The Senior Care Pharmacist

IN THIS ISSUE

February 2019 | Volume 34 | Number 2

Stand by Me

Often, we as health care professionals caring for older adults get stuck in reviewing the medical record, progress notes, laboratory results, etc., in doing our craft, and spend less time talking to those to whom we are providing care. As older adults advance in age and disability, often family caregivers become the surrogate for information relative to medication outcomes, and sometimes at a cost. This month, we have several clinical review articles on medication classes that can cause adverse outcomes in older adults, for which communication and caregiver engagement have strategic importance.

2018 ASCP Annual Meeting & Exhibition

The American Society for Consultant Pharmacists (ASCP) hosted its 49th Annual Meeting & Exhibition on November 1-4, 2018, in National Harbor, Maryland. Almost 1,200 pharmacists and exhibitors attended and celebrated senior care pharmacists as “health care heroes.”

Safety and Efficacy of Lithium for Treating Bipolar Disorder in the Older Adult

Newer studies have shed some light onto treatment options for bipolar disorder in older adults. According to recent work, lithium can and should be used as a safe and effective option in older adults to not only stabilize mood, but also to avoid the use of antipsychotics and subsequent adverse effects. Reduction in renal function still remains a concern for those on lithium therapy, especially those of advanced age, and close monitoring is recommended. More studies, including long-term studies, would be helpful in solidifying treatment decisions.

A Review of Guidelines and Pharmacotherapeutic Management of Hypertension in Older Adults

Older hypertension guidelines established more lenient blood pressure (BP) goals for older adults, but updated guidelines recommend more stringent BP control. Clinicians should be mindful of patients’ comorbid conditions and life expectancy when deciding which BP targets and antihypertensive medications to recommend. Frail older adults are more prone to adverse effects from medications as well as risks of falls because of factors such as polypharmacy, multiple comorbidities, and frailty status. Therefore, therapy should be individualized and patient-centered based on risks versus benefits of the different BP goals and medications.

Extended-Duration Use of Direct Oral Anticoagulants to Prevent VTE in Acutely Ill Patients

Extended-duration treatment for preventing venous thromboembolism (VTE) with direct oral anticoagulants (DOACs) reduced the overall number of VTE events in the acutely ill medical patient population, but with an overall increased risk of bleeding. In light of no mortality benefit, an individualized patient approach should be utilized for treatment with extended-duration DOACs in the recently hospitalized older adult population.

Osteoporosis Medication Use: A Comparison of Elderly Females Living in Long-Term Care Facilities versus Community Dwellers

This is the first U.S. national study to compare patterns of evidence-based osteoporosis medication use among older women residing in the community and long-term care under the auspices of the Medicare Part D program. It is estimated that between 7% and 14.9% of Medicare beneficiaries have osteoporosis. The authors found that prevalence of osteoporosis medications was low (less than 50%) in both community dwellers and long-term care residents, but was especially low among long-term care residents (below 35%).

A Pharmacist-Led Stroke Education and Screening Program for Community-Dwelling Older Adults

This free community-based educational program improved stroke-related knowledge of participants including those with increased risk(s) of stroke. The screening demonstrated value for evaluating stroke-related health status and identifying need for primary and secondary stroke prevention. Knowledge deficits in modifiable stroke-related factors (SRFs) and acute stroke warning signs (SWSs), as well as the need for better primary and secondary stroke prevention, identified the need for further education/intervention to aid in reduction of incidence, morbidity, and mortality caused by stroke. Average knowledge improved approximately 30% for SRFs and more than 60% for SWSs.

EPA Releases Final Rule on Hazardous Pharmaceutical Waste

Ten years in the making, the Environmental Protection Agency (EPA) has issued a final rule on how to manage hazardous pharmaceutical waste. The long-term care pharmacy industry has worked with the EPA in this process and has hosted pharmacy tours and discussions with the agency over the decade to help it better understand how drug waste is currently managed and how the EPA’s various concerns could be met with as little disruption to pharmacies as possible.

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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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