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Drive to Deprescribe – Opportunity to Optimize Medication Use in Post-Acute and Long-Term Care

The Society for Post-Acute and Long-Term Care Medicine’s Drive to Deprescribe program is available to facilities and provides both professional development and evidence-based clinical guidance focused on polypharmacy and inappropriate medication.

Facilities can enroll and commit to the goal of “25% reduction of medication use while optimizing the medication regimen (in long-stay patients),” but enrollment isn’t required to access the archived meetings and tools.

Meetings are scheduled for 45 minutes on the third Thursday of the month beginning at 2:30 p.m. MT/1:30 p.m. PT. Monthly content alternates between evidence-based clinical guidance on optimizing use of a specific class of medications and participating centers sharing their experiences with optimizing medication regimens for their long-stay residents.

Past clinical evidence-based guidance topics include:

  • Optimizing the use of antipsychotics and antidementia drugs
  • Optimizing and deprescribing benzodiazepines and other anxiolytics
  • Optimizing the use of anticholinergics to decrease anticholinergic burden
  • Optimizing the use of antihyperglycemics

Centers sharing their successes highlight strategies used to optimize medication regimens for residents despite clinical and leadership staffing shortages that have resulted in fewer medications prescribed to residents and shorter medication pass times for nurses. During the March 17 Sharing Strategies, Successes and Secrets call, one participating center shared successes in optimizing medication regimens for their residents by engaging services of a hospice nurse and a consultant pharmacist.

By making small changes in their practices to review medications, they reported a reduction from spring 2021 through February 2022 in the residents prescribed:

  • Sliding scale insulin (from 9 percent to 2 percent)
  • Anticholinergics (from 33 percent to seven percent)
  • Benzodiazepines (from 23 percent to seven percent)

Benefits to optimizing medication regimens for residents include decreased risks for adverse events such as falls and fractures, improved cognition, potentially fewer cardiovascular and hypoglycemic events, vital organ impairment and decreased risk for mortality.

For the center, optimizing medication regimens demonstrates to surveyors a systematic approach to pharmacy services (§483.45) decreasing the risk for citation. This practice may also free up nursing time for other care activities because of fewer medications and fewer adverse events (i.e., falls and hospital transfers), and lower the overall cost for medication.

Society for Post-Acute and Long-Term Care Medicine, also known as the American Medical Directors Association – AMDA, is dedicated to defining and improving quality for members, patients, families and staff in centers across America.

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