The Senior Care Pharmacist

IN THIS ISSUE

January 2019 | Volume 34 | Number 1

Breaking New Ground

ASCP’s journal has a new name and a new face: The Senior Care Pharmacist. The Society felt that senior care pharmacy, as a practice innovation and specialty, was more reflective of the journal’s content and its position within health care. As we move forward in this new year, I am confident you will notice that the quality of the content remains the same. We will to continue to fill each issue with information that will pique your interest and advance your knowledge of senior care pharmacy, bringing your expertise to older adults in all settings: the community as well as assisted living and long-term care facilities.

Dementia: The Toll on Caregivers and the Role of the Pharmacist

Spouses of people with dementia experience considerable strain as they observe their life partners’ deterioration. This stress may increase the risk of negative cognitive outcomes in the healthier spouse. A number of interventions that improve health habits and provide support can decrease caregiver burden and reduce their risk of developing dementia. Pharmacists can develop relationships with caregivers to educate them about the medications and improve their willingness to engage with pharmacy services. Senior care pharmacists can provide a thorough medication review to minimize the use of potentially inappropriate medications and suggest choices that are more appropriate.

Updates on Clostridioides (Clostridium) difficile Infection With Emphasis in Long-Term Care

Despite the decrease in incidence of Clostridioides difficile (C. difficile)—previously Clostridium difficile—infection (CDI) as a result of advanced infection control and prevention measures. CDI remains a large burden on patients and the U.S. health care system. This is because of the emergence of hypervirulent and difficult-to-treat strains of C. difficile. This infection is largely iatrogenic, and diagnosis is based on clinical presentation and laboratory tests. Treatment options include vancomycin, fidaxomicin, and fecal microbiota transplantation. Prevention centers around infection control and antibiotic stewardship. Both health care personnel and patients should work together in both the health care and community settings to decrease CDI rates by targeting the overuse of antibiotics and other medications and behaviors that increase the risk of CDI.

The Use of Low-Dose Naltrexone for Chronic Pain

The use of low-dose naltrexone for the treatment of chronic pain is novel because it is a nonopioid alternative. Its use is “off label” and has been used successfully to manage chronic pain, autoimmune disorders, and dermatologic conditions. Low-dose naltrexone could be a viable treatment option for chronic pain because other agents, such as nonsteroidal agents, have adverse effects of gastrointestinal bleeding, renal injury, and they increase a patient’s risk of myocardial infarction or stroke. In addition, low-dose naltrexone has minimal adverse effects, no drug-drug interactions, and is relatively inexpensive compared with other options for chronic pain. Naltrexone may be an option, particularly in older patients and patients with comorbidities such as cardiovascular, renal, or gastrointestinal, or liver disease.

Implementing a Systematic Approach to Deprescribing Proton Pump Inhibitor Therapy in Older Adults

A systematic approach to deprescribing proton pump inhibitor (PPI) therapy was successfully implemented for an elderly patient population. By leveraging a two-step process for target population identification—analysis of electronic health record combined with provider-pharmacist dialogue—81.6% of patients who participated in the intervention were successfully weaned off of their PPI therapy. The design of this study’s intervention and its efficacy demonstrates that team based care transformation efforts can have a positive impact on patient safety and medication related harm reduction. This was the first study that was a collaborative yet pharmacist-led population health management process to deprescribe the inappropriate use of PPIs in the elderly.

Age-Related Changes in Older Adults: Learning About Sensory Impairment Through a Simulated Experience

This research describes the impact of a sensory workshop for pharmacy students on the knowledge of sensory and mobility changes that occur as individuals age. A hands-on sensory workshop that included role-playing activities and tools to simulate age-related sensory deficits was incorporated into a hybrid elective course offered to those who have a special interest in geriatrics. Students believed the workshop increased their awareness of sensory changes in older adults that may lead to medication adverse events and affect the way a clinician communicates instructions and medical information.

What’s Ahead in 2019 in Health Care Policy?

The Centers for Medicare & Medicaid Services appears determined to continue its focus on revamping payment policy to more accurately pay for covered services. Providers may find this unsettling, but the agency seems determined to bend the massive Medicare and Medicaid entitlements toward more transparency and accountability.

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.




Nonmembers can access online abstracts to journal articles. Full articles are available for $35.00 each.


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