|The Senior Care Pharmacist|
IN THIS ISSUE
June 2019 | Volume 34 | Number 6
The ability to look through a complicated list of medications and an older adult’s accompanying medical conditions, laboratory results, physiologic parameters, and symptoms is a challenging proposition that requires a great deal of intellect and determination. Integrating the individual’s goals and desires for their health requires another set of challenges, particularly when they are unstated and difficult to obtain because of limited time to review and discuss. It is becoming quite clear, however, that this type of practice—often referred to as patient-directed care and shared decisionmaking—is becoming the expectation for how care is provided.
Patients with dementia face challenges with medication adherence because of the nature of the disease. Not only is adherence difficult in individuals with dementia, but the majority of this patient population also has comorbidities that make comprehension of complex treatment plans difficult. As dementia progresses, the risk of taking certain medications may outweigh the benefits. Therefore, the treatment team needs to reassess medication lists over time.
Pharmacogenomics (PGx), the study of how an individual’s genetic makeup affects his or her response to drugs, is a fast-growing field that gives health care providers a valuable tool to help safely and effectively manage medications. However, few providers have experience in applying the results of PGx tests to their practices, and this can lead to disregarding the data or unnecessarily modifying medication regimens. Pharmacists are uniquely positioned to become well-versed in the interpretation of PGx data, critically evaluating the “green-yellow-red” result categories that signal “go, caution, stop” for a particular medication. Using a case-based approach, this primer is intended to provide pharmacists with practical direction to aid in PGx interpretation.
This is the first study to describe long-term utilization of an on-site academic pharmacy referral service for home health care (HHC) clinicians. HHC is a key setting for pharmacists to participate in collaborative, interdisciplinary medication management for patients whose medication needs may be difficult to fully meet in other settings. The data from this study indicate pharmacists provided a needed service in HHC and that further study of the use and impact of pharmacists in this setting is warranted.
This study found that pharmacists identified more medication discrepancies during transition from hospital to home when compared with nurses, with the potential benefit of preventing more adverse drug events and resulting in cost savings. Pharmacists identified 677 medication discrepancies of which 271 (40%) were considered likely to result in an adverse event. Nurses identified 202 (30%) of the medication discrepancies identified by pharmacists. It was estimated that approximately $9,670 in additional health care expenses could have been prevented within the cohort by pharmacist intervention.
In April 2019, ASCP’s senior care pharmacists stormed Capitol Hill to advocate for their patients and their profession. Members held more than 110 meetings with health care staffers in the House and Senate and discussed our most critical priorities--pharmacist as providers and the role of pharmacists in the drug-pricing debate.
After a more-than-20-year run, the era of resource utilization groups (RUGs) is ending for nursing facilities. It was probably never a very good system for paying facilities to care for Medicare beneficiaries, but we were accustomed to it and had learned to live with its peculiarities. So, it is with some nostalgia that we bid farewell to RUGs beginning in October 2019. Simultaneously, we will welcome the patient-driven payment model.
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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.
2019 ASCP Integrated Media Kit
Nonmembers can access online abstracts to journal articles. Full articles are available for $35.00 each.
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