Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists

The 2018-2019 president of the American Society of Consultant Pharmacists (ASCP), has been involved in ASCP for the last 30 years. Her perspective is that all senior care pharmacists are "consultant" pharmacists because they give advice and don't just dispense, whether they work at a chain drug store or a nursing facility. Her highest priority is to meet the educational needs for the members and give them the tools they need to practice their profession.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Background Oral anticoagulants (OACs) are recommended for nonvalvular atrial fibrillation (NVAF) patients with moderate-to high-stroke risk. Objective To examine nationally reflective OAC usage in incident NVAF patients longitudinally. Design Three-year retrospective cohort analysis. Setting Medicare Part D recipients in the contiguous United States. PARTICIPANTS: 52,465 Medicare beneficiaries with incident NVAF in 2010 with two or more atrial fibrillation diagnoses seven or more days apart...

Objective Develop a predictive model to identify patients in a skilled nursing facility (SNF) who require a clinical pharmacist intervention. Design Retrospective, cross-sectional. Setting Nine freestanding SNFs within an integrated health care delivery system. Patients Patients who received a clinical pharmacist medication review between January 1, 2016, and April 30, 2017. Identified patients (n = 2,594) were randomly assigned to derivation and validation cohorts. Interventions Multivariable logistic regression modeling was performed to identify factors predictive of patients who required an intervention (i...

Proton pump inhibitors (PPIs) are commonly prescribed for treatment of acid-related gastrointestinal disorders. PPI use is approved for a duration of 2 to 12 weeks, depending on complication and severity. Many users lack an appropriate indication for continued therapy past the recommended duration. Long-term PPI use is associated with several adverse drug events, including acute interstitial nephritis, fractures, and Clostridium difficile-associated diarrhea (CDAD). Cautious prescribing and regular monitoring is essential, especially for older adults, as they may be at higher risk for these adverse effects...

Objective To review current literature reporting outcomes associated with utilization of the Medication Regimen Complexity Index (MRCI) with older adults in an outpatient setting. Data sources The National Library of Medicine via PubMed, International Pharmaceutical Abstracts, and the Cochrane Database were used to identify clinical trials evaluating outcomes associated with utilization of the MRCI. The medical subject heading terms "geriatrics" and "medication adherence" were used in combination with key terms "medication regimen complexity index" and "medication complexity...

Prescriptions for opioids and opioid-related overdoses have been on the rise-and in the news-in the United States for more than a decade. New guidelines and legislation related to opioid prescribing provide clinical challenges for many pharmacists and prescribers, particularly in the treatment of older adults with chronic pain. Careful patient selection, along with proper opioid dosing and monitoring, enables the pharmacist and prescriber to continue to treat the older adult with pain effectively.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: To assess the incidence of medication errors, adverse drug events (ADEs), and potential ADEs (poADEs) in patients 65 years of age and older. DESIGN: This is a retrospective cohort study (2011 to 2014). SETTING: The study was performed at a section 330 federally funded ambulatory health care center. PATIENTS: The study was a convenience sample selected in a nonrandomized way from event reports filed in those years...

Urinary tract infections (UTIs) are one the of the most common types of infections in adults older than 65 years of age. Preventing UTIs with prophylactic antibiotics increases the risk of side effects and microbial resistance, and is costly. Cranberry fruit and juices contain the compound proanthrocyanidins (PACs), specifically proanthrocyanidin-A, which exerts antiadhesion characteristics against bacteria. Cranberry products therefore have been an attractive, nonantibiotic preventative option for UTIs; however, the current literature supporting cranberry use in older adults is controversial...

PURPOSE: There are a limited number of case reports in the literature which describe hyponatremia/syndrome of inappropriate antidiuretic hormone (SIADH) induced by duloxetine. SUMMARY: This case report adds to the literature by describing a patient who developed hyponatremia/SIADH after two doses of duloxetine. CONCLUSION: Hyponatremia/SIADH can develop rapidly after initiation of duloxetine. Clinicians should be aware of the potential for this adverse drug reaction, particularly in elderly females...

OBJECTIVE: Review the clinical manifestations and treatment of primary open-angle glaucoma (POAG). DATA SOURCES: Articles indexed in PubMed, Scopus, and Cochrane Library in the last 10 years using the key words "glaucoma," "open-angle glaucoma," and "'open-angle glaucoma' AND 'treatment.'" Primary sources were used to locate additional resources. ClinicalTrials. gov was used to locate unpublished studies. STUDY SELECTION AND DATA EXTRACTION: Eighty-one publications were reviewed and criteria supporting the primary objective were used to identify useful resources...

A wide range of changes are in the future for health care: value-based reimbursement, delivery of integrated services, the continued breakdown of silos, and interoperability maximizing communication/information exchange. The American Society of Consultant Pharmacists recently held a conference focusing on key innovations in post-acute/long-term/senior care and how pharmacists can function successfully in this new paradigm in ways that promote quality medication management, address polypharmacy, improve patients' quality of life, reduce costs, and eliminate avoidable readmissions...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: Potentially inappropriate medications carry significant burden and costs to nursing facility residents and health systems. The goal of this study was to survey nursing facility providers from across the United States to describe the current utilization of deprescribing, and perceptions and desired components of a deprescribing program, in nursing facilities to reduce potentially inappropriate medications. DESIGN/SETTING/PARTICIPANTS/MEASUREMENT: We surveyed health care providers who attended the 2017 AMDA-The Society for Post-Acute and Long-Term Care Medicine Annual Conference-in Phoenix, Arizona...

Many older adults experience some degree of cognitive impairment, an important risk factor for medication nonadherence. To prevent negative health outcomes secondary to medication nonadherence, identifying interventions that improve medication adherence for older adults with cognitive impairment is crucial. Other barriers to medication adherence include the structure of the health care system as well as socioeconomic and therapyrelated obstacles. The use of pharmacist-led and population-level interventions hold promise for providing optimal medication adherence for older adults with cognitive impairment...

OBJECTIVE: The appropriateness of analgesic administrations based on pain score and medication order in older adults during hospitalization was evaluated. SETTING: As-needed analgesic administrations for geriatric patients on hospitalist general medicine services at a large-university-affiliated medical center from January 1 to March 31, 2015, were included. PRACTICE DESCRIPTION: The hospital is a level one trauma center with more than 500 beds serving an area of more than 500,000 people, 12% of whom are 65 years of age or older...