Senior Care Pharmacist最新文献

Background: Cholinesterase (ChE) inhibitors enhance central cholinergic function and are considered as standard treatments to ameliorate symptoms relating to Alzheimer's disease. Though anticholinergic medications directly antagonize the effects of ChE inhibitors, they are commonly prescribed among hospitalized adults. Objective: To determine the impact of high anticholinergic burden (ACB) on length of stay (LOS) and 30-day readmission rates among hospitalized patients receiving concomitant ChE inhibitors. Methods: This was a retrospective cohort study conducted at a tertiary care academic medical center involving hospitalized patients on medical floors who received any Food and Drug Administration-approved ChE inhibitors during their hospital stay from October 1, 2022, to September 30, 2023. The primary outcome of the study was to compare hospital LOS among patients with high (ACB ≥ 3) versus low (ACB < 3) ACB. The secondary outcome was to assess the impact of ACB burden on 30-day readmission rates. Results: Among hospitalized adults, patients with high ACB exposure had a significantly longer hospital LOS (median: 5.50 vs 4.25 days; P < 0.001) than patients with low ACB exposure, after adjusting for covariates. Analysis of secondary outcome revealed that though the high ACB group had a higher 30-day readmission rate compared with the lower ACB group (6.8% vs. 2.2%), the difference was not statistically significant (OR = 3.46, 95% CI 0.85-14.08; P = 0.083). Conclusion: A high ACB exposure among older individuals taking concurrent ChE inhibitors is associated with a longer hospital stay.

While there is existing literature on medical ethics and geriatric care, this paper offers a unique perspective by examining the specific ethical challenges and obligations faced by pharmacists caring for older people. It provides a comprehensive ethical framework tailored to this specialized area of pharmacy practice. The findings and recommendations presented in this paper have significant implications for enhancing patient-centered, ethically grounded care for older people in pharmacy settings. It offers practical guidance for navigating complex ethical dilemmas and upholding the highest standards of care for this vulnerable population.

Health care providers, at some point in their careers, will experience grief and loss of a patient. Grief is a natural response that many people experience, especially working in those fields such as community pharmacy, hospitals, hospice, and others. Pharmacists serve as community leaders and need to be properly trained early on how to deal with grief and loss both personally and within their teams. Pharmacist leaders can lead their team through hard times by developing a toolbox of skills. These skills include emotional intelligence, communication, and leadership skills to work through personal grief.

Pharmacists are ideally situated and trained to educate and advocate for the proper use of inhaled medications among patients in the community. Proper inhaler technique is an important way to prevent exacerbations and manage the symptoms associated with chronic pulmonary diseases. The American Lung Association estimates almost 6 million people 65 years of age or older had a diagnosis of chronic obstructive pulmonary disease (COPD) in 2020 in the United States. However, published reports have found that less than 20% of older people with COPD use inhalers correctly. As inhalers are the primary route of administration for medications used to treat chronic airway diseases such as COPD, pharmacist-led education can help overcome the widespread lack of knowledge regarding proper inhaler use.

Background: Additional evidence is required to address the unintended consequences of medication use in older people and the required caregiver support. To inform priorities for future research efforts, different stakeholder perspectives are needed, including those of older people, caregivers, clinicians, and researchers. Objective: To develop a co-designed medication-related research agenda. Methods: A 12-member Advisory Council, half of which were older people and caregivers, designed the research. An 11-question survey to identify priorities for medication-related patient-centered outcomes research (PCOR) topics was administered to members of the Elder Care Medicine Network (ECMN) (ie, older people, caregivers, clinicians, and researchers). Respondents were categorized into two groups with hierarchical assignment to the clinician/research group over the older adult/caregiver group. Chi-square tests compared priority areas for medication-related PCOR between the two groups. Results: There were 53 responses (48% response rate) from the ECMN, with 39.6% (n = 21) from the clinician/researcher group and 60.4% (n = 32) from the older adult/caregiver group. The priority areas from both groups included safe ways to simplify medicines (62.2%), communicating with pharmacists and prescribers about medications (58.5%), and information about safe supplements with prescription medications (52.8%). Statistically significant differences existed between the two groups in the proportions choosing the priority areas. Conclusion: Co-design of a survey to identify priority areas for PCOR demonstrated successful engagement of older people and caregivers as research partners. While older people and caregivers may have differing perspectives on the importance of specific medication-related PCOR topics, simplifying medication regimen and health care communications were germane to both groups.

President for the 2024-2025 year, Marsha Meyer sat down with ASCP's Director of Publications, Eleanor Smith, for an in-depth look at her career, her leadership style, and her plans for the association.