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Pharmacists, Physicians and Pharmacogenetics
When pharmacists track meds, collaborate with docs, everybody wins
When pharmacist and physicians work together, it improves outcomes for the patient and can save money due to unnecessary medications or re-hospitalization.
According to an article in MedPageToday.com, medication errors, unnecessary emergency room visits, preventable hospital readmissions — all costs can be reduced through better medication management and who knows medication better then the pharmacist?
When pharmacists and physicians work together, we are seeing better patient care and outcomes.
One challenge has been weak interoperability — i.e., electronic medical records that don’t speak well to one another across providers.
Yet when primary care doctors who are docked for poor performance outcomes, such as hospital readmission rates, learn that pharmacists can help doctors lower such rates, they quickly find ways to help pharmacists access their electronic medical records.
PGx Medical works directly with physicians and pharmacists across the country to help provide better quality of care to seniors through medication management. “Our PGx Medical propriety process can integrate test results with EHRs for each individual patient,” said Brant Bullard, Director of Operations for PGx Medical. “It’s seamless and everyone wins. The healthcare team will have evidence-based information at their fingertips to help them provide individualized care, and the patient lives a better quality of life.”
For more information on medication management, via pharmacogenetic testing, contact PGx Medical, info@pgxmed.com or 405-509-5112.
source: medpagetoday.com
Holiday Depression in Elderly Adults
For many seniors, the holidays can be especially sad and depressing.
For many seniors, the holidays can be especially sad and depressing.
For many seniors, the holidays are not a time of celebration and joy, but a reminder of how lonely he or she may be, the friends that have passed on, the lack of family get-togethers and an inability to participate in holiday functions. Commonly known as the holiday blues, elderly depression during the holidays affects seniors around the world, and not only during the traditional American holidays of Thanksgiving and Christmas, but other events as well.
Elderly depression, loneliness, lack of social interaction, and an inability to get around severely limit many senior’s ability to join in on holiday occasions which leads to depression.
Common Symptoms of Elderly Depression during the Holidays.
Family members and friends are cautioned to be alert to signs of holiday depression among seniors, regardless of whether they live on their own, with family members or in a long-term care facility.
Depression is more apparent in seniors who have limited options for travel, or whose family members aren’t close by. Some of the most common symptoms of elderly depression during the holidays may include:
- Change in sleeping habits
- Difficulty sleeping
- Apathy or lethargy
- Change of appetite
- Loss of interest in activities
- Loss of interest in socializing
These are just a few and individuals who know how mom or dad usually act are usually the first to pick up on clues that something isn’t right. Picking up on such clues is essential in order to help provide seniors with the attention and care needed to prevent serious repercussions and side effects of depression.
Children of aging parents can take several steps to ensure the mental health and well-being of their loved ones. Arrange regular phone contact when family members are distant to help them feel loved and cared for. If you are close, scheduling regular visits to long-term care facilities is also important so that seniors don’t feel they have been abandoned and forgotten.
Do whatever you can to involve an aging parent in holiday activities, whether it’s filling out Christmas cards, helping plan get-togethers or helping with arts and crafts for holiday decorating. Even the smallest activity can help them feel apart of the holidays.
If your family member is depressed, before starting them on an anti-depressant, ask their physician or long-term care facility if they have a pharmacogenetic test on file. This simple swab of the cheek will let your family members clinical caregivers know if the medication they are taking is appropriate and giving them the therapy they need. Depression is serious, especially for seniors who become inactive.
For more information on pharmacogenetic testing, contact PGx Medical, the trusted and experienced resource for the implementation of pharmacogenetics in the field of aging services.
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
source: boomerswithelderlyparents.com
Overuse of Antipsychotics in Nursing Homes
More than one in five U.S. nursing home residents are given antipsychotic medications
What is your medical plan of action to reduce antipsychotics in your LTC community?
The prescribing of antipsychotic medications persists at high levels in U.S. nursing homes despite extensive data demonstrating marginal clinical benefits and serious adverse effects, including death,
The analysis included 1,402,039 individuals overall, as well as a subset of 561,681 with at least 3 months of continuous observation.
A total of 308,449 of the residents had been given at least one prescription for an antipsychotic.
In more than two-thirds of cases, the agents used were from the atypical class of antipsychotics, which are primarily indicated for the treatment of schizophrenia and bipolar disorder.
“The most common antipsychotics prescribed are often used for off-label indications related to dementia, and the extended durations of use raise concerns about the care of frail elders residing in [nursing homes],” the researchers stated.
In addition, among the observed subgroup, only 7.5% had been given just one antipsychotic prescription, and the median number of such prescriptions was 10.
Even though this data dates back a couple of years, the use of antipsychotics is still prevalent in long-term care communities. In fact CMS will be coming out with new mandates for 2018 so communities should start planning now to be ahead of the mandates.
Even though some states met the original reduction guidelines, we are finding they are having trouble meeting new mandates – and have been told more are coming in 2018.
One tool used in homes across the country to help make sure residents are on medications that are actually giving them therapy, is pharmacogenetic testing.
Pharmacogenetics aligns current and future medications with each persons unique genetic profile. This simple, fully reimbursed test, will help guide healthcare professionals when prescribing medication. It takes the “guess work” out of it and provides your clinical team with evidence-based results allowing right drug, right dose, for the right person.
PGx Medical is presently enrolling provider organizations and communities in a pharmacogenetic operational pilot program. If you would like to be part of this program, please contact us at, info@pgxmed.com or 405-509-5112.
source: medpagetoday.com
Caregivers Guide to Pharmacogenetics
Getting through the transitions in life…
Help ease the transition for your loved one by being educated on the tools and resources that can help them live a long, healthy life!
When you are young, you dream of growing up, getting married and having children….but you never dream about taking care of your elderly parents. That isn’t part of the ten year plan. But things happen, life happens, and it is inevitable, we all get older and some of us will require a caregiver to take care of us as we age.
Those who work in eldercare understand and interact with caregivers on a day-to-day basis. Some are part of the “sandwich generation” who are caring for kids, grandkids and parents all at the same time. As you can imagine, this lifestyle can wear you down and take a toll on the caregivers health.
Becoming a caregiver for someone you love sometimes comes sudden due to an illness or accident. When that time comes, will you be prepared? There is no handbook, or step-by-step instructions on what to do, how to do it – or if you are even doing it correctly. You step in and do what you consider the best you can do. But so many choices.
One problem with elderly adults is the amount of medications they are taking. Some go from doctor to doctor, with a different diagnosis each time, and a whole new stack of prescriptions. Some even jump around to different pharmacies making it difficult for any clinical caregiver to keep track. This is dangerous.
Polypharmacy (the use of four or more medications by a patient, generally adults aged over 65 years) can cause falls and a whole host of other problems. Not to mention, do you even know if the medications they are taking are giving them therapy? Are they experiencing one reaction after another because their medications are interacting with each other? How would you know?
At PGx Medical, we have a sayIng, “You don’t know, what you don’t know.” Even a physician or pharmacist can’t predict how your body will respond to certain medications. So how would you know?
According to the AACP, polypharmacy has a high price tag. The economic impact of medication-related problems is estimated at $177.4 billion per year, rivaling that of Alzheimer’s disease, cancer, diabetes and heart disease. Plus adverse effects brought on by the combination of multiple drugs are thought to be responsible for nearly a third of all hospital admissions. Each year 32,000 seniors suffer hip fractures caused by medication-related problems. Its simple: They are overmedicated, feel dizzy when they stand up, and fall. Or worse, get behind the wheel of a car.
Now there is a simple test, pharmacogenetics, that can help guide healthcare professionals when dosing medications. Pharmacogenetics aligns current and future medications with each persons unique genetic profile. In other words, it will tell your physician what medications your body can metabolize, which medications might need a dosage change, and which medications are interacting…all personalized for each individual. Right drug, right dose, for the right person.
So why aren’t more healthcare professionals using pharmacogenetics in their day-to-day patient care? That is a good question. Some say it is because it is too new. Pharmacogenetics has been around for decades. And along the way, the FDA has added pharmacogenetic information (black box warnings) on certain medications suggesting a pharmacogenetic test be done prior to prescribing the medications.
We also hear from clinical caregivers that these tests are draining medicare dollars. Yes, this once in a lifetime test is fully reimbursed by Medicare, but this is based on cost savings. In fact, performing a pharmacogenetic test on elderly patients who are on multiple medications can save medicare dollars. Think about it…if you reduce a patients medications to “only” the ones that the pharmacogenetic report says they can metabolize and should give them therapy, you are saving money on unnecessary medications, and you are helping prevent future falls or re-hospitalization due to drug-on-drug interactions.
According to the CDC, in 2015, costs for falls to Medicare alone totaled over $31 billion. Medications play a big role in falls in elderly patients.
The more educated healthcare professionals are on pharmacogenetics, the more they understand the value and impact it can have on improving the quality of care in elderly adults. Our most fragile patients who are dependent on us to make sure we provide them the best care possible. All of this starts with the caregiver. Whether you are a family member, friend, or POA for an elderly adult, check into pharmacogenetics and other available tools and resources that can help provide a longer, healthier life – and make your job as caregiver a lot easier.
For more information on pharmacogenetics, contact PGx Medical, info@pgxmed.com or 405-509-5112
Over Prescribing Medications for Older Adults
Prescribing for older patients presents unique challenges.
Atypical antipsychotic medications, used for the management of the behavioral and psychological symptoms of dementia, are among the drugs most frequently associated with adverse events in long-term care facilities.
Optimizing drug therapy is an essential part of caring for an older person. The process of prescribing a medication is complex and includes: deciding that a drug is indicated, choosing the best drug, determining a dose and schedule appropriate for the patient’s physiologic status, monitoring for effectiveness and toxicity, educating the patient about expected side effects, and indications for seeking consultation.
But how do you know what a person can metabolize, or receive therapy from, and what they can’t? It’s all kind of a guessing game and you hope that you get it right the first time. Pre-marketing drug trials often exclude geriatric patients and approved doses may not be appropriate for older adults. Many medications need to be used with special caution because of age-related changes in pharmacokinetics (ie, absorption, distribution, metabolism, and excretion) and pharmacodynamics (the physiologic effects of the drug).
Adverse drug events (ADEs) are the serious consequences of inappropriate drug prescribing. The possibility of an ADE should always be top of mind when evaluating an older adult individual; any new symptom should be considered drug-related until proven otherwise.
Atypical antipsychotics:
Atypical antipsychotic medications, used for the management of the behavioral and psychological symptoms of dementia, are among the drugs most frequently associated with adverse events in long-term care facilities. In particular, psychotropic medications are associated with an increased risk for falls. In one meta-analysis of patients age 60 or older, the odds ratio for any psychotropic use among patients who had one or more falls was 1.73 (95% CI 1.52-1.97).
Use of antipsychotic medications in long-term care facilities is widespread. A study of 19,780 older adults with no history of major psychosis prior to long-term care admission found that antipsychotic therapy was prescribed for 17 percent within 100 days of their long-term care admission and for 24 percent within one year.
Pharmacogenetics is one tool that can help determine the right drug, at the right dose, for the right person. This one time test is simple to administer and will give clinical caregivers valuable information for each individual resident in a long-term care community. There is no-cost to the resident and no-cost to the community since it is reimbursed by Medicare B and in select states, Medicaid.
If you would like more information on Pharmacogenetics, or you would like to sign up for an educational webinar, contact: info@pgxmed.com or call 405-509-5112.
Source: uptodate.com
The Link Between Dementia and Hypertension
“Given the prevalence of hypertension and the fact that effective drugs are so accessible, “treatment of hypertension may prove to be one of the best ways to prevent or delay dementia.” ~AHA
CMS established new national goals for reducing the use of antipsychotic medications in long-stay nursing home residents
In a recent article in MedPage Today, the American Heart Association stated there is compelling evidence that chronic arterial hypertension in mid-life is associated with late-life dementia, including Alzheimer’s disease.
“There is a strong rationale for treating hypertension, taking into account age, brain health, cardiovascular and cerebrovascular health, and other risk factors,” according to Costantino Iadecola, MD, director of the Brain and Mind Research Institute at Weill Cornell Medical College in New York City.
Given the prevalence of hypertension and the fact that effective drugs are so accessible, “treatment of hypertension may prove to be one of the best ways to prevent or delay dementia,” the AHA statement authors wrote.
There are a number of challenges clinicians currently face in treating hypertension, including individualizing blood pressure targets, he added. In an era of “precision medicine,” these targets need to be established on a patient-by-patient basis, Iadecola said, noting that in the elderly, lowering blood pressure can be detrimental.
Control of hypertension is likely to be a fundamental step in the effort to reduce the incidence of AD and other forms of dementia worldwide, Iadecola said.
Results from the long-term randomized controlled Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial would seem to support this, he noted. Those results indicated that control of hypertension and other vascular risk factors as well as physical and mental activity and a healthy diet can prevent or improve cognitive decline in an at-risk population of elderly, Iadecola said.
With these findings, precision medicine, via pharmacogenetic testing can identify which medications work best, or at all, for each individual patient. This is critical when dealing in the long-term care setting. “In an elderly patient you don’t always have the luxury of waiting 3-6 weeks to see if a medication will work,” said Clay Bullard, President of PGx Medical, an Oklahoma based company who travels around the country educating healthcare professionals on the benefits of pharmacogenetic testing.
“Pharmacogenetics eliminates the “guessing game” or trial and error prescribing. With these new findings, it’s more important then ever to treat our aging community with the best tools and resources available, and pharmacogenetics is one of them.” said Bullard.
“Sometimes we get pushback from physicians or the nursing staff, and I ask, “what do you have to lose?” Pharmacogenetic testing is currently reimbursed by Medicare B and in select states, Medicaid.
For more information on pharmacogenetics or how to implement it into your long-term care community, contact: PGx Medical, info@pgxmed.com or 405-509-5112. PGx will walk you through the process or schedule an educational webinar for your staff.
If you would like to schedule PGx Medical to speak at your upcoming conference or corporate meeting on pharmacogenetics and how it relates to clinical concerns such as falls, dementia, sleep, pain, med management and overall staff efficiencies, send your request (with organization, date, time) to kburleson@pgxmed.com.
Read entire article at MedPageToday