Additional Information
Book Details
Abstract
This issue of Clinics in Geriatric Medicine, guest edited by Mary Ann Zagaria, PharmD, is devoted to Polypharmacy. Articles in this outstanding issue include: Centers for Medicare and Medicaid Services Support for Medication Therapy Management (Enhanced Medication Therapy Management): Testing Strategies for Improving Medication Use Among Beneficiaries Enrolled in Medicare Part D; The Role of Patient Preferences in Deprescribing; Polypharmacy Reduction Strategies: Tips on Incorporating American Geriatrics Society Beers and Screening Tool of Older People’s Prescriptions Criteria; Polypharmacy and Delirium in Critically Ill Older Adults: Recognition and Prevention; Geriatric Polypharmacy: Pharmacist as Key Facilitator in Assessing for Falls Risk; Medication Reconciliation in Long-Term Care and Assisted Living Facilities: Opportunity for Pharmacists to Minimize Risks Associated with Transitions of Care; Can Managed Care Manage Polypharmacy?; Medication Risk Mitigation: Coordinating and Collaborating with Health Care Systems, Universities, and Researchers to Facilitate the Design and Execution of Practice-Based Research; and Geriatric Polypharmacy: Two Physicians’ Personal Perspectives.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Polypharmacy\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | v | ||
| Preface: Inroads into Polypharmacy: Moving Forward with Tools, Deprescribing, and Philosophical Reflection\r | v | ||
| Centers for Medicare and Medicaid Services Support for Medication Therapy Management (Enhanced Medication Therapy Managemen ...\r | v | ||
| The Role of Patient Preferences in Deprescribing\r | v | ||
| Polypharmacy Reduction Strategies: Tips on Incorporating American Geriatrics Society Beers and Screening Tool of Older Peop ... | v | ||
| Polypharmacy and Delirium in Critically Ill Older Adults: Recognition and Prevention | vi | ||
| Geriatric Polypharmacy: Pharmacist as Key Facilitator in Assessing for Falls Risk | vi | ||
| Medication Reconciliation in Long-Term Care and Assisted Living Facilities: Opportunity for Pharmacists to Minimize Risks A ... | vi | ||
| Can Managed Care Manage Polypharmacy? | vi | ||
| Medication Risk Mitigation: Coordinating and Collaborating with Health Care Systems, Universities, and Researchers to Facil ... | vii | ||
| Geriatric Polypharmacy: Two Physicians' Personal Perspectives | vii | ||
| CLINICS IN GERIATRIC MEDICINE\r | viii | ||
| FORTHCOMING ISSUES | viii | ||
| August 2017 | viii | ||
| November 2017 | viii | ||
| February 2018 | viii | ||
| RECENT ISSUES | viii | ||
| February 2017 | viii | ||
| November 2016 | viii | ||
| August 2016 | viii | ||
| Preface\r | ix | ||
| Inroads into Polypharmacy: Moving Forward with Tools, Deprescribing, and Philosophical Reflection\r | ix | ||
| Centers for Medicare and Medicaid Services Support for Medication Therapy Management (Enhanced Medication Therapy Management) | 153 | ||
| Key points | 153 | ||
| BACKGROUND | 154 | ||
| MEDICATION THERAPY MANAGEMENT PROGRAM TARGETING REQUIREMENTS | 154 | ||
| Multiple Chronic Conditions | 154 | ||
| Multiple Covered Part D Drugs | 155 | ||
| Anticipated Part D Drug Costs | 155 | ||
| MEDICATION THERAPY MANAGEMENT PROGRAM DOCUMENTATION AFTER A COMPREHENSIVE MEDICATION REVIEW: THE STANDARDIZED FORMAT | 156 | ||
| MEDICATION THERAPY MANAGEMENT WITHIN THE LONG-TERM CARE SETTING: COMPREHENSIVE MEDICATION REVIEW AND BENEFICIARIES | 157 | ||
| INCREASING BENEFICIARY AWARENESS OF MEDICATION THERAPY MANAGEMENT | 158 | ||
| MEDICATION THERAPY MANAGEMENT PROGRAMS IMPACTED BY CENTERS FOR MEDICARE AND MEDICAID SERVICES STAR MEASURE RATINGS | 158 | ||
| THE FUTURE OF MEDICATION THERAPY MANAGEMENT: THE “ENHANCED” MEDICATION THERAPY MANAGEMENT MODEL | 159 | ||
| CLINICAL IMPLICATIONS FOR OLDER ADULTS | 161 | ||
| SUMMARY | 162 | ||
| REFERENCES | 162 | ||
| The Role of Patient Preferences in Deprescribing | 165 | ||
| Key points | 165 | ||
| INTRODUCTION | 165 | ||
| WHAT IS DEPRESCRIBING? | 166 | ||
| THE PROCESS OF DEPRESCRIBING | 167 | ||
| PATIENT PREFERENCES FOR DEPRESCRIBING | 167 | ||
| BARRIERS AND PITFALLS TO DEPRESCRIBING | 171 | ||
| SUMMARY | 172 | ||
| REFERENCES | 173 | ||
| Polypharmacy Reduction Strategies | 177 | ||
| Key points | 177 | ||
| INTRODUCTION | 177 | ||
| DEFINING POLYPHARMACY | 178 | ||
| CONSEQUENCES OF POLYPHARMACY | 179 | ||
| POLYPHARMACY REDUCTION STRATEGIES | 179 | ||
| INCORPORATING EXPLICIT CRITERIA INTO POLYPHARMACY REDUCTION STRATEGIES | 180 | ||
| American Geriatrics Society Beers and Screening Tool of Older People’s Prescriptions | 180 | ||
| Tips for Incorporating the Explicit Criteria | 181 | ||
| LIMITATIONS TO USING THE EXPLICIT CRITERIA | 185 | ||
| SUMMARY | 185 | ||
| REFERENCES | 186 | ||
| Polypharmacy and Delirium in Critically Ill Older Adults | 189 | ||
| Key points | 189 | ||
| INTRODUCTION | 189 | ||
| POLYPHARMACY IN CRITICALLY ILL OLDER ADULTS | 190 | ||
| DELIRIUM IN CRITICALLY ILL OLDER ADULTS | 191 | ||
| POLYPHARMACY AS A RISK FACTOR FOR DELIRIUM | 192 | ||
| POLYPHARMACY AS A SEQUELAE OF DELIRIUM TREATMENT | 195 | ||
| STRATEGIES TO REDUCE THE POLYPHARMACY-DELIRIUM CYCLE | 197 | ||
| SUMMARY | 199 | ||
| REFERENCES | 199 | ||
| Geriatric Polypharmacy | 205 | ||
| Key points | 205 | ||
| INTRODUCTION | 205 | ||
| TOOLS FOR FALLS ASSESSMENT | 207 | ||
| PHARMACIST ASSESSMENT FOR FALLS | 208 | ||
| Step 1 | 208 | ||
| Step 2 | 208 | ||
| Step 3 | 209 | ||
| Step 4 | 209 | ||
| Step 5 | 211 | ||
| Step 6 | 211 | ||
| OPERATIONALIZING PHARMACIST-CONDUCTED FALLS ASSESSMENT | 211 | ||
| SUMMARY | 216 | ||
| REFERENCES | 216 | ||
| Medication Reconciliation in Long-Term Care and Assisted Living Facilities | 225 | ||
| Key points | 225 | ||
| INTRODUCTION | 226 | ||
| STATISTICS | 226 | ||
| GUIDING PRINCIPLES OF MEDICATION RECONCILIATION | 227 | ||
| FOCUS ON TRANSITION OF CARE FROM HEALTH CARE ORGANIZATIONS | 228 | ||
| GOVERNMENT FOCUS OF TRANSITION OF CARE IN SKILLED NURSING FACILITIES | 228 | ||
| THE PROCESS OF MEDICATION RECONCILIATION FROM HOSPITAL TO NURSING HOME AND/OR ASSISTED LIVING | 230 | ||
| MEDICATION HISTORY PROCESS QUESTIONS | 230 | ||
| COMMON BARRIERS TO MEDICATION RECONCILIATION | 230 | ||
| ELECTRONIC HEALTH RECORDS | 231 | ||
| MEDICATION REGIMEN REVIEWS DURING TRANSITION OF CARE BY THE CONSULTANT PHARMACIST | 231 | ||
| MEDICATION REGIMEN REVIEWS FOR STAYS UNDER 30 DAYS AND CHANGES IN CONDITION | 233 | ||
| FINANCIAL INCENTIVES FOR MEDICATION RECONCILIATION | 235 | ||
| SUMMARY | 236 | ||
| REFERENCES | 236 | ||
| Can Managed Care Manage Polypharmacy? | 241 | ||
| Key points | 241 | ||
| Why Managed Care Should Be Used to Manage Polypharmacy | 243 | ||
| What Is Managed Care? | 244 | ||
| What Are the Key Opportunities for Managed Care to Manage Polypharmacy? | 245 | ||
| Managed Care’s Role in Managing Polypharmacy | 246 | ||
| Dementia and behavioral and psychological symptoms of dementia | 249 | ||
| Screening and medication management | 250 | ||
| Antimicrobial stewardship | 250 | ||
| Diabetes management | 251 | ||
| Nutritional support | 252 | ||
| The Future of Managed Care Management of Polypharmacy | 253 | ||
| REFERENCES | 253 | ||
| Medication Risk Mitigation | 257 | ||
| Key points | 257 | ||
| INTRODUCTION | 258 | ||
| TRADITIONAL MEDICATION RISK MITIGATION STRATEGIES | 258 | ||
| Traditional Medication Therapy Management | 259 | ||
| Background | 259 | ||
| Evidence | 260 | ||
| Future directions | 260 | ||
| Tools to Facilitate Traditional Medication Therapy Management | 261 | ||
| Drug interaction tools | 261 | ||
| Medication appropriateness tools | 262 | ||
| ENHANCED MEDICATION RISK MITIGATION STRATEGIES | 262 | ||
| Enhanced Medication Therapy Management | 262 | ||
| Background | 262 | ||
| Future directions | 263 | ||
| Innovative Strategies for Enhanced Medication Therapy Management | 263 | ||
| Drug interaction tools | 263 | ||
| Background | 263 | ||
| Evidence | 264 | ||
| Future directions | 265 | ||
| Pharmacogenomics | 266 | ||
| Background | 266 | ||
| Evidence | 266 | ||
| Future directions | 267 | ||
| INTEGRATING ENHANCED MEDICATION RISK MITIGATION STRATEGIES INTO CLINICAL PRACTICE | 267 | ||
| FOCUS ON PHARMACOGENOMICS | 268 | ||
| Barriers to Integration | 268 | ||
| Health care system–related barriers | 268 | ||
| Patient-related barriers | 268 | ||
| Health care professional–related barriers | 268 | ||
| Enablers for Integration | 270 | ||
| Health care system–related enablers | 270 | ||
| Patient-related enablers | 270 | ||
| Health care professional–related enablers | 271 | ||
| POWER OF INTEGRATION | 272 | ||
| Patient Case Scenario | 272 | ||
| Patient Case Explanation | 272 | ||
| SUMMARY | 274 | ||
| ACKNOWLEDGMENTS | 274 | ||
| REFERENCES | 274 | ||
| Geriatric Polypharmacy | 283 | ||
| Key points | 283 | ||
| DR CHEN | 284 | ||
| DR BUONANNO | 285 | ||
| REFERENCES | 288 | ||
| Index | 289 |