In their blogpost on AcademyHealth, Shannon Brownlee and Judith Garber of AcademyHealth organizational affiliate, Lown Institute, highlight key recommendations to eliminate medication overload in older adults.
“Every day, 750 older Americans are hospitalized for a serious adverse drug event. While prescription drugs have improved the lives of individuals around the world, increasing use of multiple medications at the same time have put millions of older Americans at risk for adverse drug events. In 2018, people over age 65 sought medical care at a clinic or emergency room 5 million times for an adverse drug event, and were hospitalized 280,000 times. In a 2019 Lown Institute report, we estimated that if nothing is done, there will be 4.6 million hospitalizations and 150,000 preventable deaths among older Americans over the next decade.
Patients and clinicians need designated time to review all the drugs a patient is taking, and discuss which can be stopped, or deprescribed, or reduced in dose. Patients who feel overwhelmed by their medication burden should be able to request a prescription checkup — a medication review with a focus on deprescribing.
The following policy changes would help facilitate prescription checkups and appropriate deprescribing:
Create avenues for clinician reimbursement for prescription checkups, such as allowing primary care clinicians to “bundle” a prescription checkup with the annual Medicare Wellness Visit.
Allow Medicare to recognize pharmacists as health providers so they can be incorporated into the care team and paid for their clinical services.
Encourage development of value-based payment models that reward clinicians for reducing adverse drug events in older patients, to incentivize preventive prescription checkups.
Establish a centralized list of every patient’s medications, or improve the usability and accuracy of electronic health records and make them interoperable across health systems, to ease the creation of a comprehensive medication list for patients.”
As much as we agree with the requirements for appropriate reimbursement and empowerment of the professionals, you can imagine that we at MUUTAA take a special interest in the last recommendation on the list. The logic has been established, the data is available, the urgent need is to embrace and deploy the technological advancements. We can tell you how.