Medication Management With Older Adults

1. Medication Management With Older Adults

2. 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

3. 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

4. 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

5. 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

6. 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

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