Personal Care in Danvers, Massachusetts

Medication Management Program

30% of all hospital admissions for seniors are directly attributable to missed or overdoses of medications.

Our medication program aims to give our patients maximum therapeutic value from their medications by addressing barriers to compliance. We seek to understand the challenges facing each patient and work with their doctor, case managers, and caregivers to create a plan that eliminates or works around these challenges.

A Program for Everyone

Our Medication Program is not just for people going home following hospital stay—it is for anyone who requires help with their medication. Physicians can make a referral for any of their patients who are having problems with compliance. This may include:

• Patients on new medications—we educate on managing side effects as well as monitoring of vital signs and other body systems.
• Seniors with a lot of medications who need help with teaching or filling pill-boxes.
• Patients taking injectable meds (e.g. insulin) and cannot safely inject themselves. We can do teaching and/or administer the medication as needed.
• Patients at high risk of overdose (e.g. due to Psychiatric condition) —we can provide a lockbox and administer the medication as needed.
• Patients with reduced mental function – we also offer a lockbox and daily or as needed administration.

Comprehensive Intake Process

Our intake process is comprehensive and involves key important steps:

Inventory of all medications We take stock of all patient’s active and inactive medications. This may include medications the patient has not refilled but is supposed to be taking. We also include over-the-counter medications. We consult with the patient’s primary doctor as well as specialists to get a comprehensive list of all medications.

Perform a Drug Interaction Duplicate Assessment

We use our software to assess the interactions of the meds. This may be drug to drug interaction. We note the interactions and discuss with the physician to make necessary adjustments. We also perform a duplicate therapy assessment to make sure the patient is not using multiple meds for the same problem. Finally, we assess the patient’s diet and herbal supplements to see if there are any known interactions (e.g. alcohol) with the patient’s medications.

Reconcile Medications with Physician

We confer with the patient’s PCP to make sure our findings are consistent with their records. We reconcile the differences accordingly. This may involve getting new orders, getting a prescription filled, or discontinuing certain medications.

Assess, Teach, Monitor, and Adjust

With a complete record of the patient’s medications, we can finally make a care plan that takes into account all the factors found.

Assess: We take time to assess the patient’s understanding of the meds they are on.

Teach: Based on how well the patients understand their meds, we create a teaching plan that aims to make the patient aware of the purpose of each medication and associated side effects.

Monitor: We monitor and document the patient’s vital signs and adverse effects during each visit.

Adjust: If necessary, we consult with patient PCP to make necessary adjustments to medications. This may involve starting a new medication; discontinue the existing one, dosage/frequency/route adjustment.

The Care Process

Weekly, Daily, or BID Nurse visits

Our medication Management Program includes visits to the patient at their residence. During each visit, we monitor the patient’s vital signs and administer the medication as needed. We do phone follow-up with patients between visits as needed to ensure patient safety and compliance. During the visit, we also

• Organize and setup medication planners
• Daily Medication reminders
• Inventory of Medications, including re-ordering

Confer with Physicians

We keep physicians informed throughout the treatment period about the patient’s condition. We notify the doctor when we believe an intervention is necessary. This may include:

• Adjust dosage/strength
• Add/Remove medications
• Prescription Refilling

Teaching

We provide teaching to patients and/or their families on various aspects of the medications they are on. Our teaching covers several topics but is customized to each patient’s needs. These topics include:

• Side effects (how to identify and cope and when to call the doctor)
• Safety of medication including risks of falls
• Food-drug or drug-alcohol interactions
• Drug/drug interactions

Lockbox Management

We provide a lockbox for patients who are unable to administer their own medications or who pose a risk of overdose. A lockable box can be placed in the patient’s house or place of residence. We also use a lockbox for certain controlled medications to comply with DEA and ensure compliance.

PT/INR Management

For patients who require International Normalized Ratio (INR) monitoring at home, our nurses can perform the test at home easily and reliably. Monitoring can be done as frequently as requested by the doctor to keep the patient’s INR within a safe range. This is convenient for patients as there is no need to travel to the clinic for testing.

Flexible Visit Times

We offer flexible visit times to our patients so they can maintain compliance with their medication regimen. Our nurses can do early morning (from 6 am) or late evening (until 9 pm). For patients in group homes or congregate houses, we can coordinate the visit times to take into account meal times or other activities.

Facts about Medications (According to CDC, updated 2012)

Did you know?

• Drug-related mortality for seniors costs the country $120 billion each year.
• Adverse drug events cause 7,000 deaths per year.
• 40% of patients enter nursing homes because they can’t self-medicate at home.
• 33% of adverse drug events are preventable.
• 30% of all hospital admissions for seniors are directly attributable to missed or overdoses of medication.
• 21% of all drug-related health complications are caused by patients failing to adhere to their medication regimens.
• An average number of medications a senior is on 8-15 medications.