Labinot Avdiu, CEO Pharm.D., Medication Management Partners
At MMP, we are advocates of fewer drugs, not more. We should work to prevent the cause of disease and, whenever possible, first attempt evidence based lifestyle modifications, and non-invasive, non-pharmacological treatments. All medications have side effects, even aspirin. Negative interactions can vary with every drug and every individual. One group, however, deserves a more watchful eye when it comes to medications given by caregivers or taken at home and that is our senior population.
Older bodies process medications differently, and seniors may take multiple drugs simultaneously for varying health conditions. So, which drugs should be avoided or taken with extreme caution and supervision in the senior population?
Lists to Assist Cautionary Senior Medications
One resource is the Beers list of medications for seniors to avoid. In 1991, Dr. Mark Beers published a list of medications that were considered to be inappropriate for people living in long-term care facilities called The American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, it has been widely accepted by many clinicians and facilities, and has been updated several times
The Beers list puts medications into three categories:
• Medications that should be avoided in seniors.
• Medications that could make the disease or condition worse because of the drug interactions or side effects.
• Medications that should be used with caution.
The list provides recommendations regarding each medication and explains why it should be avoided and if there are specific situations and conditions where risk of adverse side effects is increased.
MMP Goes Beyond Beers
While the Beers list is a great resource, it can be difficult to adhere to in practice. For example, if a pharmacist knows a drug carries a risk for a patient, a substitute may offer a viable choice with less risk (of one type, anyway). But lower risk may come with a lower efficacy rate and the disease may persist. Other factors also have to be analyzed and weighed.
What if the substitute medication is more expensive for the patient? At MMP, we’ve seen countless examples of this situation. This is why our pharmacists do both a risk/benefit analysis and a cost/benefit analysis. These analyses are more complex with seniors on multiple medications.
MMP’s knowledgeable and experienced pharmacists evaluate thousands of drug-risk alerts on a daily basis. We’ve used the Beers list, along with other resources, to focus on high-risk medications that are most likely to lead to serious adverse events or negative outcomes. We supply our pharmacists with tools to stay on top of voluminous drug risk alerts and make the most appropriate and effective decision for every prescription. Our committed pharmacists do this while minimizing treatment delay for seniors and their caregivers!
One type of drug we put on the high-risk list is any medication for which the resident does not have a corresponding medical diagnosis or drug indication. An example would be medication to treat anxiety or insomnia, which might have started out as a prescription for an acute problem, but then became part of chronic therapy – recognized by the physician and refilled by the pharmacy – in perpetuity. MMP seeks to reduce risks arising from such medications by monitoring resident medications and alerting the physicians/prescribers and caregivers when appropriate.
One Final Word
We love technology at MMP and every safety advantage it offers. Ultimately, however, the final firewall is human. We pay tribute to the watchful eyes of caregivers who are on the front lines of residential patient service – the nurses and LPN’s who make the last check before administering drugs to seniors.
Meet Medication Management Partners
Residential care providers are concerned about resident safety, caregiver efficiency, regulatory compliance and controlling their liability. MMP provides customized, comprehensive pharmacy services to seniors and others in residential care communities. Our passion is to improve the quality of life for residents and simplify pharmacy for them and their caregivers. What makes MMP distinct is our laser focus on residential care communities, our simple and scalable process, and our ability to integrate with every e-MAR. This unique combination allows us to help operators manage these risks while improving resident care. For more information about MMP, our triple verification process and ways we can help you, check out our website, call (833) 223-0386 or email us at firstname.lastname@example.org.
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