Understanding the Essential Role That Medication Management Plays in PACE

There are many challenges facing the elderly when it comes to medication. Because seniors typically take a large number of medications to manage multiple medical conditions, they’re at an increased of polypharmacy and adverse drug events. For PACE participants, the challenges are even more pronounced, as they try to navigate medication usage in their own homes. The goal of post-acute care pharmacy services in the PACE environment, then, is to ensure the highest level of safety in medication management. To achieve that goal, Grane Rx uses an innovative three-part approach called Precision Medication Management that meets the unique medication needs of PACE participants in a cost-effective way.

Part 1 of Medication Management in PACE: Clinical Consults

Polypharmacy, or the regular use of more than four medications, is significant among the PACE population. In fact, the American Society of Consultant Pharmacists reports that people between ages 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—which are often prescribed by multiple physicians, including specialists—comes an increased number of side effects, the potential for duplicate therapies, and the possibility of drug-drug interactions. Grane Rx partners with PACE centers to provide clinical consults, in which a geriatric-specialized pharmacist reviews participant medications on a regular basis. During a clinical consult, pharmacists implement a number of safety checks, including:

  • PACE medication regimen reviews that utilize Beer’s criteria and anticholinergic burden scoring and intervention
  • Reviews following a clinical change of status or emergency room visit
  • The elimination of duplicate medications
  • The identification of drug-drug interactions

Clinical consults serve a dual purpose: They help promote positive outcomes for PACE participants while helping PACE centers contain costs and make efficient decisions.

Part 2 of Medication Management in PACE: A Preferred Medication Program

In health care, including post-acute care, it’s imperative to optimize patients outcomes while containing costs whenever possible. The Grane Rx Preferred Medication program helps PACE centers tackle that balancing act when it comes to medication management. When partnering with a PACE center, Grane Rx implements a clinically appropriate preferred medication program—specific to that PACE center—to minimize medication costs. When formulating this list, the Grane Rx team works collaboratively with the PACE center team to find medications that will meet the therapeutic treatment needs of participants and prescribers while containing costs. The facility-specific preferred medication program is reviewed and tweaked regularly to ensure it contains the most clinically relevant and cost-effective medications. An automatic therapeutic interchange program is also included as part of the program. [Tweet “Here’s what you should know about #medicationmanagement in the #PACE environment”]

Part 3 of Medication Management in PACE: Pharmacogenetic Testing

Pharmacogenetics, which is defined as variations in response to medications based on a person’s genetic makeup, represents the future of medicine. In the past—and in fact, often today—prescribers were left with questions when trying to determine why a patient didn’t respond to a specific medication.

The use of pharmacogenetic testing more broadly in the future may change that.

In short, different PACE participants metabolize medications differently. Participant A may be impacted more profoundly by a medication or may have a more limited response than Participant B. That’s where taking a look inside a person’s genetic makeup and how he or she will metabolize medicine can make a difference.

Grane Rx has established partnerships with some of the industry’s leading providers of pharmacogenetic testing providers that provide state-of-the-art genetic testing and clinical decision support software.

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. It also has the potential to reduce the use of unnecessary medications that were prescribed based on an adverse reaction to another medication.

Using pharmacogenetics can help reduce the risk of adverse drug events among PACE participants—and, as a result, limit the number of hospitalizations.

The Grane Rx Medication Insights program can help make prescribing easier.

Want to learn about the impact Grane Rx services can have on your PACE center? Get started by calling (412) 449-0504 or emailing paceteam@granerx.com.

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