Clinical Pharmacy Services intervention program can successfully reduce high-risk medication refills among the elderly

October 11, 2016

Many seniors are prescribed medications considered high-risk because of their potential to cause adverse reactions and events. The U.S. Food and Drug Administration (FDA) is addressing this issue with its recent release of safety tips for older adults. Health insurers can do even more by implementing a high-risk medication intervention program.

The elderly are prescribed medication more than any other age group in the U.S. Seniors between the ages of 65 and 69 take, on average, 14 prescriptions a day. Geriatricians have been warning for years that many of these prescriptions are high-risk medications, and could harm an already frail population.

Every year, one in six adults 65 or older experiences  adverse event to medications despite national guidance from the American Geriatrics Society, Beers Criteria, and the Centers for Medicare and Medicaid Services. Many seniors have multiple chronic diseases managed by specialists who don’t communicate, and hospitalization can compound the problem. A recent study of Veterans Affairs hospitals showed 44 percent of elderly patients received at least one unnecessary prescription at discharge.

Now the FDA is weighing in with the September release of medication safety tips for older adults, which urge seniors to take medication as prescribed, keep a medication list, be aware of side effects and review medication with health care providers.

The responsibility of ensuring a prescription is safe and appropriate should not be shouldered by the elderly patient taking the prescription. Health insurers, providers and pharmacists must do their part to consider the consequences of polypharmacy.

Proactive intervention programs that focus on high-risk medications can have positive outcomes. UMass Medical School’s Clinical Pharmacy Services implemented an intervention program with targeted prescriber outreach for one of its Medicare Part D clients with dramatic results.

A team from Clinical Pharmacy Services spent nine months reaching out to prescribers on behalf of the Medicare Part D client. Clinical pharmacists connected with a prescriber or member of the office staff during 8,635 calls, and recommended that high-risk medications be removed from prescription regimens. Forty-six percent of prescribers reached during the intervention followed the recommendations and did not refill a high-risk medication.

This example is just a snapshot of the work that needs to be done to prevent seniors from taking prescriptions that may lead to a poor outcome. Physicians, hospitals, pharmacists, and health plans must all work together to be certain the elderly are only prescribed drugs that are medically necessary and medically appropriate.

Clinical Pharmacy Services has become a sought-after partner for organizations seeking results-oriented solutions to containing pharmacy costs and improving patient outcomes. Their relationship with UMass Medical School enhances their capabilities by providing access to clinical resources, and the latest and most relevant research, data and trends.

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