by PGx Medical | Sep 20, 2017 | Uncategorized
The requirements for LTC Facilities are the health and safety standards LTC facilities must meet in order to participate in medicare or medicaid programs.
What is your Patient Centered Care Plan for your LTC community?
For months now when you walk into a Long Term Care (LTC) facility, you may hear people talking about the CMS Final Ruling. Asking themselves, how they are going to make these changes with more residents then ever before, and less staff then ever before.
A high percentage of residents are admitted to a long term care facility on Friday. This allows them time to get adjusted, move-in over the weekend, and have family and friends available for the first few days. The baseline Care Plan requires facilities to develop a baseline care plan for each resident, within 48 hours of their admission, which includes the instructions needed to provide effective and person-centered care that meets professional standards of quality care. That is tough when you are short staffed to begin with and now it is on a weekend when staff is even more limited.
Below are a few key points in the Final Ruling.
- Person Centered Care: This revolves around information, being involved and allowing the patient to have more choice in their care.
- Facility Assessment, Competency Based Approach: Not a one-size fits all approach. Focus on each resident achieving their highest practicable physical, mental, and psychosocial well-being.
- Align with Current HHS Initiatives: Reducing unnecessary hospital readmissions, reducing the incidences of healthcare acquired infections, improving behavioral healthcare, and safeguarding nursing home residents from the use of unnecessary psychotropic (antipsychotic) medications.
Pharmacogenetics can help decrease, contain and/or give the facility documentation of patient centered care through personalized medicine. It can help with your baseline care plan and give you personalized data for each resident to help develop a personalized medication regime unique to each resident. Documentation on how each resident is on the right medication, at the right dosage for each individual based on their genetic make-up. And it helps in reducing unnecessary medications with scientific based evidence to back it up.
This program is quick, approximately one minute per resident, and there is no out of pocket expense for residents with medicare B and in some states, medicaid.
Pharmacogenetics aligns current and future medications with each persons unique genetic profile. Our proprietary process impacts quality, adds value and enhances the customer experience by addressing top clinical concerns such as falls, dementia, sleep, pain, med management and overall staff efficiencies.
If it isn’t currently part of your patient centered care plan, it should be. What other resource is that easy, quick to implement, and no out of pocket expense to the resident or facility. PGx Medical can be your consultant and educator in the process helping you and your clinical team implement the program.
For more information, contact: PGx Medical, info@pgxmed.com or 405-509-5112. PGx Medical is the trusted and experienced resource for the implementation of pharmacogenetics in the field of aging services.
by PGx Medical | Jun 15, 2017 | News, Uncategorized
At PGx Medical, we made the decision to focus on the field of aging services. Doing one thing, and one thing only helps us direct all our attention on the unique needs in senior communities across the country.
The American Geriatrics Society reports there are 7,300 certified geriatricians in the United States, which is one geriatrician for every 2,700 Americans who are 75 or older. Due to the projected increase in the number of older adults and the plateauing of the number of geriatricians over the last 10 years, it is expected to drop to one geriatrician for every 4,500 older Americans by 2030. In an article in Medicalnews.com, several medical experts state with a growing elderly population that is living longer with fewer physicians available to treat them, the future of geriatric medicine is on the verge of transitioning from disease treatment to disease prevention.
According to Paul Hill, MD, a geriatric psychiatrist and associate professor of psychiatry at the University of Tennessee Health Science Center (UTHSC), a common challenge for physicians is determining whether geriatric patients are taking their medicine consistently. Hill says advances in pharmacology will make the process easier.
Another issue physicians and pharmacists deal with on a frequent basis is the prescribing cascade. This is when the side effects of drugs are misdiagnosed as symptoms of another problem, resulting in further prescriptions and more side effects and ultimately drug reactions.
Older adults on multiple medications can lead to polypharmacy, which is common in geriatric patients. Polypharmacy refers to the effects of taking multiple medications concurrently to manage coexisting health problems. According to Dr. Linda Shell, MA, RN, “polypharmacy has been a silent killer for years, draining funds from Medicare and dismantling the treatment plans of millions as it becomes a habit ingrained in our culture, especially in eldercare. We’ve become resigned to the falsehood that more drugs mean better treatment, but there’s something putting an end to that.”
The CDC reports 76 percent of Americans over 60 use two or more prescription drugs and 37 percent use five or more. It is important to not only know what medications someone is taking, but track each patient’s medications and any side effects that may result from drug-to-drug interactions.
PGx Medical partners with pharmacists and physicians to educate and implement a tool to help determine the right drug, at the right dose, for each individual patient. It’s called pharmacogenetics.
Pharmacogenetics aligns current and future medications with each persons unique genetic profile. When the pharmacist and the physician work as a team to look at metabolization, side effects or any drug-drug interactions, it helps eliminate the guessing game – or prescribing by trial and error. By being proactive, healthcare professionals can help prevent the cascading event that happens when medications are added on top of one another. In the field of aging services, you may not have the luxury of waiting 3-6 weeks to see if a medication is working.
For more information on pharmacogenetics, contact:
PGx Medical
info@pgxmed.com
405-509-5112
source: medicalnews.com
by PGx Medical | May 31, 2017 | Uncategorized
Polypharmacy is defined simply as the use of multiple medications by a patient. The precise minimum number of medications used to define “polypharmacy” is variable, but generally ranges from 5 to 10.
Polypharmacy is a growing concern in the elderly population
The issue of polypharmacy is of particular concern in older people who, compared with younger individuals, tend to have more disease conditions for which therapies are prescribed. It has been estimated that 20 percent of Medicare beneficiaries have five or more chronic conditions and 50 percent receive five or more medications.
The use of greater numbers of drug therapies has been independently associated with an increased risk for an adverse drug event (ADE), irrespective of age, and increased risk of hospital admission.
There are multiple reasons why older adults are especially impacted by polypharmacy:
●Older individuals are at greater risk for ADEs due to metabolic changes and decreased drug clearance associated with aging; this risk is compounded by increasing numbers of drugs used.
●Polypharmacy increases the potential for drug-drug interactions and for prescription of potentially inappropriate medications.
●Polypharmacy was an independent risk factor for hip fractures in older adults in one case-control study, although the number of drugs may have been an indicator of higher likelihood of exposure to specific types of drugs associated with falls (eg, central nervous system [CNS]-active drugs).
●Polypharmacy increases the possibility of “prescribing cascades”. A prescribing cascade develops when an ADE is misinterpreted as a new medical condition and additional drug therapy is then prescribed to treat this medical condition.
●Use of multiple medications can lead to problems with medication adherence, compounded by visual or cognitive compromise in many older adults.
A balance is required between over- and under-prescribing. Multiple medications are often required to manage clinically complex older adults. Clinicians are often challenged with the need to match the complex needs of their older patients with those of disease-specific clinical practice guidelines.
Pharmacogenetics is a tool used in long term care communities across the country to help manage polypharmacy. Pharmacogenetics is a simple swab of the cheek that allows providers to look at how medications align with each persons unique DNA. The results help guide providers in proper prescribing eliminating unnecessary medications and guiding them when dosing changes are recommended based on metabolization.
For more information on pharmacogenetics, contact: PGx Medical at 405-509-5112 or info@pgxmed.com.
source: uptodate.com
by PGx Medical | Mar 14, 2017 | Uncategorized
Pharmacogenetics is intended to be a long term care medication management tool
Pharmacogenetics uses a patient’s genetic information to aid prescribers in selecting the right drug and the right dose for the patient.
Pharmacogenetics enables personalized therapeutic decisions for people suffering from some of the most prevalent clinical conditions in the United States, including cardiovascular disease, neuropsychiatric disorders and pain.
Why Pharmacogenetic Testing:
- Polypharmacy
- Reduction of trial and error
- Risk of adverse drug events (falls, re-hospitalization, delirium)
- Medication errors, adherence
- Regulatory guidelines
- Med pass time (increased pill burden), costs
- One size fits all
Indicators for Testing:
- Depression diagnosis
- Frequent fallers
- Increased Behaviors
- Cognitive Impairment
- Polypharmacy
- Antipsychotics / Antidepressants
- Pain management comprehensive care plan
- Re-hospitalization
One common question we hear over and over, “should everyone be tested?” No, only residents with proper medical necessity should be tested.
For more information on how to implement pharmacogenetics into your long term care community, contact: PGx Medical at info@pgxmed.com or 405-509-5112.
by PGx Medical | Mar 10, 2017 | Uncategorized
Welcome to our Friday FOCUS on Pharmacogenetics 
Each Friday we will post new and relevant information regarding Pharmacogenetics. We hope you will find this useful and pass along to colleagues. If you should have any questions regarding pharmacogenetics, please feel free to reach out to us at PGx Medical, info@pgxmed.com or 405-509-5112.
Medication Management in LTC:
You’ve seen the statistics: it is estimated there are 100,000 deaths and upwards of two million serious adverse drug reactions (ADRs) in the United States each year related to prescription drug use, costing the healthcare industry in excess of $136 billion annually according to the Food and Drug Administration. Older individuals are particularly at risk for ADRs due to polypharmacy, co-morbidities and a host of age-related variables and physiological changes that alter drug absorption and metabolism.
Genetic factors can also have a significant influence on drug response, which is estimated to account for 20 to 40 percent of inter-individual differences in drug metabolism and response. Patients with specific genetic variations are at increased risk from taking many widely prescribed drugs such as common anticoagulants, pain medications and antipsychotics.
Advances in precision medicine are helping to address this public health concern through the use of pharmacogenomics (PGx) testing to preemptively identify drug response based on a patient’s genetic makeup. In a growing number of hospitals and health systems, patients now undergo PGx testing as part of routine patient care, enabling physicians to ensure the safest, most effective medications are prescribed to every patient, reducing trial and error prescribing and improving treatment outcomes.
The benefits of PGx testing and drug-gene decision support for long-term care (LTC) populations with polypharmacy is considerable. Half of all nursing home residents take nine or more medications per day and experience a disproportionate number of medication-related issues, according to the National Institutes of Health. The lifetime value of PGx testing is greatest in adults and the elderly who have the highest clinical risk for experiencing an adverse event
For more information on pharmacogenetics, contact PGx Medical at info@pgxmed.com or 405-509-5112.
Source: iadvanceseniorcare
