Building relationships and formal partnerships between long-term care providers and pharmacists is increasingly vital to managing resident care, experts said at a Moving Forward Nursing Home Quality Coalition event Monday.
The combination of an aging population and residents living longer in nursing homes means that residents’ medication needs will likely only grow more complex in the future, according to Chad Worz, executive director and CEO of ASCP, an association of senior care pharmacists.
Pharmacists can be a key expert resource and reference point for providers navigating these complexities, the experts agreed.
“As our population grows,” Worz explained, “spots are going to be taken up by people that are more and more sophisticated, with more and more comorbidities and medications… they’re going to need access to people like pharmacists — to individuals that have experience with older adult medicine.”
Residents’ complicated medical needs are only exacerbated by cognitive decline and mental health disorders that are common among nursing home residents, noted Nicole Brandt, professor at the University of Maryland Baltimore’s school of nursing.
Care transitions between nursing homes and other healthcare settings further complicate the issue for providers, according to Alice Bonner, chair at the Moving Forward Coalition.
“Adverse medication events happen at a higher rate and with more serious consequences during… care transitions,” Bonner explained. “People are going from one team of providers to another, one setting to another, and there’s just a lot of data that gets lost or mismanaged. Even in the best case scenario, it can be difficult to pull all the pieces together.”
Communication and collaboration
It’s important that providers build relationships with pharmacists, Worz said, “so that they know you and therefore know how to help you manage medications in a better way.”
That connection can be especially vital during transitions between care settings.
“As we deal with more and more medications… what might solve your problem in an acute situation or a hospital from a medication perspective may not be the right medication for your long-term,” Worz told attendees. “Someone’s got to be there to manage that process — make sure you either return to the medication that works for you or evolve to a medication that works for you… and that’s sort of a new dynamic — we have not had that for very long in terms of making decisions based on setting.”
The experts repeatedly emphasized the importance of clear communication during care transitions — not just between nurses and pharmacists, but between all parties involved in the process.
“We need to think about how we’re communicating,” said Brandt, “amongst the providers, amongst the pharmacies, amongst the patients, and, of course, the family members that are managing [medication lists] during care transitions.”
Depending on state regulations, providers may even be able to form collaborative practice agreements with pharmacists, Brandt noted — a step that can streamline workflows and alleviate the stresses of the current nursing home staffing shortage.
“Within our practice,” she said, “we developed collaborations with our nurse practitioners and physicians to reduce the workload and burden of making recommendations — also proposing changes and following up on medication needs. And that’s a really important aspect of thinking about the healthcare shortage of people trained in geriatrics and long-term care settings.”
According to the CDC, these formal partnerships that integrate pharmacists into the processes of other care providers can improve patients’ care outcomes, especially for chronic concerns like high blood pressure.
