The objective of the nursing practice is to ensure that patients receive quality health care, and thus nurses should avoid the administration of medications with adverse effects on patients. The researchers sought to find an alternative solution to High Risk Medications (HRM) for the elderly people. These medications are termed as high risk because they are associated with an increase in morbidity, mortality, hospitalization, in-patient length of stay, and healthcare spending by the elderly people. Hence, the problem of the study is beneficial to nurses as it explores solutions to an issue that has bedeviled their profession for a long time.
In addition, the researchers found a strong correlation between HRM and other factors such as geography, social income, race, and gender. The findings unearthed unethical behaviors in the practice, which implies that the HRM alternatives are made available to some patients based on the aforementioned factors. In addition, the researchers found that HRMs are unsuitable for patients aged 65 and above because they have many associated adverse effects that outweigh their benefits. Hence, there is a great need to adopt the alternative medications and do away with HRMs in order to reclaim the reputation of the nursing profession since nurses are supposed to take care of patients un-discriminatively.
Researchers had various reasons for their study, which included advocating the adoption of alternatives to HRM, disclosing discrimination in the medical practice, and educating the public on HRMs. HRMs have adverse effects to patients, and thus they should be eliminated in the medical sector in a bid to create room for the adoption of safe alternative methods. According to this study, there is a clear indication of geographical discrimination where the southern regions are affected more by the HRM effects than the northern parts of the United States. Other factors such as socio-economic, race, and gender have reasonable explanations for creating differences in the findings. Alternatives to HRM are expensive, and thus they are not affordable to many people. White people have a record of failing to seek mental health services unlike black people and other races, which make them prone to the adverse effects of HRM. On the other side, females have a high chance of suffering from the adverse effects of HRM due to hormonal imbalances (Qato & Trivedi, 2012). Hence, the purpose of the study was significant to nursing.
The main research question was not stated, but it can be said to be “understanding predictors of HRM use at the population level” (Qato & Trivedi, 2012, p. 551). The objective of the research was to find a knowledge gap, which exists in trying to understand the predictors of HRM use in different populations. In their study, the researchers examined the prevalence and predictors of HRMs among a national sample of elderly Medicare Advantage enrollees. From the findings, the researchers observed wide geographic variation in the use of these medications that were not explained by socio-demographic factors. In addition, it was observed that the female gender, the white race, low SES index score, and low personal income also predicted the receipt of HRMs. Hence, the findings answer the aforementioned research question.
There were two main variables with the elderly population making the independent variable and HRM being the dependent variable. According to the researchers, the use of HRM in elderly patients is dependent on various factors, which include the likelihood of patients suffering from adverse effects of HRM such as morbidity and mortality. Hence, their alternatives are considered after they are found dangerous to the patients, thus making them the dependent research variables.
The researchers did not base their work on a theoretical framework. The research was purely experimental, and thus it used retrospective analysis of Healthcare Effectiveness Data and Information Set (HEDIS) data for 6,204,824 enrollees, aged 65 years or older, enrolled in 415 MA plans in 2009. Considering that the objective was to determine the receipt of High Risk Medications amongst the elderly, the researchers used the appropriate framework by making it experimental in order to support the hypothesis by the analysis of the experiment findings. However, the researchers were filling a knowledge gap by creating a theory of predictors of the use HRM in a given population.
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