News
Budget Crisis in Oklahoma: Being Efficient With What You Have
A projected 25% cut in Medicaid provider payments could go into effect June 1 and elderly Oklahomans will be hit hardest in a state already ranked as worst in the country for healthcare access.
So the big question is…what can we do to help offset these budget cuts?
The Oklahoma Association of Health Care Providers said the cuts would likely leave more than 90% of the state’s nursing homes operating at a loss and in danger of closing. read more…
Reducing Falls in Nursing Homes
Fall prevention in nursing homes continues to be a major focus for quality improvement in patient safety.
According to the Centers for Disease Control (CDC), medication management can reduce interactions and side effects that may lead to falls. Although many medication classes have been linked to falls, the evidence is strongest for a few drug categories. For patients 65 or older, Eliminate medications if there is no active indication to use them, reduce doses of necessary medications (e.g., antihypertensives) to the lowest effective dose. Avoid prescribing medications for an older person where the risk from side effects outweighs the benefit (e.g., skeletal muscle relaxants). MOST importantly, reduce or eliminate: Psychoactive drugs, especially any benzodiazepines. Any medications with side effects like drowsiness, sedation, blurred vision, or confusion. Sedating over-the-counter (OTC) medications, specifically Benadryl and Tylenol PM, which contains Benadryl. read more…
Pharmacogenetics: Valuable information for actionable treatment recommendations
PGx Medical test results provide clinicians with valuable patient-specific information to make better therapeutic treatment decisions.
The PGx Medical team works alongside healthcare professionals to implement pharmacogenetics in the Long Term Care setting. A simple swab of the cheek will help healthcare providers manage medications by reducing unnecessary medications, or confirming residents are on the right medications and dosage.
Medications may be assessed in the following areas of clinical care: hypertension, hyperlipidemia, arrhythmia, anti-coagulation, thrombophilia, depression, psychosis, anxiety, ADHD, pain (including musculoskeletal, arthritis, migraine and neuropathic), bipolar and seizure.
With the PGx Medical Metabolic Validation Program, via pharmagogenetic testing, you will receive a customized patient report which includes personalized result interpretations and actionable treatment recommendations.
For more information, contact:
PGx Medical
Individualized Care – Personalized Medicine
405-509-5112
info@pgxmed.com
Dementia Patients and Antipsychotic Medications
Pharmacogenomic testing is an evidence-based tool that provides information about a patient’s response to medications and can help guide healthcare professionals when dosing medications.
According to the new guidelines from the American Psychiatric Association, healthcare providers should focus on “judicious” use of antipsychotic medications when treating people with dementia.
The guidelines, published this week in the American Journal of Psychiatry, acknowledge antipsychotics can be appropriate for people with dementia who exhibit severe or agitation or psychosis. But providers should assess each patient’s symptoms and and possible nonpharmacological interventions before administering the drugs, experts cautioned.
“Over the last few years there have been a number of additional studies that suggest there can be harms with these medications,” author Laura Fochtmann, M.D., told MedPage Today. “As the number of older individuals with dementia increases, we want to be assured that patients are getting the most appropriate form of treatment.”
The guidelines include recommendations to taper and eventually discontinue antipsychotic use if patients experience significant side effects or see no significant response after a 4-week trial. Patients who show an “adequate” response to antipsychotics should also have their doses tapered within 4 months of starting on the drug, unless they exhibit a recurrence of symptoms during tapering or withdrawal, the authors said.
With pharmacogenomic testing, healthcare professionals can avoid the “trial and error” or guessing game. They will have an evidence based tool to help guide them in dosing.
“You don’t always have the luxury of waiting 4-6 weeks when you are dealing with a patients who is agitated or displaying aggression. To wait 4 weeks and find out the medication isn’t working, or that the medication you gave them is having an adverse reaction with another medication they are taking, that is hard on everyone,” said Clay Bullard, President of PGx Medical.
PGx Medical is headquartered in Oklahoma but offers education and implementation of their Metabolic Validation Program across the country. “Our program is designed to help healthcare professionals avoid the “trial and error” process and offer their patients more precise, pinpoint therapy. By knowing which medications a patient has the ability to metabolize properly, allows the healthcare provider to accurately prescribe medications. That doesn’t mean they won’t have side effects from that medication, it just means their body will metabolize the medications the way the drug manufacturer intended, therefore giving them therapy.”
Bullard went on to say, “dementia patients can’t always tell you if their medications are, or are not working. So to have a customized patient report which includes personalized result interpretations and actionable treatment recommendations for each patient, it really helps shorten the timeframe giving that individual therapy a lot sooner.”
When a dementia patient is treated with medications that work and lessens the agitation and aggression, it may help offset the fatigue and burnout on the staff and caregivers.
For more information on the PGx Medical Metabolic Validation Program, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
Source:
American Psychiatric Association
American Journal of Psychiatry
MedPage Today
Pharmacogenetic Testing: Depression in the Elderly
As a healthcare professional, wouldn’t you want to know if the medications you are giving your patients are giving them therapy?
As our healthcare industry continues to evolve, so does the practice of prescribing medications. Gone are the days of “trial and error” or guessing if a medication will work. With elderly patients, sometimes they don’t have the luxury to wait.
Clinical depression in the elderly is common. Late-life depression affects about 6 million Americans age 65 and older. Physical conditions like stroke, hypertension, atrial fibrillation, diabetes, cancer, dementia, and chronic pain further increase the risk of depression.
According to psych central.com, a common treatment for clinical depression is a type of medication called an antidepressant. Antidepressants come in a variety of forms, but all of them work by impacting certain neurochemicals in your brain, such as serotonin and norepinephrine. Antidepressants are most commonly prescribed by a psychiatrist, but may also be prescribed by a family physician or general practitioner to treat depression.
The most commonly prescribed modern antidepressants include SSRIs — such as Prozac, Lexapro, Celexa and Paxil — and SNRIs — such as Pristiq, Cumbalta and Effexor. Although the claim is made that some people may be able to start to feel less depressed within 2 weeks of taking one of these kinds of antidepressants, most people won’t start experiencing the full positive effects of the medication until 6 to 8 weeks after beginning it.
As a physician, what if you knew scientifically which medications your patients have the ability to metabolize – if they are a poor or ultra-rapid metabolizer of those medications – or if they are on multiple medications that interact giving them no therapy. That tool is available and now it is affordable for elderly patients with Medicare B, it’s called pharmacogenetic testing.
Pharamcogenetic Testing:
The PGx Medical test results provide clinicians with valuable patient-specific information to make better therapeutic treatment decisions. Medications may be assessed in the following areas of clinical care: depression, anxiety, psychosis, hypertension, hyperlipidemia, arrhythmia, anti-coagulation, thrombophilia, ADHD, pain (including musculoskeletal, arthritis, migraine and neuropathic), bipolar and seizure.
With the PGx program you will receive a customized patient report which includes personalized result interpretations and actionable treatment recommendations.
The PGx Medical team works alongside healthcare professionals each step of the way. For more information on this medication management program, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
Medication Problems in our Elderly
For our elderly, medications can mean life or death. So making sure they are on the proper medications is important.
According to the Department of Health and Human Services, approximately 200,000 older adults are hospitalized annually due to adverse drug reactions (ADRs). And 55 percent of the elderly don’t take their medications according to the doctor’s orders.
For some, it is a vision problem – not being able to read the small print on prescription labels which can lead to potentially dangerous misuse. For others, it may be due to memory loss, dementia or Alzheimer’s disease and they simply forget to take their medications which can lead to life threatening situations. For a patient in Memory Care, it is difficult for them to tell you if their medications are working properly.
But, what if they are taking their medications as prescribed but they don’t have the ability to metabolize those medications? Not only are they throwing money away on medications that aren’t working, their health may be diminishing while they are on a “trial and error” medication. Have you ever heard a physician say, “take this for three weeks and if it doesn’t work, come back and we’ll try something else?” In an elderly person, sometimes you can’t afford to wait.
A lot of senior communities around the country have implemented the Metabolic Validation Program, via pharmacogenetic testing. By doing a simple buccal swab of the cheek, the healthcare team can now know scientifically if a medication has the ability to metabolize in that individual, as well as if they are having drug-on-drug interactions, or may need a dosage adjustment according to their rate of metabolism.
So what does it cost the individual or the facility? Medicare B covers the cost of the test and in some states, medicaid covers it as well. You might be asking yourself, “Will this bankrupt medicare?” The answer to that is no. Due to overspending on unnecessary medications, this test is actually a cost savings. A 30-day supply of Ability can cost upwards of $1,400. So think about individuals on multiple medications that are not giving them therapy. This once-in-a-lifetime test is a cost savings and helps with efficiencies in the nursing home setting.
If you would like more information on the Metabolic Validation Program, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
sources: agingcare.com, department human health and services