Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

Arbour SeniorCare

Name of Innovative Program: 
Bi-annual total medication review to save costs, prevent drug interactions, and side effects in long-term care settings
Sponsoring Organization
Arbour SeniorCare
Name of Innovative Program Lead: 
Michael C.LaFerney
E-mail Address of Innovative Program Lead: 
laferney@hotmail.com
Project Description: 
Twice yearly medication review of patients recieving behavioral health medications in long -term care settngs to determine medication that can be eliminated. ( all patients can use the model and can be used in physicans offices ) Purpose:Avoid no longer needed medication, avoid drug interactions, and save costs.The process and things to look at in order to identify unneeded medication is prsented in this article. Essentail for understanding the project and how it works.http://www.reflectionsonnursingleadership.org/Pages/Vol39_2_Col_LaFerney... reviews benefit patients AND nursingThe patient was right. He WAS on too many medications. 
Creativity and Innovation: 
Once put on certain medications in nursing homes they stay on indefinitely .Examples are drugs like cholinesterase inhibitors -deigned to slow down the progression of Alzheimer's diesease and effective for only nine months but they stay on these till they die-often years with no benefit and wasted money.Comphresive medication reviews are rarely done, but can be done quickly and effectively. Twice a year minimum could save thousnds of dollars, preventunneeded side effects including costly falls, sedation and other issues leading to further impairment in cognition and function.                                                                                                                                                                                                                                              
Leadership: 
Can be implemented in not only long-term care settings , but in doctor;s nurses, and othe healthcare providers practices. Patients should be taught to list all meds, including herbal remedies and then  have their physician review them twice yearly to ensure medications are still needed.
Sustainability: 
Long-term care administrators and public health agencies would certainly supprt it as the costs saved would be signigicant.Nurses and families would support it as it would save money and lead to better care.
Replicability: 
Can easly be done -takes a little time to review and assess but benefits are pronounced. Including improved compliance time saving. (less medication for patients to have toswallow, less pills for nurses to pass. Less medications in carts-less risk of drug diversion.)Just use the questions asked above and then eliminate the medications that you can. If unsure a taper can be done to see if they can tolerate being off it.
Results/Outcomes: 
Outcomes:Improved patient careLess side effects, drug-to-drug interactions, and incidents leading to more costly incidents as falls.Less costs :Uneeded cholinesterase inhibitors, antipsychotics, niaspan,.Vitamins and other medications leading to reduced costs.{potentionally thousands of dollars in savings)Time saved for nurses -better patient compliance with medicationLess risk of drug diversion 
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