Medication Safety: A New Program with Pathlights
September 29, 2022
When Barbara was due home following a hospital stay, doctors advised someone check in on her. She chose Pathlights, her local Care Coordination Unit, to fill that role. “They care about you,” she says.
Barbara, 82, takes more than 15 pharmaceuticals to manage her medical conditions. Still, it’s a precarious situation to be in. A lengthy list of pharmaceuticals prescribed by different doctors may result in bad interactions between drugs, improper dosages and side-effects like dizziness and confusion that can lead to falls—all alarms signaling it’s time to reexamine your medications.
The care coordinator who visited Barbara at her Chicago Ridge home suggested she participate in HomeMeds, a new, free program offered by Pathlights that enlists a pharmacist to review your medications and suggest any necessary changes. Pathlights partners with Coordinated Care Alliance (CCA) and AgeOptions to implement the evidence-based HomeMeds program which completes a risk assessment and an alert process that reduces medication-related problems.
“We make sure the medications that they are taking, are taken safely,” says Maureen Mott, care coordinator at Pathlights. “HomeMeds is designed to address medication safety and quality of life issues by screening for and resolving potential medication problems.”
You don’t have to be a client or receiving services from Pathlights to participate in the program. What’s more, patients can have their medications reviewed by a pharmacist as often as they like.
Here’s how it works
A Pathlights’ care coordinator does a brief assessment with the patient in person or over the telephone, to find out their current disease state, symptoms and medications. They also obtain permission to receive the patient’s health history and contact their doctor, if needed. From there, a pharmacist reviews the information, determines if there is any correlation between the medications and symptoms they are experiencing, and puts it all in a report. To keep it simple, Pathlights summarizes the pharmacist’s findings and recommendations in a letter mailed to the patient, along with educational materials about their conditions.
“We’re not taking over as the participant’s healthcare provider, because they know more about their patient than we do,” says Preston Hall, PharmD of Pharm United LLC in Fort Worth, Texas and Pathlights’ partner in HomeMeds. “We’re facilitating communication between the patient and their healthcare provider.”
Hall explains that, during appointments, when the physician asks, “Do you have any questions for me?” the patient participating in the HomeMeds program will have more insight into their disease state and medications. They can ask the right questions. They will understand why they are taking certain medications. If they suffer side effects, the pharmacist will suggest alternative drugs to help eliminate those problems. Sometimes the culprit is dosage, particularly with maintenance drugs. Patients don’t realize a dosage that was appropriate in middle age is causing dizziness and confusion in older adulthood and requires modification.
Duplicate drugs that need to disappear from the patient’s regime, as well as gaps in treatment can also show up on the assessment.
“You can really get a good glimpse of what is going on with the patient: Seeing how the actual person is taking the medication, figuring out if it’s appropriate or not, finding out why they are not taking it as prescribed on the bottle or asking them if they know why they’re taking it,” Hall says.
A big red flag is when a patient reports conditions or disease states, but the pharmacist doesn’t see a medication or treatment for it. “We can tell the doctor that the patient is reporting they have this condition but they’re not taking any medications for it,” Hall explains. “It could be a surprise to that healthcare provider. They could say, ‘No. We have them on this medication’ and for some reason, the patient didn’t pick up the prescription or never knew there was a prescription for it.”
If there’s an urgency, Hall will call the doctor directly, so they can follow up with the patient right away. Otherwise, the patient waits for their next appointment to discuss the pharmacist’s findings.
Barbara’s doctors updated her medications based on feedback from HomeMeds. Even though she continues to take the same number of drugs, she has no complaints. She feels fine.