Ready to save money? New PACE pharmacy services may not get your attention, but the ways they can lower your costs will. From the way meds are filled and delivered to technology and data solutions, new PACE pharmacy services can impact your bottom line.
Meds2Home Streamlines Your PACE Pharmacy Needs
Meds2Home is the future of PACE pharmacy, and the future is here. Keep reading to learn how your center can benefit.
Improve Medication Adherence and Clinical Outcomes. The fall-out from medication non-adherence is one of the greatest liabilities and potential costs to PACE centers. With Meds2Home, participants receive their daily medication regimen in color-coded, smart-labelled boxes. All of their meds come in presorted pouches with simple instructions and easy to read educational materials that reinforce health literacy. The result: better adherence and clinical outcomes which in turn minimize your PACE center costs.
Streamline Your PACE Pharmacy Services and Save. Grane Rx frees up PACE center resources so you can focus on participant care. Your team does the prescribing and then the Grane Rx PACE Pharmacy takes over. We couple powerful automated technologies with highly trained pharmacists to fill your prescriptions and seamlessly deliver them to participants at their home. Best of all, our interoperable system integrates with yours so you can maintain your workflows and continue using your existing EHR system. The result: streamlined pharmacy services that save you time and resources.
New Pharmacy Services Include Consulting and Testing
Pharmacy consults traditionally respond reactively to address issues a participant is having with medication. Early or proactive pharmacy consults look at a participant’s medicationsbefore there is a problem. That’s where Grane Rx’s Medications Insights program powered by YouScript™ comes in. We use a patented technology to help mitigate polypharmacy issues and identify and make medication changes before there is a need to invest in high cost lab tests. Our software enables prescribers to quickly identify more medication interactions and offer alternative medications both within the same medication class and for the same medication. Read more about the benefits of early pharmacy consults related to polypharmacy in the elderly.
Pharmacogenetic testing goes even deeper to assess the effectiveness of particular drugs for particular patients. Consider that 75 percent of all patients have some genetic variations in their medication metabolism enzymes, which may affect how they metabolize, process and react to treatments. Pharmacogenetic testing is beginning to explain the variances that have been seen between patient reaction to particular doses of particular medications.
This tool provides information to improve medication management by enabling providers to select the most appropriate medication at the most appropriate dose for a patient based on how their body will metabolize a medication. This has the potential to reduce the number of medications given to reduce side effects of other medications. That reduction can bring real cost savings as well as positive clinical outcomes.
A great pharmacy partner is always looking for ways to save you money, whether it’s creating a formulary for your organization or exchanging inefficient practices for more streamlined effective ones. Your pharmacy solution may be working, but checking out new pharmacy services may bring cost savings you can’t afford to pass up.
In PACE pharmacy, medications are typically dispensed to participants in monthly increments that are either picked up at the PACE center or delivered to the home. But what happens when a participant’s medication regimen needs to change in the middle of a cycle? Because PACE participants usually take multiple medications for a variety of medical conditions, it isn’t uncommon for physicians to switch out a medication or change its dosing. It also isn’t a problem. We’ve created a seamless process designed to handle medication regimen changes when they occur—without compromising participant safety or health. Read on to learn more.Let’s first take a look at the “why” behind our packaging. Medication nonadherence is a significant problem among the senior population and is especially critical for PACE participants. With this in mind, Grane Rx uses innovative packaging called SimplePacks when dispensing PACE pharmacy medications. This packaging is just one part of the overall Grane Rx PACE Pharmacy Solution, which is designed specifically with seniors in mind—featuring clear, understandable information about medications to encourage adherence.Each month, participant’s medications are packaged together inside two color-coded boxes: one for everyday medications and one for medications that are taken as necessary. Within those boxes, medications are packaged in SimplePacks, which are easily opened perforated packs of medications taken at the same time of day, whether morning, noon, evening or at night. This unique PACE pharmacy solution offers a much better medication management system than the bingo cards typically used by long term care pharmacy and other PACE pharmacy providers.The very thing that makes our packaging unique and innovative—our SimplePacks perforated pill packs—can seem like it would be tricky when medication changes are needed. But actually, that isn’t the case.
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“Immediate Change” Medications in PACE Pharmacy
The first step in managing medication changes is identifying medications that must be immediately changed. The vast majority of medication changes, including dosage changes, don’t need to be made immediately. Those changes can simply wait until a participant’s medications are dispensed again.Our PACE pharmacy worked with a team of physician and pharmacy experts to compile a list of medications that need to be changed immediately, along with medications that are more subjective in nature. When Grane Rx partners with a new PACE center, we review this list with the center’s medical staff to ensure it aligns with their practices. The center-specific list is adjusted as necessary at that time.Prescriptions identified as immediate change medications are placed in separate SimplePacks and not commingled with other medications. This typically includes certain classes of medications, such as anti-hypertensive drugs, that require periodic adjustments to dosage or to determine which medication works best for a participant. Because these medications are automatically packaged separately from the rest of a participant’s medication regimen, those pill packs can simply be removed and the replacement medication incorporated—at any time.In the case that a new, non-immediate change medication is prescribed for a participant, that medication is packaged as a one-off and then incorporated into the participant’s normal SimplePacks the following month.When it comes to PACE pharmacy services, Grane Rx thinks through all the possibilities and offers the solutions your PACE center needs. Get started today by calling (412) 449-0504 or emailing paceteam@granerx.com. ]]>
In less than a year, Pennsylvania will join the ranks of states offering managed care for long term services through their state Medicaid program. As we prepare for the roll-out, the question emerges: How will Community HealthChoices, Pennsylvania’s MLTSS program, impact long term care pharmacy services?Over the past decade, we’ve seen managed care carve out a significant footprint among state Medicaid programs. While not all states offer managed care programs, an increasing number do — a total of 40 states. In addition, MLTSS specifically is gaining ground.At its roots, managed care is designed to promote community-based care, meaning LTC pharmacy services must adapt to providing medications and other care for the home environment. In that way, Grane Rx is ahead of the curve, and we’re focused on the aspects of care needed for optimal at-home medication adherence. Let’s take at those areas of focus:
MLTSS & Long term Care Pharmacy Focus: Adherence
Under managed care, there’s an emphasis on care coordination. Managed care organizations have incentives to keep people healthy and in their home, largely seeking to avoid long-stay care in a Skilled Nursing Facility, hospital admissions, and emergency room visits. Medication adherence will play a significant role in helping keep people healthy and in the home.Because of this, it’s important for long term care pharmacy providers to not only dispense medications, but also work to improve adherence with medication regimens. Medication non-adherence is a significant issue in the United States, contributing to up to $300 billion in avoidable health costs each year. Non-adherence has a variety of causes, ranging from lacking access to necessary medications to not understanding the medication regimen.Grane Rx offers a comprehensive approach to improving medication adherence. For one, the Grane Rx Meds2Home™ program eliminates the need to travel to a pharmacy to obtain medications. Through the program, medications are delivered directly to the home.For residents being discharged from an SNF, Grane Rx pharmacy providers ensure they’re set up with the medications they need — and that they understand how to properly take those medications. In addition, we follow up with patients to see if they’re getting the medications they need, and if they’re not, communicate that information to the patient’s care team so that they can also follow up. This helps eliminate patients falling through the cracks after discharge.
[Tweet “With MLTSS implementation in PA, there will be 2 key areas of focus for #longtermcarepharmacy.”]
MLTSS & Long term Care Pharmacy Focus: Education
Many Americans lack the basic health literacy necessary to process and understand health information, including that related to their medications. In fact, according to the U.S. Department of Health and Human Services, only 12 percent of adults in the United States have proficient health literacy. The problem is particularly profound among the senior population, with only 5 percent at a proficient health literacy level.Overcoming that challenge and promoting medication adherence requires long term care pharmacies to provide careful and thorough educational resources. For Grane Rx, these resources begin within the medication’s packaging. Because we recognize that every person takes in information differently, our packaging uses a combination of words, colors, numbers and symbols. The packaging is paired with LearnRx medication summaries that provide easy-to-understand information about each medication.When people understand why they’re taking each medication, they’re more likely to adhere to their medication regimens. The Grane Rx EasyRead Pharmacy Solution pairs an image of each medication with the medication’s name, a description of the tablet or capsule, and the indication for use of the medication.Through thorough educational efforts, we work to improve medication adherence while decreasing the risk of rehospitalization and improving quality of life.The Grane Rx team strives to stay ahead of changes to the long term care pharmacy landscape, including the implementation of MLTSS. To learn how your organization could benefit, call (866) 824-MEDS (6337) or fill out this quick form.]]>
By Jennifer Devinney, RPh, PharmD
Polypharmacy is an often silent, but very serious, problem in PACE pharmacy today. It is defined as the administration of more medication than is clinically indicated, which represents unnecessary medication use. Thorough PACE medication management is key to limiting polypharmacy.Polypharmacy is especially prevalent in elder care where it has been estimated that approximately a quarter of patients are prescribed nine or more medications, with some studies showing much higher percentages of patients exceeding five, nine or ten medications.
Defining Necessity
For a medication to be considered necessary, it should be prescribed with a clear diagnosis that is supported by practice guidelines, clinical research or standards of care at a dose, duration, frequency and route of administration in concurrence with these guidelines. Additionally, medications should be used at the lowest effective dose for the shortest duration possible, avoiding duplication of therapy with other agents. The medication should be monitored according to practice guidelines, including periodic lab levels as well as clinical monitoring for therapeutic response and the development of adverse effects. When prescribing a medication, definitive therapeutic goals should be established in addition to the indication for use. Having clear therapeutic goals is vital in order to appropriately assess whether a medication is beneficial as therapy progresses. It also enables the healthcare team to create a larger and more comprehensive care plan for the participant.
[Tweet “With seniors taking multiple medications, #polypharmacy is a growing concern in #PACEpharmacy”]
The Role of Medication Review
A thorough medication review when a participant is accepted is one of the most important PACE pharmacy practices to help eliminate unnecessary medications. It’s important to determine why a participant is using a particular medication and to match each medication to an appropriate diagnosis. Often, medications are associated with a general diagnosis, no diagnosis or a diagnosis that is not an FDA-approved indication. In these cases, clinical judgment should be utilized to determine whether the off-label use is appropriately supported based upon the participant’s medical history and if the benefits of therapy outweigh the risks of adverse effects.The psychotropic medication class, which includes antipsychotics, anxiolytics and sedative/hypnotics, is one of the highest risk medication classes for the geriatric population. The risk of adverse events, including increased mortality, is very high in the elderly—making the risk versus benefit line with psychotropic medications extremely tenuous. When psychotropic medications are used outside of their FDA-approved indications, the literature supporting their use is lacking. In fact, most literature does not recommend off-label use due to lack of positive outcomes. Due to inherent risks, psychoactive medications need to have a clear goal of therapy, which includes specific target behaviors that support the use of the medication. Adverse effect monitoring is extremely important for this class since these medications carry substantial risks, and periodic dose reductions are necessary to provide evidence that the lowest effective dose is being utilized. Optimizing medication regimens when more than one agent is being used to treat a condition is another important practice for preventing polypharmacy. The most prevalent example of this would be using multiple agents to manage hypertension. It’s not uncommon to see as many as four or five antihypertensive medications ordered for the same participant. One of the fundamental guidelines in treating a disease state that may require more than one medication is to start with one medication and maximize the dose until either the maximum recommended dose is reached or the maximum dose without adverse effects is reached. After the maximum dose is reached, then another agent can be added and titrated if better control is needed. participants on multiple medications at suboptimal doses should have their regimen evaluated and, if clinically acceptable, have a medication discontinued while adjusting the doses of the other medications.
Drug Classes of Particular Concern
Proton pump inhibitors (PPIs) are one of the most commonly prescribed unnecessary medications. PPIs are frequently utilized for treatment of GERD in the elderly. Practice guidelines recommend treating GERD initially with PPIs for eight to 12 weeks and then evaluating whether the GERD has improved. Often, the evaluation does not occur and many participants will remain on PPIs for years without any dose reductions to see if the dose or medication is still needed. Long term use of PPIs increases the risk of certain complications, such as osteoporosis and clostridium difficile infection. Allergy medications prescribed for long term chronic use are another commonly seen unnecessary medication. Many times allergy symptoms such as runny nose and itchy eyes are often seasonal or otherwise short-lived, yet the participant is ordered a long term scheduled dose of an antihistamine medication. It’s important to periodically evaluate whether these medications are still necessary since they have adverse effects such as drowsiness. Trial, as-needed orders are a good way to check whether this type of medication is still necessary. Some other more commonly seen unnecessary medications include:
Overactive bladder medications for participants who are already incontinent
Antihyperlipidemic medications for participants with hospice-qualifying disease states such as advanced stages of COPD, congestive heart failure or renal failure
Scheduled cough and cold medicines used beyond an acute illness
Some vitamins and supplements
Limiting Polypharmacy in PACE Pharmacy
One of our consistent clinical goals in the PACE pharmacy solutions we offer is to assist our partners in reducing unnecessary medication orders per participant by ensuring that each medication has a clear purpose, is meeting clinical goals and is necessary to maintain the overall well-being of that participant. Reports that outline the numbers of scheduled and PRN medications each participant is ordered are available to assist with these efforts and to trend progress. Our goal is to help reduce polypharmacy and the potential dangers associated with it, while optimizing medication administration and pharmaceutical spending.]]>
When compared with long term care pharmacy, PACE pharmacy presents its own unique set of challenges. Because participants are in the home environment rather than in a long term care setting with clinicians on hand, questions, concerns and needs may arise at any hour of the day. That’s why around-the-clock PACE pharmacy staffing is vital.Having PACE pharmacy providers available 24 hours a day, seven days a week means that there’s always a geriatric pharmacy expert on hand who can help PACE center staff meet participant needs. This allows for a smoother process for PACE medication management.
So what are the distinct advantages of having around-the-clock PACE pharmacy staffing for your PACE center? There are three main benefits.
Benefit 1: PACE Pharmacy Providers Can Answer Clinician Questions
There are many scenarios in which questions arise related to PACE participants and their medication regimens. When a provider is preparing to prescribe a new medication, he or she may have questions about what medications are in stock or what medications are on the preferred list. Or someone on the PACE center staff may need clarification in order to answer a question posed by a PACE participant or caregiver about a medication regimen.
That’s where Grane Rx’s commitment to 24/7 PACE pharmacy staffing makes an impact. Whether during the day or in the middle of the night, a certified geriatric pharmacist is available to answer questions promptly either by phone or through the EHR system, making the process of medication dispensing more seamless. And when participants and their caregivers fully understand their medication regimens, they’re more likely to adhere to them.
[Tweet “Around-the-clock staffing for #PACEpharmacy services benefits participants and staff”]
Benefit 2: PACE Pharmacy Providers Can Make Adjustments to Medication Regimens
Sometimes changes to a participant’s medication regimen can’t wait until standard business hours. If medications have been added to a participant’s regimen and the participant begins to experience side effects, Grane Rx PharmDs are available to perform a medication review. During this review, the pharmacist can help determine what medication or interaction could be causing the effects, as well as make suggestions to a provider about an appropriate alternative medication.This benefit is especially important when a PACE participant is first admitted and begins working with PACE center staff. As PACE medications are initially prescribed, there’s typically a need for adjustment. Having PACE pharmacy providers available 24 hours a day allows for those adjustments to be made quickly and efficiently.
Benefit 3: PACE Pharmacy Providers Can Promptly Fill Emergent Prescriptions
The final benefit may in fact be the most significant. When a PACE participant has emergency medical needs, such as that for an illness or injury, he or she needs medication promptly. With Grane Rx’s around-the-clock PACE pharmacy staffing, participants have quick access to medications when they need it most.
This prompt access allows participants, for example, to begin antibiotic or antiviral regimens quickly, which begins the process of limiting an illness’ effects. The sooner a participant can begin taking medication for an emergent need the better, making 24/7 access to PACE pharmacy services essential.
Our commitment to 24/7 staffing is just one part of Grane Rx’s approach to PACE pharmacy services. Make the transition to Grane Rx today by calling (866) 824-MEDS (6337).]]>
In the last few years, pharmacy benefit managers, often referenced as PBMs, have taken on an increasingly prominent role in PACE pharmacy.
To fully understand the role of PBMs in PACE pharmacy, first consider the role of pharmacy benefit managers more broadly. The American Pharmacists Association defines a pharmacy benefit manager as a third-party administrator of prescription drug programs, working with companies to maintain or reduce the pharmacy expenditures of plans without sacrificing healthcare outcomes.
The role of PBMs in PACE pharmacy is more specific—they support PACE Plans in navigating the complexities of Medicare Part D plan participants. Working with the pharmacies, PBMs play three main roles in PACE programs.
PBMs Facilitate the Management of Rebates for PACE Programs
The cost of pharmaceuticals from all types of pharmacies, from retail stores to long term care, is largely determined by pharmaceutical manufacturers. Cost savings can be obtained through negotiating drug pricing with pharmaceutical companies, as well as manufacturer rebates.While PACE plans could try to negotiate directly with pharmaceutical companies on their own, the associated paperwork and follow-up required can be a significant challenge, , in addition to IT and data processing requirements will cause substantial time investment. That’s where the role of the PBM comes into play. PBMs work to streamline the process and help ensure PACE programs obtain the rebates for which they’re eligible.
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PBMs Help Ensure the PACE Program Formulary Is on Target
PBMs also play a significant role in establishing and fine-tuning formularies or Preferred Medication lists for PACE programs. Formularies are continually reviewed to incorporate the most cost-effective and clinically relevant medications. Because they’re well-versed in what pharmaceutical rebates are available, PBMs can advise PACE providers about which clinically appropriate medications can be obtained at the greatest cost savings, without sacrificing outcomes for participants. For example, a PBM can evaluate what medications within a class or for a specific medical indication might be best to incorporate into the PACE program’s drug plan.
PBMs Provide Reporting and Analytics Related to PACE Program
In addition to helping facilitate rebates and working hands-on with a PACE program’s formulary, PBMs also provide reports and analytics related to pharmacy services. Reports often contain an overwhelming amount of data, and sorting through and analyzing the data requires a significant time investment. Typically, PACE pharmacy providers don’t have someone in-house dedicated to analyzing and using this data to create efficiencies and cost savings. This represents one of the most significant benefits of working with a PBM. In this role, PBMs utilize technology to assess the roster of individuals in the PACE plan in real-time. They can then work with the pharmacy to analyze costs and how effectively rebates and the formulary are performing, allowing PACE programs to make just-in-time adjustments as needed.In addition, PBMs can provide the in-depth data necessary to meet Medicare Part D reporting requirements and help PACE programs adhere to associated regulations.Pharmacy benefit managers provide PACE pharmacies with multiple efficiencies. In the future, those efficiencies may also spread into pharmacy services for Skilled Nursing Facilities, as those centers realize how PBMs can partner with their pharmacy provider to help them optimize outcomes while managing costs.Grane Rx partners with AscellaHealth to provide PACE programs with seamless access to cost-effective pharmacy services. Wondering about other ways we can assist your program? Contact Scott Sosso at Grane Rx by calling (412) 449-0504 to learn more about our Precision Medication Management services and other ways we work to moderate costs. ]]>
Seniors typically deal with a multitude of comorbid medical conditions, requiring a significant number of medications. In fact, according to the American Society of Consultant Pharmacists (ASCP), while the elderly population makes up less than 15 percent of the total United States population, they consume 40 percent of all prescription medications. The goal of PACE pharmacy, then, is to ensure the highest level of safety in medication management. To facilitate that goal, Grane Rx’s Precision Medication Management program utilizes a three-part approach designed to provide cost-effective solutions to the pharmaceutical needs of participants of your PACE center.
Polypharmacy, or the regular use of more than four medications, is significant among the long term care population. The ASCP reports that people between the ages of 65 and 69 take an average of 14 prescriptions per year, while those age 70 or older take an average of 18.With an increased number of medications comes an increased number of side effects and the possibility of medication interactions. Grane Rx partners with PACE centers and the long term care industry to provide clinical consulting services. The foundation of these services are in-depth medication consultations to optimize participant medication therapy and outcomes.As part of clinical consultation, pharmacists implement a number of interventions, including:
Comprehensive medication regimen reviews
Clinical change of status or emergency room/hospital admission reviews
Targeted medication class and disease state management reviews
Medication utilization optimization reviews to focus on reducing and eliminating polypharmacy
The aim of all clinical consults is to help ensure positive outcomes for residents while helping PACE centers lower costs and make efficient decisions with downstream impact.
Pharmacogenetics is defined as variations in response to medications based on a person’s genetic makeup. In other words, different residents metabolize medications differently. Patient A may be impacted more profoundly by a medication or may have a more limited response or negative reaction than Patient B. Grane Rx has built a partnership with some of the industry’s leading pharmacogenetic testing companies in the country that provide state-of-the-art genetic testing and clinical decision support software. Utilizing innovative technology, providers can comprehensively analyze an individual’s genetic makeup and how his or her body absorbs medication. This risk assessment tool helps providers determine the most appropriate dose of medication for each participant—whether that’s a higher or lower dose than standard, the normal dose, or an alternative medication. In addition, it has the potential to reduce the use of unnecessary medications that were prescribed based on an adverse reaction to another medication.Pharmacogenetics will likely become a standard of care across health care, particularly in the medication management of the senior population. More precise medication orders have the potential to positively impact the provision of care and its associated costs, reducing medication side effects and improving resident outcomes.
[Tweet “#Polypharmacy is a significant issue in #longtermcare. Innovative #medicationmanagement can help”]
Precision Medication Management, Facet 3: Preferred Medication Program
Anyone involved in long term care will tell you that it’s imperative to optimize resident outcomes while containing costs whenever clinically appropriate. The Grane Rx Preferred Medication program helps PACE centers strike that careful balance when it comes to medication management.With each center it partners with, Grane Rx implements a customized, clinically appropriate preferred medication program to minimize medication costs. Through this program, Grane Rx works collaboratively with the facility to meet the therapeutic treatment needs of the residents and prescribers while optimizing cost containment efforts. The facility-specific preferred medication program is continually reviewed in order to incorporate the most cost-effective and clinically relevant medications. An automatic therapeutic interchange program is also included as part of the program.Want to learn about the impact Grane Rx services can have on your PACE center? Reach out to us here or call (866) 244-MEDS (6337).]]>
In recent years, the older population and their caregivers have increasingly turned to long term care programs that allow them to age within their own communities, such as PACE centers. When evaluating options, potential participants consider a number of categories, including pharmacy services.
So what are participants and their families seeking in a PACE pharmacy? Read on for a look at three criteria they’re evaluating:
PACE Pharmacy Evaluation Criteria #1: Medication Safety
For PACE participants and their families, safety is of the utmost concern. And with good reason. A 2012 study found that each year in the United States, the inappropriate use of medication — such as misuse of antibiotics or mismanaged polypharmacy — leads to approximately 10 million avoidable hospital admissions and 4 million emergency room visits.Participants and their families want a PACE pharmacy that prioritizes safety and helps ensure the appropriate use of medication. Grane Rx utilizes brightly colored boxes to enable a quick and easy distinction between everyday meds vs. meds that are taken on an as needed basis.Grane Rx promotes medication safety in a number of ways, including:
packaging automation for higher levels of accuracy
medication consultation
review of possible drug-to-drug interactions
literacy tools to improve medication compliance
[Tweet “3 criteria people look for in a #PACEpharmacy”]
PACE Pharmacy Evaluation Criteria #2: Simplicity and Convenience
Participants in PACE programs typically have a large number of chronic or acute medical conditions. To care for those conditions, participants may have dozens of medications to take on a daily basis. Keeping track of those medications and ensuring they’re taken correctly can be challenging. Participants and their families want ways to simplify medication therapy.Grane Rx offers a unique solution set to meet that need. As part of the PACE Pharmacy Solution, Grane Rx dispenses medications in prepackaged SimplePacks. This packaging uses automation to prepackage medications together so that they can be taken at morning, noon, evening, at bedtime, and on an as needed basis, simplifying the process of taking medication and replacing outdated, less functional punch cards.In addition, Grane Rx’s PACE Pharmacy program delivers medications directly to each participant’s home, alleviating the need for the PACE site to manage medications at the center or worry about medication deliveries.
PACE Pharmacy Evaluation Criteria #3: Education
As important as clinical reviews and safety protocols are, participant education plays an equally important role in promoting the appropriate use of medications. To help ensure medication adherence, participants and their families need to have a thorough understanding of medications, including what purpose the medications are prescribed for and what the dosages are.Education is a significant part of the Grane Rx dispensing process. SimplePacks are paired with EasyReadTM medication summaries that help participants have more informed about their medications. Providers can counsel participants and their family members about medications and any potential barriers to taking medications correctly. The packaging itself helps reinforce participant education. SimplePacks are labeled with written information about medications paired with visual representations of what each medication looks like.Grane Rx provides comprehensive PACE pharmacy solutions to help you meet participant needs. ]]>
For decades, when people aged and developed chronic medical conditions, they were moved from their homes into a nursing home setting. The advent of the Program of All-inclusive Care for the Elderly (PACE) in 1971 marked a change in that process, allowing many people to age in the comfort of their own home. Today, the ability to obtain comprehensive PACE care, including medications, and remain at home is further evolving long term care.
PACE: The Future of Long term Care
While the implementation of PACE has been a gradual process over the last several decades, PACE centers represent the future of health care. Several factors will likely continue to drive an increase in PACE utilization:
An aging Baby Boomer population will increase overall demand for long term care services. Estimates from the United States Census indicate that there will be 69.4 million American seniors by 2030. This nearly doubles the 35.5 million seniors in the year 2000.
Baby Boomers largely desire maintaining some level of independence, making PACE centers a preferred method of long term care.
Since the inception of the Affordable Care Act in 2010, health care as a whole is moving toward a “medical home” model, where patients receive collaborative care that’s focused on quality and safety. PACE centers align with this model of care.
[Tweet “The impact of #PACE medications at home on #longtermcare”]
PACE Medications at Home
The average PACE participant has eight acute or chronic medical conditions and needs assistance with at least three activities of daily living. Because of the sheer number of health conditions experienced by this population, medications play a significant role in PACE.The role of the geriatric pharmacist in delivering PACE medications at home is complex. Before medications are dispensed, pharmacists implement a number of quality assurance and safety processes, including:
elimination/prevention of duplicate medications
monitoring of associated labs
enforcement of Beers criteria from the American Geriatric Society
dose adjustments
identification of drug interactions
After these processes take place, PACE medications can be then be packaged and delivered for use in the home, which helps allow the older population to age at home as long as possible, while still supported by an interdisciplinary team.Grane Rx partners with PACE centers to provide pharmacy solutions from initial prescription ordering to packaging and delivery of medications. Our PACE pharmacy solution set includes innovative, participant-friendly medication packaging, known as SimplePacks; clear and effective labeling and prescription directions; and 24/7 access to certified geriatric pharmacists. Grane Rx also takes the quality assurance process one step further — 12 automated security checkpoints are involved in dispensing SimplePacks, helping to reduce the number of medication errors.Once SimplePacks have been dispensed, they’re delivered to the home of the participant. This program eliminates the need for the clinical staff to manage the medications and provides more time for participant care. Further, this program helps enhance medication compliance and adherence, which will improve outcomes for participants in the program.
The usage of PACE medications at home helps strike a balance. While helping improve medication safety and adherence, it also provides the older population the opportunity to age at home, a continuation of the evolution of long term care.]]>
Nursing Home Pharmacy Services Improve Med Adherence
Medication adherence means taking the right dose of the right medication at the right time—always. Patients are at risk of problems if they:
forget to take medication
take the wrong dose
take only some of their medication
take the medications the wrong way or at the wrong time
skip medication because of side effects, cost, or other reasons
Grane Rx Meds2Home™ program can help. SimplePacks, prepackaged daily doses help people take the all of the right medications, every day. Multi-checkpoint systems in the packaging process mimic checkpoints in the medication administration process and reduce errors. Clear labeling helps people know what they are taking and how to take it. SimplePacks make safe and effective medication taking easy for people at home.
Nursing Home Pharmacy Services Provide Oversight
With many elderly people on multiple meds, polypharmacy is a significant risk factor. While polypharmacy itself isn’t a problem, multiple medications increases the risk of medication interactions, missing medications, or taking medication incorrectly.
Pharmacists identify potentially contraindicated medications. They know which medications are of concern in aging bodies that process drugs differently. They also advise on ways to streamline pill load, which is yet another way to help with medication adherence. Grane Rx solutions allow people living at home with simple packaging and easy to read labels.
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Nursing Home Pharmacy Services Reduce Rehospitalization
Better medication adherence and reduced adverse drug events aren’t just numbers. They’re important factors in both quality of life and keeping people healthy at home. Medication mismanagement is the number one reason for hospital readmissions. Having medications delivered home through the Grane Rx Meds2Home program is a big step to reducing reducing medication mismanagement and thus lowering hospital readmissions. Patients don’t have to stop at the local drug store to pick up medications — they often leave the Skilled Nursing Facility with medications in hand. This has a clear impact on the elderly served. It also has a significant impact on managing costs for your center.
There are many factors that go into successful outcomes for people living at home. Pharmacy is one of them. Bringing the best of nursing home pharmacy services home can be the difference between staying at home and rehospitalization for the elderly in a PACE program or those needing meds after a stay in a skilled nursing facility.]]>
Grane Rx promotes medication safety in a number of ways, including:
