A collaboration between United Hospital Fund and seven New York nursing homes reduced the number of potentially harmful medications prescribed to nursing home residents by 8%.
The second annual, six-month trial period also recorded a decrease in the number of residents receiving 10 or more drugs.
The results extend beyond the numbers. Leaders also reported improved safety and quality of life for residents.
“We’ve seen a reduction in falls and hospitalizations,” Maria L. Franco, chief pharmacy officer for Garwin Healthcare System, a participating community, told McKnight’s Long Term Care News. “We have also seen improved cognitive function in some residents and reduced gastrointestinal side effects from some medications.”
Medication overdose can cause a number of problems, especially for residents transitioning from a skilled nursing facility to home.
“As part of the (a)transition project, we found that managing multiple medications was frequently cited by patients and families as a key issue in transitioning to home,” said Director of Quality and Efficiency, UHF Quality Institute said Joanne Guzik in a long-term interview with McKnight. news. “We decided to address this issue in the long-term care setting, believing that there is ample room for improvement and that it would be easier to review and prescribe appropriately when hospital stays are longer. ”
It is estimated that 50% of long-term care residents are receiving nine or more medications, and this group is 2 more likely to experience side effects than residents receiving fewer medications. It will be twice as expensive. So this partnership comes at a perfect time for some communities.
Stuart B. Almer, president and CEO of Gerwin Healthcare System, told McKnight’s Long Term News, “Our pharmacists are already working on prescription withdrawal efforts and increasing “We were dedicated to maintaining safe prescribing practices for patients.” “UHF’s focus aligned perfectly with ours.”
However, although the initial efforts to cancel prescriptions were well-intentioned, patients who were used to their normal daily lives voiced concerns.
“Residents and families may be hesitant to prescribe medications they have been taking for years because of the perception that something is being taken away from them,” Guzik said. “With clear communication, most residents and their families were actually willing to take less medication.”
Drugs targeted by the alliance included antihistamines, antidepressants, and opioids, which saw declines of 68%, 62%, and 53%, respectively.
the beginning of something good
The seven communities participating in this initiative are Eager Healthcare and Rehabilitation Center, Gerwin Jewish Nursing and Rehabilitation Center, Hebrew Home of Riverdale, Jamaica Hospital Nursing Home, Mary Manning Walsh Nursing Home, New Jewish Home, and Manhattan NYC Health + Hospital. /Governor.
Healthcare providers hope to expand the deprescription initiative to other areas of elderly care.
“We would love to expand our deprescription efforts to the rest of the health care system, including assisted living facility residents, adult day care participants, and home care patients,” Franco said. “Programs specific to discharged residents and others receiving our services within the community could lead to increased non-inpatient deprescription to streamline medication regimens globally.” There is a sex.”
Some health care providers may not know where to start when addressing tapering of high-risk medications. Choosing the right plan and resources can be the best starting point.
“Educating medical staff, providing tools and resources to deprescribe, and engaging a critical multidisciplinary team to monitor patients for deprescription side effects is critical,” Guzik said. said.
