Tuesday, April 07, 2009
Keeping track of prescription drug medications can be down right confusing – especially when taking multiple prescriptions as many patients commonly do. In fact, according to a recent national survey, patients over the age of 65 take an average of nine different medications. This population in particular is at higher risk for experiencing an adverse drug reaction that can lead to a trip to the emergency room, serious complications and sometimes, even death.
To remedy that, a new program launched by Presbyterian Hospital connects pharmacists to patients 65 and older for a personal, one-on-one prescription drug consultation by the phone. Within seven days after a patient is discharged from the hospital, a pharmacist calls the patient and carefully reviews each medication he or she is taking, including confirming the drug’s name, dosage, and regimen as prescribed by the physician. Following this free education session, the pharmacist then reports the findings to the patient’s primary care physician including sending a list of medications that are reconciled and flagged for any drug interactions.
As a result, the program led to a drop in hospital admissions related to adverse drug reactions in patients followed by Safe Med Pharmacists from 17.9 percent to four percent. Additionally, the American Society of Health System Pharmacists (ASHP) also granted Novant Health a $50,000 award, which honors a pharmacist-led team that guides a program aimed at improving medication safety.
“I’ve worked with many patients who are confused about why they are taking certain medications or even what they are used for, especially when the dose is changed or if a new prescription is recommended,” said Safe Med pharmacist Rebecca Bean. “My goal is to fully explain why patients are taking each prescription including benefits of therapy, possible adverse effects and optimal administration time. Additionally, patients need to be aware of food and drug interactions. In the case of adverse effects, cost issues or potential drug interactions, a recommendation to the physician will be made with a suggestion for alternative therapy if indicated.”
After the consultation with patients, Bean mails the patient an easy-to-read guide that lists information about each drug in layman’s terms and in a much larger typeface than what is found on a typical retail pharmacy prescription bag.
Bean has many examples of patients she has helped. “One patient I counseled didn’t realize he was supposed to stop taking one medication after his physician prescribed a new one. He essentially was double dosing. I worked with another patient who accidentally stopped taking a prescription she was supposed to continue,” Bean shared. “One woman was moved to tears after our session. She was so relieved to have someone take the time to review her long list of medications as she had an adverse drug event in the past.”
For patients who have follow-up questions, a toll-free number is available. Caregivers, such as adult children caring for their elderly parents, can receive prescription drug counseling for those whom they are caring.
“Medication reconciliation is an enormously important issue, “ said Nan Holland, R.N., B.S.N., M.P.H., senior director of clinical services and quality at Novant Health. “To date, our pharmacists around North Carolina have counseled more than three thousand patients since we launched the program in January 2007.
In addition to being age 65 and older, patient who are eligible for the program must meet one of the following:
• Have a primary care physician in Novant Medical Group
• Have a complex medical condition such as congestive heart failure, dementia, coronary artery disease or chronic obstructive pulmonary disease or a combination of diseases or conditions.
• Take a high-risk medication found on the “Beer’s List,” which is a guide produced by renowned gerontologist Mark Beers, M.D.; examples of high-risk medications include diazepam and amitriptyline.
• Have had three or more urgent care readmissions within a six-month period
• Have had more than five routine medications on admission to an acute care facility or at discharge
• Be referred by their Novant Medical Group provider.
