Everyone working to improve care transitions for older adults knows that we need better strategies for helping them—and their caregivers—to manage medications. Frail older adults live with so many conditions, and take so many prescription and over-the-counter medications, that understanding their treatment regimen, much less following it, is a real challenge. Organizations around the country are trying various interventions to improve medication management and reconciliation. Among them is HomeMeds, an evidence-based medication management system anchored by the California-based Partners in Care Foundation (Partners).
In a recent phone call with Partners founder and president, June Simmons, MediCaring learned more about HomeMeds, and how it has successfully addressed this critical patient safety issue. Simmons explained that the program relies on the insights and expertise of social workers who are assigned to coordinate care for community-dwelling elders. By going to the patient’s home, social workers can gather information otherwise missed and address issues that arise because of language or cultural differences, or cognitive problems.
“Social workers can gather data and contribute information. When they go out to the home, they do a full assessment of the patient, both medical and nonmedical. They report on particular problems, such as changes in blood pressure or other vital signs, falls, increased confusion, that might coincide with medications.”
This information is entered into an electronic record, which launches an alert if problems are indicated. After a follow-up call to verify that the patient is, in fact, taking the problem medication, the project’s consultant pharmacist reviews the patient’s information to develop a plan of care. If a change in prescribing is indicated, the pharmacist sends the comprehensive medication assessment and recommendations to the patient’s physician. The pharmacist tracks the status of the report, and notes any changes in medication in the record.
The goal of the program is to keep patients out of the nursing home and, as Simmons says, “Take the right medications, and take them the right way.”
Over 40 sites around the country have adopted HomeMeds, and are using it in diverse settings, including post-hospital care transitions programs, physician groups, area agencies on aging, an Indian tribal community, assisted living, homecare, home-delivered meals, and Medicaid waiver programs. In a YouTube video about the work, Simmons describes her hope that this intervention will become a routine part of improving public health, “like putting fluoride in the water.”
Those interested in learning more about the program can read detailed studies at www.homemeds.org. A four-minute video is available at: http://www.youtube.com/user/ithealthcare. And more information is available by contacting Sandy Atkins at [email protected].
key words: medication management, medication reconciliation, geriatrics, social workers, Partners in Care