by brant bullard | May 22, 2016 | News
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. (more…)
by brant bullard | May 17, 2016 | News
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. (more…)
by brant bullard | May 9, 2016 | News
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
by brant bullard | May 2, 2016 | News
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
by brant bullard | Mar 23, 2016 | News
As the education of Pharmacogenomic Testing becomes more prevalent within the LTC arena, many questions have been raised as to the potential for “true savings” or “financial benefits” to testing.
Clay Bullard, President
PGx Medical
Several studies have been published that speak to both the clinical and financial benefits of utilizing testing. The goal of this article is to highlight several of these reference studies and their findings, all in an effort for CEO’s, DON’s and Physicians to potentially rethink some of their processes in Medication Management for LTC residents.
In 2014, the amount of money spent on prescriptions in the US was approximated to be $300 billion, with an estimated 6.3% annual increase according to Medicare and Medicaid data1. It is estimated that an additional $.50 is spent on Adverse Drug Reactions (ADR’s) for every $1 spent on the initial prescription. Polypharmacy dynamics increase significantly within the Elderly, specifically LTC residents, compounds additional costs associated with falls, hospitalizations, increased level of care, pain management and so on2-6.
Other studies have shown that implementing the PGx testing program can change referral rates and decrease mortality rates within LTC facilities. This can lead to higher census rates, better marketing efforts and staff efficiency7-8. A healthier patient population on fewer medications, and lower mortality rates, should provide a positive value proposition for any LTC facility Owner, CEO, Physician, or care provider to consider.
Additionally, one study has shown the value of testing to decrease patient treatment cost by over 60% in a clinic setting9. In the hospital setting, studies show the true impact to care providers, as hospital length of stay was three times longer with twice the amount of hospital charges/cost for patients who had an ADR and intermediate metabolization of their 2D6 gene10. Implementing Metabolic Validation testing early in the care process is key to provide clinical and financial benefit11.
In summary, the argument that there is not data to support the value proposition for a program that costs an LTC facility $0 to implement, has now been eliminated. We are very excited to have an overwhelming amount of clinical and statistical data that supports the “real world” feedback we receive daily from clinicians in facilities all over the United Sates. These data points validate the clinical and financial impact the program has had and can have in an LTC facility.
We hope every facility will ask the simple question, “Is our facility doing everything we can do to offer the best opportunities for quality of life for your residents?”
For more information, contact:
PGx Medical
info@pgxmed.com
405-509-5112
References:
- (Centers for Medicare and Medicaid Services. Available from: https:// www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends- and Reports/NationalHealthExpendData/Downloads/proj2014.pdf. CMS; 2013. Accessed November 27, 2015.)
- SgangaF,LandiF,RuggieroC,etal.Polypharmacyandhealthoutcomes among older adults discharged from hospital: Results from the CRIME study. Geratr Gerontol Int. 2015;15(2):141–146.
- 10. Runganga M, Peel NM, Hubbard RE, et al. Multiple medication use in older patients in post-acute transitional care: a prospective cohort study. Clin Interv Aging. 2014;9:1453–1462.
- 11. Garfinkel D, Mangin D. Feasibility study of systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med. 2010;170(18):1648–1654.
- 12. Garfinkel D, Zur-Gil S, Ben-Israel J. The war against polypharmacy: a new cost- effective geriatric-palliative approach for improving drug therapy in disabled elderly people. Isr Med Assoc J. 2007;9(6): 430–434.
- Winner J, Allen JD, Altar CA, Spahic-Mihajlovic A. Psychiatric phar- macogenomics predicts health resource utilization of outpatients with anxiety and depression. Transl Psychiatry. 2013;3:e242.
- Garfinkel D, Mangin D. Feasibility study of systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med. 2010;170(18):1648–1654.
- 12. Garfinkel D, Zur-Gil S, Ben-Israel J. The war against polypharmacy: a new cost- effective geriatric-palliative approach for improving drug therapy in disabled elderly people. Isr Med Assoc J. 2007;9(6): 430–434.
- Herbild L, et al. Does Pharmacogenetic Testing for CYP450 2D6 and 2C19 Among Patients with Diagnoses within the Schizophrenic Spectrum Reduce Treatment Costs? Basic & Clin Pharmacol&Toxicol 2013; doi10.1111/bcpt.12093.
- Chou WH, et al. Extension of a Pilot Study: Impact From the Cytochrome P450 2D6 Polymorphism on Outcome and Costs Associated With Severe Mental Illness. J Clin Pyschopharmacol 2000;20(2):246-251.
11. Saldivar JS, Taylor D, Sugarman EA, Cullors A, Garces JA, Oades K, Centeno J; Initial assessment of the benefits of implementing pharmacogenetics into the medical management of patients in a long-term care facility; Dove Medical Press, 19 January 2016 Vol2016:9 Pages 1-6
by brant bullard | Mar 3, 2016 | News
Maintaining a healthy mind, body, and spirit is as important to the caregiver as it is older adults.
Making sure your elderly family member is taking the right medications is important to getting them up, out and active.
A recent survey of 17,000 Medicare beneficiaries found that 2 out of 5 patients reported taking five or more prescription medicines.
According to Drugwatch.com, adults 65 and older often take multiple medications, both prescription and over-the-counter (OTC) drugs. When people take more than one drug at the same time, it is called polypharmacy. While medications are intended to improve lives and relieve symptoms, in some cases they cause more problems.
Older adults may also fail to take the drugs in the proper way because they lose track of them, and sometimes certain drugs may interact with each other, causing additional symptoms and health problems.
By 2030, about 72 million people will be 65 or older. Today’s seniors live longer than before, which makes it important to make your extra years as fun-filled and pain-free as possible.
Adverse reactions attributable to prescription drug use cause an estimated 100,000 deaths and more than two million serious reactions in the United States each year, costing the healthcare industry more than $136 billion annually.
The PGx Medical Metabolic Validation Program can help reduce unnecessary medications and the risk for adverse drug reactions (ADR). A simple swab of the cheek can tell your healthcare provider what medications your body is able to metabolize which eliminates the trial and error process. This test can improve clinical outcomes and reduce the overall cost of prescription drugs by enabling better drug selection, earlier favorable results and lower rates of ADRs.
For more information, contact PGx Medical at (405) 509-5112 or info@pgxmed.com. www.pgxmed.com
