The global healthcare industry recognizes four primary vital signs that are indicators of the human body’s essential life-sustaining functions. The vital signs provide a quick snapshot of the patient’s general health.
|4 Primary Vital Signs||Measurement Equipment|
|Heart rate (pulse)||Stethoscope / watch|
|Respiratory rate||Stethoscope / watch|
Paramedics and Emergency Response Technicians often observe pupil size as a vital sign that indicates medical conditions such as trauma, circulatory system arrest, central nervous system injury or drug overdose.
When a patient’s vital signs show readings that are outside of the normal range, a physician or healthcare provider is then able to order a set of tests to diagnose the exact cause, based on their medical knowledge of potential causes of those abnormal readings.
It is common for patients that are 65 years and older to take medications to treat chronic conditions. For instance, cardiovascular disease requires statins and other medication to lower cholesterol levels and normalize blood pressure. Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that causes shortness of breath, also common amongst seniors. Drugs that treat COPD are bronchodilators and steroids. Abnormal vital signs may indicate that the patient with these chronic conditions is not taking their medication as prescribed. Conversely, a patient with poor medication adherence will definitely have vital signs with abnormal, health-threatening readings.
The healthcare industry views medication adherence as one of the biggest problems amongst elderly adults. It is estimated that less than 50% of prescriptions are taken as prescribed. Poor adherence is reportedly the 3rd most common reason for seniors’ admission to hospital emergency rooms and is the cause of 69% of medication related hospital admissions (source: Adherence to Medication, New England Journal of Medicine, Aug. 4, 2005).
The 3 most common reasons cited for poor adherence are as follows:
- Cost: The cost of medication can be very expensive. This prompts the senior to conserve the supply and make it last longer. Some seniors on fixed incomes are simply unable to afford their prescriptions on a consistent basis. Another aspect of cost is a risk-benefit perspective. Sometimes there is a perception that the cost of the medication outweighs the benefit, which leads to non-adherence.
- Cognitive Issues: Seniors may occasionally forget to take medication. Stress and fatigue can exacerbate forgetfulness. In some situations, cognitive decline makes forgetfulness a more frequent issue.
- Side Effects: Seniors may avoid medication due to worrisome, unpleasant side effects such as sedation, nausea or constipation.
These causes are irrespective of socio-economic factors and ethnicities.
By declaring Medication Adherence as the 5th vital sign, especially for adults 65 years and older, and establishing a method for measuring adherence regularly, healthcare workers will be equipped to determine whether the other vital signs are affected by poor adherence, and if the patient is at risk of complications from under or over-medication. The goal for improvement of medication adherence is to prolong independence and prevent emergency room visits.
|The 5thVital Sign||Measurement Equipment|
|Medication Adherence||CuePath (real-time adherence monitoring service)|
|Medication Possession Ratio (measured by pharmacist, based on lateness of prescription refill order)|
Ultimately, the improvement of medication adherence saves lives. Knowing the patient’s baseline medication adherence level is an effective first step to understanding the status of the conditions being treated by medication and provides additional insight into the patient’s general state of health.