Medication Management With Older Adults

The Need for Medication Management Older people take over 1/3 of all Rx drugs and half of older people take 3+ meds Multiple physicians prescribing multiple medications Documented adverse drug events 7,000 deaths each year $2 BILLION annually for medical costs At least 25% of adverse events are preventable 13% of total population take 33% of Rx meds An adverse drug event is defined as “an injury due to an adverse drug reaction or a medication error.

What is “Medication Management”? Medication screening During multiple phases in the pharmaceutical process Implementation of change strategies to fix identified problems Use of human and/or computerized technology Use of evidence-based guidelines as decisional support mechanisms

Home Health Criteria & Medication Management Model Intervention Inappropriate therapeutic duplication of meds Cardiovascular med poblems Inappropriate psychotropic med use with concurrent falls or confusion; and Inappropriate use of non-steroidal anti- inflammatory drugs

Core Elements of MMM Screening and identification of problems using a computerized screening algorithm Structured in-home assessment Pharmacist and nurse made recommendations to address problem and contacted the MD Nurse assisted person with med changes and monitored effects of change MMM = Medication Management Model Those who were confirmed to have a verified med problem were included in the study and randomized to either intervention and control Control subjects received usual home healthcare nursing services

MMM Results Overall, med problems resolved for 50% of intervention group compared to 38% of control For therapeutic duplication: 71% resolved in intervention group compared to 24% in control Model is feasible, flexible and sustainable as an in-home service to frail older adults Data collected 90 days post intervention; sample

For More Information See Partners in Care Foundation Homemeds Medication Safety Program at www.picf.org