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Impact of Drug Therapy CostsResearch Proposal

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¶ … Drug Therapy for Chronic Disease Management of Seniors and Aging in Atlantic Canada

The concern of the research is to understand the link between management of chronic illnesses in seniors and general health care costs, since many chronic conditions increase with age.There is rising drug costs, high use in the elderly, and dwindling access to realistic and inexpensive coverage has been the highlight on the debate regarding what needs to be done to provide prescription drugs to seniors. Rise in medicine costs for illness management is a major concern for aging as well as senior citizens in Atlantic Canada, with different medicines annually produced gaining Health Canada approval.Many elderly and chronically sick patients take less prescribed medication because of cost concerns, particularly patients with low income, multiple chronic health issues, or no prescription drug coverage. There are consequences associated with underuse of medication due to cost and they include: increased visits to emergency department, psychiatric and nursing home admissions, and reduced health status (Piette, Heisler & Wagner, 2004).

The high costs of drugs and the absence of prescription coverage often result in additional impacts. Clinicians that are sure that their patients are not in a position to pay for high cost medications are not likely to prescribe them despite the fact that they are effective. Moreover, for the elderly people a large portion of their salary is used to cater for their health care; hence, impacting greatly on the poor seniors. For the seniors with a low income they are faced with the challenge of having to restrict their spending on medication for the favor of food, clothes and various utilities. Even for the seniors that do not restrict their spending on medications they often forego some goods and services that are vital for their wellness (Steinman, Sands & Covinsky, 2001)

Although cost-related importance in public health medication underuse is gaining attention, there is a limited understanding of the way medication costs impact the elderly with different clinical and socioeconomic features.The insufficient amount of data on the problems of adhering to medication due to cost restrictions has significance on a number of factors. It has an effect on the clinical issues and also limits the understanding of the adherence problems among different socioeconomic groups. The existing estimates that give the relation between the personal costs and underuse are likely to mask paramount differences in treatment procedures. With this you can have an individual that is very sensitive to the cost pressures especially if they hold the perception that taking the medication will have little to no effect on their well-being and longevity. On the other hand, the patient that holds the idea that the medication is important is likely to adhere even when there are high costs to be incurred (Piette, Heisler & Wagner, 2004).

Therefore, it is vital to understand the association of chronic illness management among seniors with overall cost of healthcare, given that prevalence of numerous chronic problems rises with age. Canadian seniors account for roughly 44% of the nation's publicly-financed healthcare expenditure (Canadian Institute for Health Information, 2009). Costs of prescription medications are rising more rapidly than that of all other healthcare segments. Thus, this study intends to establish a link between drug therapy costs and chronic illness management in Atlantic Canada's elderly population.

Statement of problem

With the huge financial impact in Canada that is due to chronic conditions, the direct influence that it has on the health care costs and the indirect influences such as decrease in productivity; there is a considerable need for the research to focus on the subject. The research serves to give one an understanding of the relationship that exists between the overall costs in health care and the proper management of the chronic conditions among the seniors. This is important since the prevalence of most chronic illnesses is more with age (Canadian Institute for Health Information, 2011).

Objectives of the study

The study will focus on seniors since they are likely to have chronic conditions, particularly comorbidities that tend to be complex and difficult to manage. This research aims to:

Assess how rise in medication expenses for Atlantic Canada's aging and senior population impacts their illness management

Examines experiences of seniors in Atlantic Canada under medication for chronic conditions within primary health care (PHC) setting

Focus on the patients that are not under any insurance cover and have cost restrictions to access the appropriate medication

Determine the frequency of the medication restriction behavior

Determine the particular patients that are most likely to get the medication restriction, and the modifications that prescription coverage has on the risk.

Rationale of the study

The concept of disease management involves reduction in healthcare spending and improvements to QOL of patients suffering chronic illnesses, through prevention or minimization of disease effects via integrated patient care (Academy of Managed Care Pharmacy, n.d). The study's rationale will be determining how chronic illness management is impacted by rise in costs of drug therapy. In order to evaluate the link between cost of medication and management of chronic disease in elderly individuals, the study will use literature review to formulate the problem and to come up with the research problem (Conrad & Serlin, 2011).

The findings and methodology in the studies used in the study will be useful in showing, shaping and informing both the research method and research question.The study will persuasively use literature review to inform and justify research methods and questions in the study.Illness management of Atlantic Canada's aging and senior citizens will be the study's dependent variable, whereas rise in expenses linked to drug treatment for different conditions impacting Atlantic Canada's aging and senior citizens will be the independent variable. In addition, pharmaceutical companies and the government (i.e., developers of healthcare policy) will be potential co-variables.

The research will provide policymakers, doctors and clinicians with more information on the effect that cost has on the use of prescription medications among patients that have chronic illnesses. This would be helpful as the research focuses on persons with chronic conditions with the aim of identifying factors such as prevalence, risk factors, and factors that affect the adherence to medication whilst considering the cost restrictions. The research builds on the evidence on medication underuse due to cost, the measures that are involved in the documentation of the underuse of specific medications, the measures used in the identification of persons that are commonly affected by the adherence problems, and the differences that are present in the socioeconomic factors that affect underuse of different treatments (Piette, Heisler & Wagner, 2004).

Therefore, the national governmentwill be charged with the responsibility to look into the concerns of the senior's healthcare. A good approach would be to come up with a health strategy that focuses on the aged to give the seniors undivided health care attention that focuses on the prevention as well as the management of chronic conditions. Also there should be a focus on giving support to the primary care services such as the home care services that put emphasis on building collaborative teams. Lastly, a useful approach would also be to redirect the funding of health to preventive programs and services and more so the public health personnel (Canadian Nurses Association, 2011).

Lastly, examining incomes of individuals suffering from chronic illnesses can actually enable researchers to uncover differences in levels of adherence. For better explaining this finding, researchers can include income as a key determinant for adherence to medication. Moreover, the findings in the study may be useful in enhancing the understanding of elderly patients' utilization of health care services, health status and medication management.

Literature review

According to Canadian Institute for Health Information (2011) many seniors accounting to 94% report to a regular place of care. The same proportion of seniors has a regular medical doctor, which is higher than in other age groups, including the age between 45 and 64 (90%), age between 25 and 44 (82%) and age between 18 and 24 (78%). Seniors with one and two chronic condition(s) take an average of 3 and 4 prescription medications, respectively. Those with three chronic conditions take on average 6 prescription medications. This is the same trend that has been observed in adults of age 45 to 64. Previous research indicates that the various age groups among the elderly people the seniors that have more than three chronic diseases need more attention. The estimate is that their number of visits to a health care facility is up to three times that of their counterparts that lack chronic conditions. These seniors with three or more chronic conditions have a higher number of visits and appointments with nurses, counselors, therapists and social workers. They also have more visits to diet experts, special doctors and pharmacists are two times higher than those of fellow seniors without a chronic condition (Canadian Institute for Health Information, 2011).

Seniors in Canada account for close to 44% of public health care costs. There is a study that was conducted in 2000 whose… [END OF PREVIEW]

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