Taking medications doesn’t need to be so stressful
Whether they use a box, a smartphone app, or simple notes, people who take several medications have to keep them all straight.
Multiple medications are often necessary for older patients. More than half of adults 65 and older report taking four or more prescription drugs, according to the Kaiser Family Foundation.
But the more medications a person requires, the more chances of problems—even hospitalization because of adverse drug events or not adhering to a prescription.
“As people get older, they tend to have more medical conditions, which may require more medications,” says Brian Gates (’99 PharmD), a professor of pharmacotherapy at Washington State University College of Pharmacy and Pharmaceutical Sciences (CPPS) and a board-certified geriatric pharmacist.
Brian Gates (Courtesy WSU Pharmacy and Pharmaceutical Sciences)
One of the riskiest times is the transition from hospital to home care. In a 2009 WSU study, almost 90 percent of patients receiving home health care services from a Medicare-certified home health care agency experienced at least one medication discrepancy in that transition.
Pharmacists are ideally suited to identify, prevent, and resolve medication-related problems during transitions of care. They leverage in-depth knowledge of medications and the effects on the body to work closely with older people.
“One problem is that some patients go back to whatever meds they were taking before they went to the hospital. The pharmacist in home health helps identify those situations and alert patients and other clinicians to prevent adverse effects,” says Jeffrey Clark (’09 PharmD), an associate professor in CPPS. He is also board-certified in geriatrics.
Jeffrey Clark (Courtesy WSU Pharmacy and Pharmaceutical Sciences)
Whether you are aging in place, transitioning back home, or receiving care at a facility, your pharmacist—and especially a senior care pharmacist—can help with medication evaluation for older patients or family members who help them. You can find a senior care pharmacist through the American Society of Consultant Pharmacist’s website.
For example, Providence Visiting Nurses Association (VNA) Home Health in Spokane Valley has utilized consultant pharmacists as part of the home health care team for almost 30 years. WSU faculty, resident pharmacists, and students from CPPS perform medication reviews, assess patients in the home, and collaborate with other providers to improve patient outcomes.
Gates and Clark both work as consultant pharmacists with Providence VNA and have measured the effectiveness of pharmacists on the health care team. That includes significant reductions in hospitalization from adverse medication events.
A recent quality improvement project identified that patients at high risk for hospitalization, who also had two or more medication discrepancies when starting home health care, were about two times as likely to be hospitalized within 30 days. As part of an interdisciplinary team, Gates and Clark took steps to improve medication reconciliation and evaluation that resulted in reduced hospitalizations.
Technology like medication management apps, smart pill dispensers, and telehealth can improve monitoring and support. However, communication between the patient and pharmacist is still crucial, and sometimes lost with new technology or mail delivery, Clark says.
Education is key, since pharmacists help patients understand the purpose of their medications, which medications are most effective, how to take them safely, and potential side effects, Gates says. If a person has many medications, there can be real difficulty in understanding health information. Cognitive impairment can also affect a patient’s ability to effectively manage and take all their medications.
“Pharmacists can help you, as a patient, understand what meds are doing for you, and the individual risks and benefits of each one,” Clark says. “By working with providers, we can also help determine which ones are no longer necessary.”
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