The Consultant Pharmacist's Role in Long-term Care Facilities

1988 ◽  
Vol 1 (3) ◽  
pp. 166-172
Author(s):  
Charles H. Brown
Keyword(s):  
Drug Therapy ◽  
Adverse Effects ◽  
Long Term Care ◽  
The Elderly ◽  
Drug Regimen ◽  
Pharmaceutical Services ◽  
Term Care ◽  
Care Facilities ◽  
Multiple Drugs

As the elderly portion of the US population continues to grow at an alarming rate, it is expected that the extent of their drug utilization will also escalate proportionately. The typical geriatric patient often presents with multiple medical disorders that are being treated with multiple drugs. With the elderly, as the number of medications increase numerically, the incidence of adverse drug reactions may increase exponentially. At times, one drug may be prescribed to treat the adverse effects of another medication. Studies show that the cost benefits of having consultant pharmacists conduct drug regimen reviews on patients in long-term care facilities resulted in a savings of $220 million. These cost savings resulted from the influence of consultant pharmacists decreasing the number of drugs per patient, amount of nursing time spent on drug administration, number of hospitalizations resulting from adverse effects, and overall cost of medical care. These data influenced the development of federal regulations that now require pharmacists to perform monthly drug regimen reviews on all patients residing in either intermediate or skilled nursing facilities. In addition to clinical drug therapy monitoring, the consultant pharmacist also participates in the infection control and pharmaceutical services committees and presents in-service training programs to the nursing staff. In performing various clinical and administrative functions, the consultant pharmacist must be able to work with other health care personnel in improving pharmaceutical services and patient care. As a result, there will be an even greater need in the near future for pharmacists who have been clinically trained to evaluate drug therapy in the elderly.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

scholarly journals Care and management demands of long-term care facilities for the elderly in Brazil: an integrative review (2004-2014)

2017 ◽  
Vol 20 (2) ◽  
pp. 286-299 ◽  
Author(s):  
Fátima Ferreira Roquete ◽  
Carolina Campos Ricci Frá Batista ◽  
Rodrigo Caetano Arantes
Keyword(s):  
Long Term Care ◽  
Quality Care ◽  
The Elderly ◽  
Integrative Review ◽  
Elderly Persons ◽  
Term Care ◽  
Care For The Elderly ◽  
Care Facilities ◽  
Care Demands

Abstract Objective: to analyze the care and management demands of Long-Term Care Facilities for the Elderly (LTCFs) in Brazil. Method: an integrative review of literature was carried out, organized into six stages: a) elaboration of a guiding question; b) online search of LILACS, SciELO, PubMed, the CAPES Portal and the Brazilian Society of Geriatrics and Gerontology databases; c) article selection, following the exclusion and inclusion criteria, with the sample composed of 17 articles; d) commented analysis of the selected articles; e) deliberation on the results obtained, formulated from the synthesis and interpretation of the selected studies; f) presentation of the results of the review. Results: the care demands identified are related to the process of caring and assume a working team with geriatric and gerontological knowledge, while the management demands include the means and resources needed so the care can be provided effectively. However, the LTCFs were found to rely on professionals who are unprepared to provide care or to assume an organizational management role, meaning care for the elderly is restricted to the essentials for their basic needs. Conclusion: the care demands were easily identified in the analyzed publications, however, there is a lack of research that evaluates management demands in a broader and more in-depth manner. It is suggested that studies aiming to broaden theoretical knowledge of the care and management demands of LTCFs are carried out, to stimulate effective and positive actions in the practices of these institutions, seeking to offer top quality care to elderly persons that live in these facilities, that responds to the real needs of their current stage of life.

Interprovincial Comparisons of Public and Private Sector Long-Term Care Facilities for the Elderly in Canada

1994 ◽  
Vol 20 (3) ◽  
pp. 278 ◽  
Author(s):  
Janet Greb ◽  
Larry W. Chambers ◽  
Amiram Gafni ◽  
Ron Goeree ◽  
Roberta Labelle
Keyword(s):  
Private Sector ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Public And Private ◽  
Care Facilities ◽  
Public And Private Sector

scholarly journals 2055. Action: A Year in the Lives of Consultant Pharmacists Working on Antimicrobial Stewardship in Long-Term Care Facilities

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S692-S693
Author(s):  
Philip Chung ◽  
Alex Neukirch ◽  
Rebecca J Ortmeier ◽  
Scott Bergman ◽  
Mark E Rupp ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
First Generation ◽  
Long Term Care ◽  
Diagnostic Testing ◽  
Drug Regimen ◽  
Term Care ◽  
Clostridioides Difficile ◽  
Care Facilities ◽  
Tract Infections

Abstract Background The CDC recommends consultant pharmacists (CP) support antimicrobial stewardship (AS) activities in long-term care facilities (LTCF) by reviewing antimicrobial appropriateness. We initiated a project training CP from a regional long-term care pharmacy to support AS implementation in LTCF. Methods CP were trained to evaluate the appropriateness of all systemic antimicrobial therapy (AT) and provide prescriber feedback during their monthly drug regimen review (DRR). An electronic database was developed to facilitate data reporting. Antimicrobial use (AU) and adverse events (AE) from 32 LTCF were analyzed for 2018 using descriptive statistics. Results A total of 5327 courses of AT with a median duration of 7 days (IQR 5–10) were reviewed. The majority of AT was started in the LTCF (55%) but was also initiated in hospitals (24%), clinics (11%) and emergency departments (2%). Of 2926 AT started in LTCF, 36% were based on nurse evaluation (NE) while 33% began after prescriber evaluation (PE). Fluoroquinolones (FQ) and first-generation cephalosporins were the most commonly prescribed agents (Table 1). Treatment or prophylaxis of urinary tract infections accounted for 40% of AU (Figure 1). Diagnostic testing was associated with 37% of AT courses. Urine cultures were the most frequent test performed (81%). Overall, 41% of AT was determined to be inappropriate resulting in > 800 feedback letters sent to prescribers. Unnecessary antibiotic starts (based on revised Mc Geer or Loeb’s criteria) were identified as the most common reason (Figure 2). AT appropriateness varied depending on the setting in which it was initiated. A majority (87%) of AT initiated in hospitals was found to be appropriate with 56% and 46% appropriate for ED and clinic starts. Appropriateness of LTCF initiated AT was 49% (59% after PE and 42% after NE). AE were associated with 3% of AT with allergic reactions and Clostridioides difficile infections occurring with 0.4% and 0.7% of AT, respectively. AE were most frequently associated with folate antagonists (5%) and FQ (3%). Conclusion This study demonstrates many AU improvement opportunities exist in LTCF and CP can play an important role in identifying them if trained in AS principles. CP should review all AU for appropriateness and provide data to inform AS efforts in LTCF. Disclosures All authors: No reported disclosures.

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