Blog by Mark Wolfe, Customer Account Representative, GrandView Pharmacy
Many times, long term care facilities allow their residents choice of pharmacy when they discuss living arrangements within their facilities. Allowing the residents choice in selecting their pharmacy seems like the prudent thing to do. Even though the facility has a ‘house pharmacy’ they still allow residents pharmacy choice. Resident and family satisfaction are critical within the facility selection process. Residents new to long term care facilities fear surrendering their independence and control over their own lives. Selecting ones’ own pharmacy choice is one selection residents feel they can make on their own and still participate in their own care decision. Also, it appears this is one area that the facility can allow some leway. But the data from l-t-c specialists suggest these very same facilities are not doing their residents any favors by such suggestions.
According to the Journal of American Geriatrics Society filling prescriptions at multiple pharmacies was associated with lower medication adherence for older adults in l-t-c settings causing a significant likelihood of drug to drug interactions. Adults using multiple pharmacies to fill their prescription needs consistently had a higher incidence of non-adherence to physician’s orders(1).
Additionally, use of multiple pharmacies can present numerous problems in U.S. nursing home residents resulting in death and hospitalizations. This is typically referred to as polypharmacy. Polypharmacy is the simultaneous use of one, two or more pharmacies to fulfill one’s prescriptions needs. Elderly use multiple pharmacies because they are seeking to manage the cost of medications. One pharmacy offers a significant discount on a medication while another pharmacy is acceptable to their insurance plan, or it is more convenient for their caregivers to access. These pharmacies are not aware of the other medications the patient/resident is using, or the communication is poor resulting in drug to drug interactions, or medications not being accessed/obtained due to delivery or no delivery, or even the family members getting the medications to the loved ones’ long-term care facility on a timely basis. All these instances or occurrences add up to a real problem. Prescription-related medication problems result in an estimated 119,000 deaths annually. Additionally, in any given year >175,000 elderly patients will visit the emergency room because of an adverse reaction to a commonly prescribed medication. (2)
If this weren’t bad enough, there are additional problems if adverse reactions occur. Since primary care doctors and specialist physicians may not be communicating with one another, let alone even know the patient is seeing one another, potential problems are simply looming to occur.
So how does an elderly person address the issue of controlling the cost of prescription medications while working best with their list of physicians, all the while trying to maintain a relationship with one pharmacy, or pharmacist? Grandview Pharmacy tries to make it easy to use just one pharmacy. They do this by controlling costs of prescription medications via price matching, as well as other valuable services. A long-term care resident can share their current list of medications from their current pharmacy and the related costs with the Grandview Pharmacy Account Manager for their resident facility. In most case, Grandview Pharmacy can match the prices they are already paying. Additionally, Grandview can also evaluate the residents’ insurance plans to determine if they are in the best plan possible given their health condition, current costs, and current medications, etc. The Grandview Consulting Pharmacist can also perform drug regimen reviews to communicate to the facility and their physicians any recommendations on their drug regimen to eliminate drug to drug interactions and more.
By having one pharmacy and pharmacist more consistent care can be offered and help eliminate collateral medications unknown to the residents’ physician teams. All in all, that is a much better way to control overall cost of medications, keep the resident healthy, and eliminate any unnecessary trips to the hospital.
1. Journal of American Geriatrics Society, Vol 62, Issue 2. Zachary Marcum, PharmD MS, Julia Driessen, PhD, etal.
2. “Addressing the Polypharmacy Conundrum”, US Pharm. 2017;42(6): HS-14HS-20 Justin Sherman, PharmD; Leslie Davis, PharmD Candidate; Kori Daniels, PharmD Candidate
About the Author
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