug regimen review and medication reconciliation, instructing patients and caregivers in self-care methods and facilitating communication with physicians.  A primary concern is non-adherence with medications in older adults which has been associated with polypharmacy and complicated medication regimens.5-9  When patients are taking 4 or more medications, the rate of non-adherence is 35%.10  Medication non-adherence is associated with potential disease progression, treatment failure, hospitalization, and ADEs, all of which could be life-threatening.

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