The Medication-Falls Connection | Episode 9

The Medication-Falls Connection | Episode 9

Summary   In this episode, Scott Stewart and Caitlin Little discuss the impact of medications on fall risk in long-term care residents, emphasizing the importance of medication review to prevent falls and improve patient safety.   Keywords   falls, long-term care, medications, pharmacology, elderly, medication review, patient safety   Key topics   -Six drug classes associated with falls: antipsychotics, benzodiazepines, antidepressants, anticonvulsants, antihypertensives, hypoglycemic agents -Physiological changes in aging affecting drug metabolism and sensitivity -Polypharmacy and its impact on fall risk -Signs of medication-related fall risk: dizziness, confusion, sedation -Questions to assess medication impact on falls: dose changes, recent PRN meds, blood pressure and glucose levels -Role of pharmacists in medication review and fall prevention   Takeaways   -Medications like antipsychotics, benzodiazepines, and antidepressants significantly increase fall risk in elderly long-term care residents. -Age-related changes in pharmacokinetics and polypharmacy increase sensitivity to medications, raising fall risk. -Regular medication review focusing on recent dose changes, PRN medication use, and vital signs can help identify med-related fall risks. -Pharmacists play a crucial role in evaluating and optimizing medication regimens to prevent falls.   Host Names   Scott Stewart PharmD and Caitlin Little PharmD   Chapters   00:00 Introduction to Falls in Elderly Care 02:54 Medications and Their Impact on Falls 08:41 Understanding Body Changes and Polypharmacy 12:45 Assessing Fall Risks and Medication Review 17:20 Conclusion and Call to Action   Resources and Contact Info   Mangoni AA, Jackson SH. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol. 2004;57(1):6-14. doi:10.1046/j.1365-2125.2003.02007.x LinkedIn - Scott - https://www.linkedin.com/in/scottstewart [https://www.linkedin.com/in/scottstewart] ; Caitlin - https://www.linkedin.com/in/caitlin-w-987309177/ [https://www.linkedin.com/in/caitlin-w-987309177/] Emails - Scott - sstewart@pharmcarecorp.com [sstewart@pharmcarecorp.com] ; Caitlin - cwaldroup@pharmcarecorp.com [cwaldroup@pharmcarecorp.com]

Survey Hot Spots: The Pharmacy Issues Driving Citations In LTC Today | Episode 8

Survey Hot Spots: The Pharmacy Issues Driving Citations In LTC Today In this episode, Scott Stewart and Caitlin Little dive into the critical pharmacy-related compliance issues faced by long-term care facilities, especially focusing on F tags related to medication labeling, storage, and medication errors. They highlight practical strategies for facilities to improve systems, prevent deficiencies, and ensure quality resident care. Key Topics Covered: * Overview of major pharmacy F tags, especially F-761 (labeling/storage) and F-755 (pharmacy services) * Common deficiencies such as short expiration dates on inhalers, nebulizers, and eye drops * Tips for proper medication storage, including refrigerator temperature logging and secure storage of controlled substances * The importance of accurate medication labeling, dating, and storage practices * How medication errors are classified, with emphasis on significant errors that pose risks to residents * The domino effect of medication inaccuracies leading to multiple deficiencies * The interdisciplinary approach needed to reduce errors and improve compliance * Emerging focus on chemical restraints and the importance of documentation Timestamps: (00:00) - Welcome and episode overview (00:16) - Pre-podcast personal updates and banter (02:00) - Observations on family dynamics and parenting challenges (07:52) - The role of ProPublica in tracking deficiencies in nursing homes (11:54) - Deep dive into F-761 (labeling/storage) deficiencies (17:35) - Establishing systems for medication labeling and storage (21:00) - Proper locking and security of controlled substances (25:00) - The importance of refrigerator temperature logs and storage (28:22) - Pharmacy services systems and medication ordering challenges (34:23) - Managing medication access and errors with communication (36:14) - Understanding significant vs. non-significant medication errors (40:45) - The impact of resident condition, drug category, and error frequency (48:50) - Examples of omissions and domino effect in deficiencies (50:24) - Differentiating between significant and non-significant med errors (55:35) - Common issues with medication timing, shaking suspensions, and crushing pills (61:36) - The rise of chemical restraint concerns and documentation (66:29) - Final thoughts on collaborative efforts to improve medication safety Resources & Links: [ProPublica Nursing Home Deficiency Data](https://www.propublica.org/ [https://www.propublica.org/] RN deficiency database) ASHP Safe Practice Guidelines for Medication Administration Connect with Scott Stewart: LinkedIn - https://www.linkedin.com/in/scottstewartpharmd/ [https://www.linkedin.com/in/scottstewartpharmd/] Connect with Caitlin Little: LinkedIn - https://www.linkedin.com/in/caitlin-w-987309177/ [https://www.linkedin.com/in/caitlin-w-987309177/] Stay tuned for more insightful episodes on compliance and resident safety in long-term care.

Rethinking Insulin in Long-Term Care: Safer Strategies for an Aging Population | Episode7

Summary   This episode explores the complexities of insulin management in long-term care, emphasizing the importance of tailored treatment goals, de-intensification strategies, and non-insulin therapies to improve resident safety and quality of life.   Keywords   diabetes, insulin management, long-term care, de-intensification, non-insulin therapies, hypoglycemia, hyperglycemia, resident safety   Key Topics   - Differences in diabetes management between community and long-term care - Goals of diabetes treatment in elderly residents - Risks of aggressive insulin therapy: hypoglycemia and falls - De-intensification strategies for insulin regimens - Role of non-insulin therapies in long-term care - Importance of individualized care plans and safety protocols   Host Names   Scott Stewart and Caitlin Little Host Links   LinkedIn - https://www.linkedin.com/in/scottstewart [https://www.linkedin.com/in/scottstewart] LinkedIn - https://www.linkedin.com/in/caitlinlittle [https://www.linkedin.com/in/caitlinlittle]   Chapters   00:00 Rethinking Insulin in Long-Term Care 07:54 The Shift in Treatment Goals for Elderly Diabetics 15:58 De-Intensifying Insulin: When Less is More 29:26 Careful Adjustments in Insulin Regimens 34:52 Exploring Non-Insulin Options 43:44 DPP-4 Inhibitors and Their Role 51:44 Individualized Care and Team Collaboration   Resources   American Diabetes Association - https://diabetes.org [https://diabetes.org] American Geriatric Society - https://www.americangeriatrics.org [https://www.americangeriatrics.org] Metformin information - https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/metformin-quest… [https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/metformin-quest…] SGLT2 inhibitors overview - https://www.fda.gov/drugs/resources-information-approved-drugs/overview-sglt2-inhibitors [https://www.fda.gov/drugs/resources-information-approved-drugs/overview-sglt2-inhibitors] GLP-1 receptor agonists - https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/overview-glp-1-… [https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/overview-glp-1-…] Hypoglycemia management protocols - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151244/ [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151244/]

Antidepressants Unpacked: What LTC Teams Need to Know | MedTalk Rx | Episode 6

Summary In this episode, Scott Stewart and Caitlin Little delve into the complexities of antidepressant use in long-term care settings, discussing the prevalence of depression among elderly residents, the various types of depression, and the pharmacological and non-pharmacological treatment options available. They emphasize the importance of proper assessment, monitoring, and de-prescribing practices to ensure the best outcomes for residents. The conversation highlights the need for a collaborative approach among healthcare providers to manage depression effectively in this vulnerable population. Takeaways * Over 40% of long-term care residents are on antidepressants. * Depression is often exacerbated by changes in living conditions and health status. * The DSM-5 criteria for diagnosing depression include emotional and physical symptoms. * SSRIs are commonly used due to their favorable side effect profile. * SNRIs can help with both depression and neuropathic pain. * MAOIs and TCAs are less commonly used due to side effects. * Atypical antidepressants like Wellbutrin and Mirtazapine have unique benefits and risks. * Non-pharmacological interventions can significantly improve residents' quality of life. * Documentation of symptoms and treatment responses is crucial for effective care. * De-prescribing should be approached cautiously to avoid withdrawal symptoms. Chapters 00:00 Introduction to Antidepressants in Long-Term Care 03:01 Understanding Depression: Definitions and Diagnoses 05:58 Epidemiology of Depression: Statistics and Prevalence 09:01 Types of Depression and Their Clinical Presentation 12:11 Assessing Depression: Tools and Scales 14:50 Pharmacological Treatments: SSRIs and SNRIs 17:55 Exploring Other Antidepressant Classes 20:49 Conclusion and Key Takeaways 36:12 Understanding Side Effects of Antidepressants 39:45 Exploring Wellbutrin: Benefits and Risks 42:51 Mirtazapine: A Multifaceted Approach 45:32 Trazodone: Sleep Aid or Antidepressant? 48:25 Emerging Treatments: NMDA Antagonists 50:30 Antipsychotics in Depression Management 54:37 Non-Pharmacological Approaches to Depression 01:00:06 The Importance of Deprescribing 01:07:09 Practical Takeaways for Managing Depression Keywords antidepressants, long-term care, depression, elderly, mental health, pharmacotherapy, non-pharmacological interventions, de-prescribing, nursing homes, healthcare

Consultant Cart Talk | MedTalk Rx | Episode 5

Keywords   medication carts, audits, nursing, healthcare, medication management, patient safety, nursing education, pharmacy consulting, medication errors, long-term care     Summary   In this episode, Scott and Caitlin discuss the significance of medication carts in healthcare settings, emphasizing the importance of audits and proper management to ensure patient safety. They share personal anecdotes and insights into common issues faced with medication carts, such as expired medications and organization challenges. The conversation highlights the need for collaboration between nursing staff and pharmacy consultants to improve medication management practices.     Takeaways   Medication carts are crucial for accurate medication administration. Audits help ensure medications are stored and managed correctly. Common issues include expired medications and disorganization. Collaboration between nurses, medication aides, and pharmacists is essential. Education and training can improve medication management. Loose tablets can lead to storage deficiencies. Proper dating of certain medications is vital for safety. Overflow in medication carts can cause confusion. Regular communication can enhance medication management practices. A systematic approach can help reduce medication errors.     Chapters   00:00 Introduction and Personal Updates 05:00 The Importance of Medication Carts 07:45 Common Issues with Medication Carts 15:58 Collaborative Solutions for Improvement