Prime Time Living - Page 28 - Pharmacist from page 8

Prime Time Living
- Page 28
Pharmacist from page 8
does, and that’s the AGS Beers Criteria, a list of potentially inappropriate medications to avoid with older adults.”

The American Geriatric Society ( www.americangeriatrics.org ) 2019 Beers Criteria “includes lists of certain medications worth discussing with health professionals because they may not be the safest or most appropriate options for older adults. Though not an exhaustive catalogue, the five lists included in the AGS Beers Criteria describe particular medications with evidence suggesting they should be:

1. Avoided by most older people (outside of hospice and palliative care settings);

2. Avoided by older people with specific health conditions;

3. Avoided in combination with other treatments because of the risk for harmful “drug-drug” interactions;

4. Used with caution because of the potential for harmful side effects; or

5. Dosed differently or avoided among people with reduced kidney function, which impacts how the body processes medicine.”

In a 2013 study published by the American Association of Family Physicians ( www.aafp.org ), researchers found, “Adverse drug events occur in 15 percent or more of older patients presenting to offices, hospitals and extended care facilities.

These events are potentially preventable up to 50 percent of the time.”

In the past, our medications and supplements would come from a single source, but no longer. Says Brandt, “Patients today have fewer safety nets because they tend to use multiple pharmacies or even use mail order, which means no one has a complete overview of all the medications you are taking. You can get products anywhere. But you’re looking for the service a pharmacist can provide, someone you can sit with and discuss all your medications and feel as if that person is part of your team. Look at your choices and identify one as your primary pharmacist; it should be a person you’re comfortable with and with whom you can be open.”

If you’re on Medicare, you do have an advantage. After your first year, a free annual wellness visit is permitted with no copay. Included, if you ask, is a Comprehensive Medications Review.

If you have Part D, the Medicare prescription drug benefit, you can contact your provider and request Medication Therapy Management. After either of these, you receive a personal medication list and action plan. It describes each drug you take, what it is for, how often you take it, plus room for you to fill in what you did.

If you reside in a facility with a medical staff – assisted living, nursing home, senior residence – a pharmacist may be part of the team. Hospitals and hospices automatically include them. Those at risk, however, are people aging in place. For them, the goal is to prevent adverse events from happening a possible consequence of being on multiple meds. That’s when having a pharmacist who reviews your drugs is really important.

What else can a pharmacist do to make your life easier? Quite a bit. The CDC lists a few of the ways:

•Talking to you about your medicine. Your pharmacist can explain the small print – what the medicine is for, how best to use it, what side effects you may experience, and what to do if you have side effects.

•Suggesting ways to help you take your medicine. Your pharmacist can help you learn how to take your medicines as directed as well as solve any problems you might have in doing this. For example, your pharmacist can suggest routines or tools such as a daily pillbox to help you take your medicine at the right time in the right dose. Your pharmacist can also help connect you to prescription discounts and aid programs.

•Talking to you about medicine safety. Your pharmacist can give you important advice on which over-the-counter medicines, such as pain medicines and dietary supplements, are safe to use in combination with your prescription medicines.

•Identifying or managing health problems. For example, if you get your blood pressure checked at the drugstore, share your numbers with your pharmacist. Your pharmacist can talk to you about your risk for high blood pressure, help you monitor your blood pressure, and direct you to medical care if needed. Your pharmacist can also consult your doctor to ensure you get the best treatment available.

•Helping you manage other heath conditions. Pharmacists can provide immunizations, like yearly flu shots, and teach you how to use health equipment such as blood glucose monitors if you have diabetes and inhalers if you have asthma.

It adds that, “your pharmacist can alert your doctors if they separately prescribe medicines that interact badly, before a problem occurs. Your pharmacist can also consult your doctor and advocate for you if you’re struggling with taking your medicines or have side effects.” It recommends that the next time you visit a pharmacy, take this list of questions with you.

•What is this medicine supposed to do?

•How and when should I take it?

•What are possible side effects? What should I do if I get them?

•Should I avoid certain activities, like driving or running?

•Should I avoid certain foods while taking the medicine, such as milk products or grapefruit?

•If I’m having problems with this medicine, when should I call my doctor?

•Can you give me a list of my prescribed medicines?

Brandt actively advocates for and promotes optimal care for older adults and is one of the authors of the AGS Beers Criteria. “We’re changing pharmacy education to be more inclusive of older adults and their specific situations, recognizing their special needs, and promoting inclusion of pharmacists in medical teams because of their specialized knowledge.

The University of Maryland School of Pharmacy continues to expand geriatric training opportunities including palliative and hospice care.”

When it comes to you and your medicines, pharmacists are – or should be – your best resource. Their education delves into disease prevention and public health, therapeutic decisions, recommended drug therapy monitoring and patient evaluation, therapeutic decision making in each major system/disease state, and much more. Physicians rely on guidelines for prescriptions, but pharmacists have a bigger picture and can supplement a doctor’s knowledge.

The next time you get a prescription renewed, take a few minutes to talk with the person behind the counter. You may not need him or her today, but, if and when you do, you’ll know that person is there to help. •