Senior Care Pharmacist最新文献

Delirium is common among older adults in post-acute care and often goes unrecognized, particularly when presenting with hypoactive or mixed features. This case example describes an 85-year-old man admitted to an inpatient rehabilitation facility after hip fracture repair who developed acute confusion, inattention, fluctuating consciousness, and functional decline five days into his stay. Guided by the Age-Friendly 4Ms framework, the interdisciplinary team addressed underlying causes. Within one week, the patient demonstrated substantial improvement. This case highlights the critical role of early recognition, interdisciplinary collaboration, and evidence-based pharmacologic and nonpharmacologic interventions in managing delirium, emphasizing how the 4Ms of Age-Friendly care can optimize recovery and support a return to baseline function in older adults.

Background Almost 900,000 patients in the United States living with chronic obstructive pulmonary disease (COPD) require home health care each year. Pharmacists are integral members of the home health care team, especially for older adults living with COPD, because of their expertise in identifying and resolving medication therapy problems (MTPs) during transitions of care. Objective To identify, characterize, and compare the quantities and categories of MTPs in older adults living with COPD who require home health care following hospital discharge. Methods This cross-sectional study involved adults aged 65 years and older living with COPD who were discharged from an academic medical center between June 1, 2023, and November 30, 2023. MTPs were classified using two frameworks: the American Society of Health-System Pharmacists (ASHP) and the Pharmacy Quality Alliance (PQA). Results During the study period, 535 older adults were prescribed home health care, 15 of whom had a hospitalization discharge diagnosis of COPD and were screened for inclusion. Among the 13 patients eligible for inclusion, 92.3% experienced one or more MTPs. Almost 80% of the identified MTPs involved issues related to medication indication: 50% of this cross-sectional cohort were not prescribed medications when clinically indicated, and up to 40% of patients were prescribed medications without apparent indications. The ASHP framework identified more than twice the number of MTPs compared to the PQA framework. Conclusion The ASHP framework may identify more MTPs than the PQA framework in older adults living with COPD who require home health care upon discharge. Further research evaluating pharmacist interventions related to MTPs would be beneficial across diverse settings and patient populations.

With the increasing prevalence of polypharmacy, age-related physiological changes, and the need for individualized pharmacotherapy in older patients, understanding new drug approvals is crucial to optimizing medication management. This review synthesizes the latest evidence on recently approved medications including Atzumi™ and Brekiya® (dihydroergotamine mesylate) for migraine headaches, Attruby™ (acoramidis) for transthyretin amyloid cardiomyopathy, and Blujepa® (gepotidacin) for uncomplicated urinary tract infections. Insights are offered into prescribing considerations for these agents in older populations, potential drug-drug interactions, and administration and handling tips. This work will be of significant interest to health care professionals as they evaluate the appropriateness of these new therapeutic options.

In this case study, an interdisciplinary team of clinicians, including a clinical pharmacist, cardiologist, and physical therapist, presents an approach to assessing, mitigating, and engaging in shared decision-making for fall risk reduction in an older adult through lifestyle modifications, physical activity, and medication regimen adjustments. This case explores a frequently encountered clinical dilemma: balancing the safe use of oral anticoagulants for stroke prevention in atrial fibrillation (AF) with the risks associated with recurrent falls-an area where shared decision-making is crucial. It also highlights the value of an interdisciplinary team utilizing the Age-Friendly Health Systems 4Ms framework, which focuses on aligning care with what matters most to the older adult.