The Senior Care Pharmacist

IN THIS ISSUE

July-August 2019 | Volume 34 | Number 7

Adapting to New Paradigms

Insomnia is a common occurrence for many older adults. The origin varies, and the treatment options range from good to bad to potentially hazardous. In this issue, we present two perspectives on insomnia. What is the best dose of melatonin for sleep in older adults? And what is the relationship between anxiety and depression symptoms and the use of nightly sleep medication.

A Visual Summary of ASCP’s 2019 Forum

A “graphic recording” is the real-time translation of conversations or presentations into text and pictures. This six-page layout documents key ideas in visual form presented at the ASCP 2019 Forum. These graphic recordings give meeting and conference attendees an opportunity to absorb content on a visual level.

Optimal Melatonin Dose in Older Adults: A Clinical Review of the Literature

Evidence assessing the use of melatonin for sleep disorders in older adults is limited. This clinical review highlights the lack of a strong understanding regarding the minimum effective dose of melatonin in older adults. No randomized controlled trial in this review found 0.5 mg melatonin to be an effective dose, indicating that this dose may be too low for improving sleep in older adults. Melatonin dosages between 1 mg and 6 mg were found to have statistically significant improvement in sleep compared with placebo.

Provider Education About Pneumococcal Vaccination Practices for Older Adults

Academic detailing is an evidence-based technique designed to change clinical practice and improve decision-making by customizing medication-related materials and sharing them through provider education. In this study, the team used the academic detailing model to provide educational outreach to local rural health care providers about pneumococcal immunization practices, The objective of this work was to describe an interdisciplinary academic detailing project implemented to address low pneumococcal immunization rates.

PACE: An Interdisciplinary Community-Based Practice Opportunity for Pharmacists

In the United States, Programs for the All-inclusive Care of the Elderly (PACE) provide a valuable service to older adults with significant nursing needs by allowing them to remain safely living in the community for as long as possible by providing extensive, community-based health care services. Ample opportunity exists to provide meaningful pharmacy services within these programs. Pharmacists working in PACE programs can expect to significantly impact clinical outcomes, health care expenditures, and patient advocacy.

Engaging Students and Pharmacists in Medical Missions

Medical mission trips help meet the needs of underserved populations in the United States and abroad. As the medication experts, pharmacists play an important role in providing services during these trips. Students can serve as pharmacist-extenders by applying the knowledge, skills, and values to reach more patients in resource-limited settings. This paper describes several faith-based domestic and international medical missions. These not only benefited those in need, but also fostered professional growth for participants.

Anxiety and Depression Symptoms and Every-Night Sleep Medication Use in Older Adults

The authors of this study found that older adults who suffer from anxiety and depression are more likely to use sleep medications every night. Given the preponderance of data demonstrating modest sleep benefit with considerable adverse drug event risk in older adults, efforts should be undertaken to improve management of these anxiety and depression symptoms to possibly mitigate excess consumption of sedatives.

Impact of the Pharmacists’ Patient Care Process on Medication Adherence in Older Adults With Multimorbidity

A pharmacist’s patient care process is a novel practice model that demonstrates the unique role and benefit of the pharmacists as part of the direct patient care team. This study emphasizes that strategies to facilitate long-term medication adherence should be part of implementing this model in the pharmacist-led medication management clinic, which improved medication adherence and persistence, decreased number of potentially inappropriate medications, and assisted in preventing care transitions in ambulatory older adults with multimorbidity and polypharmacy.

Impact of Pharmacy Medication Reviews on the Prescribing of Potentially Inappropriate Medications for Older Veterans in Primary Care

This study evaluated the use of potentially inappropriate medications in a Veterans Affairs medical center home-based primary care setting. The center required medication reviews, unlike geriatric primary care without a formal pharmacy review. In addition, it described the types of pharmacists’ medication-related recommendations made to primary care providers and determined the acceptance rate of these recommendations. In this study, no change in potentially inappropriate medications was observed in the veteran’s primary care group, while an increase was observed in the geriatric primary care group.

To Legislate or Regulate

The delegation of authority to write regulations is included in almost every law passed by Congress and signed by the president. As such, regulations carry the force of law.

READ THE JOURNAL

The Senior Care Pharmacist® is the official peer-reviewed journal of the American Society of Consultant Pharmacists (ASCP). It is the only journal dedicated exclusively to the medication therapy needs of older adults. ASCP members receive The Senior Care Pharmacist® as a member benefit. All articles (2004 to present) are free online for members.




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Editorial Office
H. Edward Davidson, PharmD, MPH
Insight Therapeutics, LLC
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Norfolk, VA 23510
757-625-6040; Fax 757-625-4538
edavidson@inther.com


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