Title of presentation goes here
Improving Medication Safety among Community Dwelling Older Adults Raeann G LeBlanc, DNP, ANP/GNP-BC University of Massachusetts Amherst Purpose To improve medication safety among community dwelling older adults through in-home medication assessment and generated alerts using an informatics based intervention.
Introduction Prevention of medication related problems are important to maintaining health and safety in one’s home for community dwelling older adults. Assessment of medications and self-management are essential elements of medication safety and care coordination. The Framework for Geriatric Homecare Excellence (Collaboration for Home Care Advances and Practices, 2009) is used as the foundation for this project to reduce medication related problems and maintain health at home.
Results
Methods
Top 4 Medication Related Problems Falls + psychotropic
9%
Low SBP related to med
9%
Confusion + physchotropic
11%
NSAID use age > 80
14%
Dizziness related to med
Generate & Share Alert (Client, PCP, Case Manager, Nurse)
31%
Alerts
Table 1
Home Visit 2: Repeat above Med list & EBP education/teach back
51% of Community Dwelling Older Adults had a medication safety alert
Available Medication List 94%
Conclusions
48%
Background Use of multiple and inappropriate medications increases the risk of serious and fatal outcomes for community dwelling older adults (Gurwitz et al., 2003 & Fulton et al., 2005). References Gurwitz, J., Field, T. S., Harrold, L. R., Rothschild J., Debellis, K., Seger, A.C., … Bates, D.W. (2003). Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA, 289, 1107–16. Fulton, M., & Allen, E. (2005). Polypharmacy in the elderly: A literature review. Journal of the American Academy of Nurse Practitioners, 17,4, 123-132.
Home Visit 1: Medication assessment (HomeMeds) Side effect & symptom assessment (dizzy, confused, falls) Orthostatic vital signs Health literacy (STOFHL) Drug Regimen Unassisted Grading Scale
Post
Pre Table 2
Sample n=35 Males = 31% Mean Meds = 12
Mean Age = 80 Females = 69% Mean Diagnoses = 6
High number potential med related problems Polypharmacy prevalent Med changes on urgent alerts, but not non-urgent Assessment of health literacy important to education interventions (adequate health literacy in this sample based on STOFHL scores) Most common education concept – avoidance of duplication in class of anti-inflammatory drugs Clients, caregivers, case managers found the receipt of a medication list beneficial HomeMeds™ informatics system increases collaboration and communication of information to PCP, case managers, nurses, caregivers, clients In home assessment of medication selfmanagement and medication review, though time intensive, reveal significant potential for risk reduction related to potential medication problems
Introduction Prevention of medication related problems are important to maintaining health and safety in one’s home for community dwelling older adults. Assessment of medications and self-management are essential elements of medication safety and care coordination. The Framework for Geriatric Homecare Excellence (Collaboration for Home Care Advances and Practices, 2009) is used as the foundation for this project to reduce medication related problems and maintain health at home.
Results
Methods
Top 4 Medication Related Problems Falls + psychotropic
9%
Low SBP related to med
9%
Confusion + physchotropic
11%
NSAID use age > 80
14%
Dizziness related to med
Generate & Share Alert (Client, PCP, Case Manager, Nurse)
31%
Alerts
Table 1
Home Visit 2: Repeat above Med list & EBP education/teach back
51% of Community Dwelling Older Adults had a medication safety alert
Available Medication List 94%
Conclusions
48%
Background Use of multiple and inappropriate medications increases the risk of serious and fatal outcomes for community dwelling older adults (Gurwitz et al., 2003 & Fulton et al., 2005). References Gurwitz, J., Field, T. S., Harrold, L. R., Rothschild J., Debellis, K., Seger, A.C., … Bates, D.W. (2003). Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA, 289, 1107–16. Fulton, M., & Allen, E. (2005). Polypharmacy in the elderly: A literature review. Journal of the American Academy of Nurse Practitioners, 17,4, 123-132.
Home Visit 1: Medication assessment (HomeMeds) Side effect & symptom assessment (dizzy, confused, falls) Orthostatic vital signs Health literacy (STOFHL) Drug Regimen Unassisted Grading Scale
Post
Pre Table 2
Sample n=35 Males = 31% Mean Meds = 12
Mean Age = 80 Females = 69% Mean Diagnoses = 6
High number potential med related problems Polypharmacy prevalent Med changes on urgent alerts, but not non-urgent Assessment of health literacy important to education interventions (adequate health literacy in this sample based on STOFHL scores) Most common education concept – avoidance of duplication in class of anti-inflammatory drugs Clients, caregivers, case managers found the receipt of a medication list beneficial HomeMeds™ informatics system increases collaboration and communication of information to PCP, case managers, nurses, caregivers, clients In home assessment of medication selfmanagement and medication review, though time intensive, reveal significant potential for risk reduction related to potential medication problems
