Clinical Software in Long-term Care Consultant Pharmacy Practice

1988 ◽  
Vol 1 (3) ◽  
pp. 218-224
Author(s):  
James A. Sherman
Keyword(s):  
Long Term Care ◽  
Pharmacy Practice ◽  
Human Memory ◽  
Drug Regimen ◽  
Accurate Information ◽  
Term Care ◽  
Drug Regimens ◽  
Computer Based ◽  
Software Programs

As evidenced in 1985, and confirmed through preliminary analysis of a 1988 survey, 96.3% of long-term care (LTC) providers were using computers in providing dispensing services. It is the challenge of using this current tecnhology to merge existing drug management (prescription processing) and clinical applications that identifies the frontier of computerized pharmacy practice. Software programs are currently available that enable the consultant to uniformly apply set indicator criteria without ommission or human memory lapse to all LTC resident drug regimens. It is the degree to which these drug regimen review software programs may be integrated with prescription processing software, and the extent that the programs exceed the indicators that may be used in evaluating their impact and value. This value may be reflected in decreased consultant pharmacist review time, patient benefit, physician response, perceived administrator/nursing home benefits, and the usefulness of reports and outcome statistics generated. The advantages, disadvantages, guidelines for software evaluation, and currently available clinical programs are presented in order to provide accurate information to those consultant pharmacists seeking to expand or implement new computer based clinical services.

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.

scholarly journals Prescribing-Assessment Tools for Long-Term Care Pharmacy Practice: Reaching Consensus through a Modified RAND/UCLA Appropriateness Method

Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 194
Author(s):  
João R. Gonçalves ◽  
Betsy L. Sleath ◽  
Manuel J. Lopes ◽  
Afonso M. Cavaco
Keyword(s):  
Long Term Care ◽  
Inappropriate Medication ◽  
Pharmacy Practice ◽  
Clinical Information ◽  
Daily Practice ◽  
Health Technology ◽  
Assessment Tools ◽  
Term Care ◽  
Study Participants

Medicines are the most used health technology in Long-Term Care. The prevalence of potentially inappropriate medicines amongst Long-Term Care patients is high. Pharmacists, assisted by prescribing-assessment tools, can play an important role in optimizing medication use at this level of care. Through a modified RAND/UCLA Appropriateness Method, 13 long-term care and hospital pharmacists assessed as ‘appropriate’, ‘uncertain’, or ‘inappropriate’ a collection of commonly used prescribing-assessment tools as to its suitability in assisting pharmacy practice in institutional long-term care settings. A qualitative analysis of written or transcribed comments of participants was pursued to identify relevant characteristics of prescribing-assessment tools and potential hinders in their use. From 24 different tools, pharmacists classified 9 as ‘appropriate’ for pharmacy practice targeted to long-term care patients, while 3 were classified as ‘inappropriate’. The tools feature most appreciated by study participants was the indication of alternatives to potentially inappropriate medication. Lack of time and/or pharmacists and limited access to clinical information seems to be the most relevant hinders for prescribing-assessment tools used in daily practice.

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.

scholarly journals Use of Immunochromatographic SARS-CoV-2 Antigen Testing in Eight Long-Term Care Facilities for the Elderly

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 868
Author(s):  
Martina Ifko ◽  
Miha Skvarc
Keyword(s):  
Long Term Care ◽  
Health Care Facilities ◽  
Accurate Information ◽  
Clinical Validation ◽  
Antigen Test ◽  
Term Care ◽  
Care Facilities ◽  
Antigen Tests ◽  
Antigen Testing

The clinical validation of the NADAL COVID-19 antigen test (Nal von Minden, Moers, Germany) started in eight Slovenian long-term health care facilities in October 2020. The purpose of clinical validation is to implement the test into the everyday working process in long-term care (LTC) facilities and demonstrate how it can be used to mitigate the spread of the virus in these environments. The facilities compared the results of antigen tests to the results obtained using Cobas 6800 SARS-CoV-2 real-time reverse transcription polymerase chain reaction (RT-PCR) (Roche, USA). Sensitivity (86.96%, 95% CI: 66.41–97.23%) and specificity (88.24%, 95% CI: 80.35–93.77%) of the NADAL COVID-19 antigen test were good. Rapid antigen testing served well for early detection of infection and helped to prevent and control spread of the SARS Cov2 in six out of eight LTCs. Moreover, mini-outbreaks were quickly resolved in all six LTCs. Locally validated immunochromatographic SARS-CoV-2 antigen testing can be used to contain the spread of the virus in LTCs. Antigen tests also deliver accurate information very quickly if used early with a low threshold. The NADAL COVID-19 antigen test proved to be a good screening tool to detect SARS-COV-2 in LTCs.

Development and implementation of a long-term care-based introductory pharmacy practice experience course

2014 ◽  
Vol 6 (3) ◽  
pp. 393-400 ◽  
Author(s):  
Paul Gavaza ◽  
Donna M. Adkins ◽  
Ethan Hodges ◽  
Susan L. Mayhew ◽  
Charles Breese
Keyword(s):  
Long Term Care ◽  
Pharmacy Practice ◽  
Term Care ◽  
Practice Experience

Geriatrics & Gerontology: Pharmacists' Perceptions of Geriatric Pharmacy Practice

1983 ◽  
Vol 17 (2) ◽  
pp. 134-138 ◽  
Author(s):  
Peter P. Lamy ◽  
William Simonson ◽  
Clara C. Pratt
Keyword(s):  
Patient Compliance ◽  
Long Term Care ◽  
Medication Use ◽  
Pharmacy Practice ◽  
The Elderly ◽  
Care Patient ◽  
Drug Reactions ◽  
Term Care ◽  
Content Areas

Four hundred thirty-two pharmacists from two separate pharmacy organizations associated with geriatric practice were surveyed to determine their perceptions of 51 content areas in terms of their importance for inclusion in pharmacy curricula. The population surveyed was also asked to respond to the question: What do you believe is the most difficult aspect of geriatric pharmacy practice? Demographic and descriptive information was collected for each respondent, for statistical purposes. The most important content areas for inclusion in pharmacy curricula were the pharmacist's responsibility in long-term care, patient compliance, drug interactions, adverse drug reactions, and psychotropic medication use. The most difficult aspects of geriatric pharmacy practice identified included inadequate geriatric knowledge, patient compliance, physician overprescribing, communication with the elderly, and lack of professional and/or financial recognition.

implementing Student Pharmacist- Led Health Outreach Events at Long-term Care Facilities in a Medically Underserved Community

2021 ◽  
Vol 36 (8) ◽  
pp. 387-395
Author(s):  
Megan Giruzzi ◽  
Nick Giruzzi ◽  
Virginia Gonzalez ◽  
Kimberly McKeirnan
Keyword(s):  
Patient Care ◽  
Long Term Care ◽  
Pharmacy Practice ◽  
Lessons Learned ◽  
Medically Underserved ◽  
Care Process ◽  
Term Care ◽  
Care Facilities ◽  
Medication Reviews

OBJECTIVE: To describe the process of creating precepted, student pharmacist-led health outreach events at long-term care facilities and to describe the lessons learned during the implementation process. SETTING: Yakima, Washington, a medically underserved area. PRACTiCE DESCRiPTiON: Pharmacy students, supervised by pharmacist preceptors, conducted health outreach events at local long-term care facilities on a rotating monthly basis. These students provided comprehensive medication reviews, blood pressure screenings, and blood glucose screenings. PRACTiCE INNOVATION: Pharmacists providing medication reviews at long-term care facilities where residents manage their medications can address polypharmacy by identifying medication discrepancies, determining the effectiveness of treatment, and improving patient outcomes. Conducting health outreach events with pharmacy-student involvement includes the added benefit of providing students with the opportunity to gain hands-on experience before beginning their clinical Advanced Pharmacy Practice Experience (APPE) rotations and practice skills described in the American Society of Consultant Pharmacists Geriatric Pharmacy Curriculum Guide and Pharmacist's Patient Care Process. RESULTS: Nineteen health outreach events at long-term care facilities were held, and more than 100 residents participated annually. Students coordinated events successfully after developing a standardized set of questions, which was necessary for planning, and identifying someone to act as an event coordinator, recruiting students and ensuring they were appropriately trained, and creating a monitoring form to be filled in and shared with the participant. Students learned key lessons including naming the events appropriately to avoid confusion, understanding that not all long-term care facilities are alike, deciding how many students to recruit from each cohort to participate in events, optimizing the preceptor-to- student ratio, and ensuring preceptors were thorough in their oversight of students. CONCLUSION: This work described the implementation of health outreach events conducted by supervised student pharmacists at long-term care facilities. Health outreach events could be conducted by other colleges or facilities to provide important medication review and health screening services for long-term care facilities' residents, as well as providing student pharmacists with opportunities to learn and practice patient-care related skills.

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