With an aging population comes the unfortunate increase in hospital visits, often resulting in an increase in medication needs. When long-term care residents return to their facilities after a hospital stay, it can be difficult to keep track of their prescriptions.
According to AgingCare, the average elderly American takes four or more prescription drugs each day. Previously reported by McKnight’s Senior Living, data from the CDC shows that 78% of adults over 55 have at least one chronic condition that requires medication. This is a significant problem in LTC communities, given residents often see many different doctors.
The term polypharmacy has many unique definitions, in fact, a Boston Medical Center Geriatrics study found there were more than 138 definitions of the word alone. Most commonly, it can be described as the unwarranted use of medications or medications that no longer provide benefit to a patient, usually elderly, who is on multiple daily medications.
At Omnicare, we are really calling polypharmacy “medication stewardship.” Medication stewardship has three essential components that our consultant pharmacists focus on: medication overuse, misuse and under-use. It is our consultant pharmacists’ responsibility to work with patients and make recommendations.
Upon a patient’s arrival at an LTC facility, consultant pharmacists immediately get to work and conduct a medication regimen review. Polypharmacy can frequently occur when patients have multiple doctors or pharmacies that are not communicating, so conducting a medication review can help assess which treatments are still necessary. We aim to be that central voice to manage all medication communication.
We focus on the potential reduction of medications wherever possible. In 2021, 38.3% of our pharmacist recommendations consisted of polypharmacy/deprescribing. As an example, in our fall prevention program, we specifically identify patients who are at high risk for falls, knowing some medications can contribute to instability and lack of balance. By communicating to their physicians that certain medications could cause a patient to fall, we find the medical team to be much more open to minimizing those adverse effects through our deprescribing recommendations.
Our consultant pharmacists made more than 1.6 million medication recommendations in 2021, aiming to improve medication intake, and as a result, saved our customers more than $7.79M by discontinuing prescriptions that were no longer necessary. Since polypharmacy has so many definitions, it isn’t always depicted as a negative practice, but it can become dangerous when medications interact, or if a patient has too many prescriptions in their name.
Polypharmacy affects every single program we’ve developed, as a cornerstone of our customized care. Treating patients based on their individual disease state is crucial to providing quality care, and we will continue to prioritize polypharmacy and medication stewardship. LTC facilities house some of our most beloved relatives and friends, and it’s essential that we provide each and every one of them with the very best care.
Tom Katofiasc serves as a Senior Manager of Clinical Services at Omnicare, a CVS Health Company. He has been with Omnicare for 26 years and in the long-term care industry for 33 years.
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
