The Long-Term Care Pharmacy

With Support from LTCP Next-Level Care is Achievable

Antipsychotic Medications
A long-term care pharmacy can help reduce antipsychotic use and is a valuable partner with SNFs in the care of long-term care patients. Dan Hallman

During the long-term care industry’s transformative last decade, new approaches to resident care have shaped today’s communities with the hope of creating a more fulfilling aging experience. Especially important is the shift to person-centered care which has fostered a collaborative environment where the residents, their families, and their community medical team interact more frequently.

This enables residents to have more of a voice when it comes to decisions about their care.

  Cited as one of the Advancing Excellence in America’s Nursing Homes Campaign’s nine quality goals, this engagement helps to improve overall well-being. Additionally, many communities are changing their structure and operations to offer progressive levels of care so residents can age in place.

To make these improvements, communities are turning to their industry partners, and the long-term care (LTC) pharmacy is a uniquely-positioned source of support. In the past, primarily tasked to dispense medications, today’s LTC pharmacy should also include an expert team to counsel communities on means of improving residents’ quality of life.

Here are three important ways assisted living and skilled nursing communities can engage the know-how of their pharmacy partner:

Targeted Education

Medications dramatically impact residents’ health, cognizance, comfort, and safety, so the LTC pharmacy’s responsibility is to ensure this component of the care plan is effective.

But since medication decisions are made by the physicians, the LTC pharmacy often plays a major role in educating a facility’s medical team on over-the-counter and prescriptions drugs’ effects on geriatric patients.

Utilizing regularly scheduled visits, the LTC consultant pharmacist collaborates with the community’s team to identify polypharmacy or potential negative drug interactions and then recommends therapeutic drug interchanges.

This information better arms the medical staff on how medications may be causing persistent health issues.

The educational component also extends to best practices for administering medications or medication-related health needs. The pharmacy’s nursing staff can tailor medication management training for those providing this service. Other education topics include, but are not limited to, PICC line and IV insertion certification and diabetes care.

Looking to the future, the next phase of person-centered care could include LTC pharmacists directly counseling residents and their families.

Guidance on Industry Changes

The off-label use of antipsychotics, hospital readmissions and proper disposal of medications are complex issues that have gained national attention, spurring important regulatory changes and much debate on how individual communities can best address them. The LTC pharmacy is a helpful resource to assess where the facility currently stands and how it can adjust to solve these problems.

In recent years, industry associations and government agencies together have launched initiatives to reduce off-label antipsychotic use in dementia care. To meet these goals, the consultant pharmacist should proactively work with the medical team to identify who is being prescribed antipsychotics, if the need still exists and suggest alternative courses of treatment, if possible. By benchmarking with monthly assessment meetings, the team works together to measure the reduction program’s effectiveness.

The LTC consultant pharmacist can also work directly with the community to reduce hospital readmissions. Patients are often prescribed new medications when released to a community after a hospital stay. The resident may not know how to use new medications or they may negatively interact with other drugs in the regimen, causing adverse effects that can lead to hospital readmissions. By ensuring proper medication use and administration, the LTC pharmacy can help facilities stop the “revolving door” of hospital readmissions in healthcare.

Finally, both assisted living and skilled nursing facilities struggle with proper disposal of unused medications, especially those that operate in states without return regulations. The long-term care pharmacy is well-versed in this issue and can offer technology solutions or process suggestions tailored to the individual facility.

Preparation for Compliance

While all of these services are important, the pharmacy’s role in helping a facility stay in compliance remains one of the most critical. The LTC pharmacy can perform in-house mock surveys – checking medication carts and MARs for consistency, ensuring that drugs are housed correctly and not expired, among other reviews.

In addition, by attending regular state compliance meetings, the pharmacy team takes a front-line approach as a liaison to the community and to better assist with regulations, policies and procedures.

Without question, improvements in the long-term care industry require a united effort from all involved. By allowing the LTC pharmacy to integrate fully into its operations, an assisted living or skilled nursing community has a greater chance of staying informed in this ever-changing industry while also continuously raising standards of care to better serve the aging population.

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