Speaker Explores the Importance of Medication Management

By Lauren Williams

kullgren1cisKindred offers all levels of post-acute care, and in our Integrated Care Markets, where we offer all levels of care in one geographic area, we can help patients transition through the full continuum of Kindred care, from the long-term acute care hospital all the way to home. With that ability to transition patients through many levels of care comes the opportunity and challenge of ensuring that those transitions are done well.

Approximately 60 percent of medication errors occur during transitions of care. In addition, 50 percent of all hospital-related medication errors are linked to poor communication at transitions of care and data shows that patients tend to miss one to two doses of their medication during transitions. These were some of the takeaway messages from a presentation titled "Medication Management and Polypharmacy across the Continuum," delivered by Justin Kullgren, PharmD,  CPE, South College School of Pharmacy, at this year's Clinical Impact Symposium.

Kullgren reminded participants that in 2005, the Joint Commission designated medication reconciliation at times of transition a National Patient Safety Goal. The goal of medication reconciliation, he said, is to improve patient well-being throughout the continuum of care.

So why is this such a big deal? Kullgren supplied some important facts:

  • Geriatric patients take one-third of all prescription medicines in the United States, and 50 percent of all over-the-counter medications
  • One of three people over the age of 65 will experience an adverse drug event requiring hospital admission
  • Falls are the fifth leading cause of death in developed countries and medication is related to many of these falls
  • 25 percent of elderly patients with a hip fracture die within six months of the injury
  • There are approximately 100,000 emergency hospitalizations for adverse drug reactions among the geriatric population in the United States per year

Kullgren challenged the group to think about what they could do to reduce the incidence of medication management-related complications. He personalized the issue by pointing out that certain medications can affect the ability for clinicians to do their jobs - side effects such as constipation and confusion will affect patients' ability to achieve results in rehab, for example.

kullgren2cisUsing the lowest effective dose of medication is advised, especially due to pharmacokinetic changes that geriatric patients undergo.

Simplifying regimens is ideal.

Educating patients about the dangers of missing or mixing medications and utilizing one pharmacy is important, as is designating one clinician as the prescribing manager, as the incidence of adverse drug reactions is directly proportional to the number of clinicians involved in a patient's care.

Kullgren kept the discussion lively by using texting technology to lob questions at the group and letting them respond via their cell phones. Questions posed included "what class of drugs is most highly associated with hospitalizations?"

The topic of medication management will be further explored in various sessions to take place over the next few days at the symposium.