2018 Poster Winner: Enhancing Medication Safety Among Community-Dwelling Frail Seniors
CALTCM 2018 Poster Session: 1st Place Winner
Presented by: Marsha Meyer, PharmD, BCGP, [email protected]*
*Dr. Meyer is the team’s corresponding author (See full list below).
 

Background: Medications play a key role for frail seniors in community or post-acute settings. Yet, medication misuse can increase health risks and negatively impact outcomes. The Community Medication Education, Data and Safety (C-MEDS) program was designed to provide brief, in-depth, at-home customized medication safety interventions for seniors and family caregivers. Key goals of the C-MEDS program include: (1) reducing medication-related problems, (2) increasing self-efficacy in medication management, (3) improving communication and coordination of care between the patient and caregiver and the health care system and (4) improving medication adherence. It is a pharmacist-directed program, utilizing a team of geriatrics experts.

The C-MEDS program was developed and implemented by Independence at Home, a community benefit of SCAN Health Plan. It was implemented as a pilot program in 2017 for adults age 55 and older living in Los Angeles or Orange County, California. The program is no longer in the pilot phase and has served more than 130 participants to-date. Preliminary evaluation confirmed the effectiveness of the program in reducing medication-related problems for older adults in at-home settings.

Methods: Data are collected at program enrollment, during the intervention phase and at program completion (approximately four months). Validated assessment tools are utilized, as well as direct observation. Final outcomes measures will be reported as part of the comprehensive evaluation. These will include the number of medication problems/barriers at program start/completion; efficacy in medication knowledge and administration as measured by the MUSE risk for medication adherence (via the MedAdhIR), observed pill counts and client satisfaction with the program.  

Results: Preliminary program outcomes indicate a reduction in the number of medication problems and an increase in medication knowledge and adherence among program participants, as well as improvements in medication system management. Despite relatively high rates of healthcare use, this sample (n= 104) of community-dwelling older adults demonstrated significant challenges in medication management, with 58 percent reporting some level of problems with medication adherence. Health burden of the average older adult client includes an average of 5.3 chronic medical conditions, challenges with vision and hearing and a median medication adherence rate of 42 percent. Forty-seven percent required the services of a caregiver in medication management to help overcome deficits in health literacy, cognition and numeracy.

Conclusion: Early indications are that the C-MEDS medication safety program improves medication safety and ongoing medication management for frail and other community dwelling seniors.

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Authors:
Romilla Batra, MD, MBA, [email protected]
Susan Enguidanos, PhD, MPH, [email protected]
Denise Likar, MSW, [email protected]
Marsha Meyer, PharmD, BCGP, [email protected]