Navigating New Frontiers: The Expanding Role of Pharmacists in the Aging I/DD Population

Thanks to advances in healthcare and community support, individuals with intellectual and developmental disabilities (I/DD) are experiencing unprecedented longevity. This demographic shift presents a unique set of challenges and opportunities for community providers who support these individuals, especially when it comes to medical management. Among these, the role of the pharmacist in ensuring safe, effective, and tailored medication regimens for aging-related conditions has become increasingly critical to the delivery of quality care in the I/DD population.

We sat down with two industry experts for a deep dive into the impact of aging on the I/DD population. Kyle Simmons, Co-President of Boomer Solutions – A Guardian Pharmacy, is an experienced senior care pharmacist with a long history of service to the disabled community. Michelle Mincks, LNHA is a director of sales for Guardian Pharmacy of the Heartland and a former community owner and operator. Together, they discussed the evolving role of the long-term care (LTC) pharmacists in ensuring high-quality care for individuals with disabilites.

The Aging I/DD Population: A Closer Look

Between 2008 and 2017, the average age at death rose more for adults living with I/DD, including intellectual disabilities, Down syndrome, and cerebral palsy, than for adults without IDD, according to the Centers for Disease Control and Prevention’s National Vital Statistics System. This increasing longevity of individuals with I/DD stands as a testament to advancements in healthcare accessibility and quality. However, as these individuals age, they are more prone to developing aging-related medical issues such as arthritis, type 2 diabetes, kidney disease, heart disease, and Alzheimer’s disease, along with other dementias. In fact, according to the World Health Organization, individuals with disabilities have twice the risk of developing conditions such as diabetes, depression, obesity, and stroke. Consequently, providers of I/DD community services and their care professionals are frequently encountering complexities associated with aging.

“Increasingly, providers are expressing a need for education on diagnoses and drugs related to medical conditions of older adults, issues that they were less likely to encounter in the past,” Mincks observes. “This shift requires expanded education and training for staff and better support systems—including more collaborative support from ancillary service providers such as therapy, lab, and pharmacy.”

The complexity of managing these chronic conditions is compounded by the pre-existing challenges associated with I/DD, necessitating a nuanced approach to healthcare.

LTC Pharmacies at the Forefront of Personalized Care

With their expertise in medication management, pharmacists are ideally positioned to address the unique needs of the aging I/DD population. In LTC pharmacy, their role extends beyond dispensing medications to include comprehensive medication management. While LTC pharmacies provide systems designed to ensure the safe use of medications, including innovative packaging technologies and integration with the community’s electronic medication records, their pharmacists offer comprehensive medication regimen reviews, chronic disease state management, and personalized consultations. These person-centered services are vital to preventing medication-related problems and optimizing therapeutic outcomes, especially for those with complex health profiles.

Medication adherence is crucial for managing chronic conditions, preventing complications, and facilitating independence. However, individuals with I/DD may face barriers to adherence, including cognitive impairments and difficulties in understanding medication regimens. LTC pharmacies can enhance adherence through individualized education, simplifying medication schedules, and employing adherence aids. Furthermore, they serve as an accessible source of information and support for caregivers.

“LTC pharmacies are more than ancillary service providers to communities that support individuals with disabilities. We serve as protectors and partners, stepping in to bridge the gap for this vulnerable population,” says Simmons. “I/DD service providers can rely on the pharmacist’s expertise to ensure safe medication use and promote medication adherence, which are key to wellness and independence for individuals with disabilities.”

As the I/DD population continues to age, the role of pharmacists will undoubtedly expand and evolve. There is a growing need for specialized training and education in geriatric and I/DD care among pharmacists to better understand and address the unique challenges faced by this population.

“The reliance on a pharmacist’s specialized knowledge is paramount, as is the necessity for comprehensive education on the medical conditions prevalent among the aging population — conditions previously unfamiliar to many providers,” Mincks asserts.

Tackling Polypharmacy and Drug Interactions

Polypharmacy, or the use of multiple medications, is a common issue among the elderly, including those with I/DD. The risk of adverse drug reactions and drug-drug interactions increases with the number of medications prescribed. In this complex landscape, pharmacists play a critical role in managing these risks by leveraging technology to review and optimize medication regimens, ensuring that each medication is necessary, effective, and safe.

“Serving this vulnerable population is emotionally fulfilling,” says Simmons. “When you’re personally driven by what you do, you strive for better, more innovative ways to serve. We’re continually developing and testing new technology that helps promote medication adherence and protect individuals from medication harm.”

For instance, Guardian’s proprietary Clinical Intervention program led to over 10,000 pharmacist-led interventions for duplicate therapy across 43 pharmacy locations last year. Nearly 4,000 drug interactions were identified and addressed, and over 9,000 interventions were made for unusual dosing reflecting a drug dose, duration, or frequency of therapy that was potentially inappropriate for the individual’s age, health status, gender, or other factor. This process often involves deprescribing unnecessary medications and recommending alternatives with fewer side effects or interactions.

“Beyond the analytics, the impact our pharmacists have in humanizing the services and support we provide, not only to the individuals but also to their caregivers, inspires me every day,” adds Simmons.

Collaborating for Comprehensive Care

The effective medical management of the aging I/DD population requires a collaborative approach. LTC pharmacy teams—which include pharmacists, pharmacy technicians, and nurses—serve as an integral extension of the community’s care team. They work closely with physicians and other healthcare professionals to develop and implement comprehensive care plans. They also address complex insurance billing issues and ensure safe medication administration practices within the community. Such collaboration is essential for addressing the multifaceted health needs of individuals with I/DD, ensuring that medication management is seamlessly integrated with their overall care strategies.

Conclusion

The aging of individuals with I/DD presents both challenges and opportunities for providers. LTC pharmacies, and the pharmacists and nurses they employ, are poised to play a pivotal role in this evolving landscape. By embracing a personalized, collaborative approach, pharmacists can ensure that the aging I/DD population receives the care and support they need to live healthy, fulfilling lives. As we look to the future, it is clear that pharmacists will continue to be invaluable allies to providers in the care of this unique and growing population.

“Community providers need the expertise of their LTC pharmacy partners now more than ever,” concluded Mincks. “It is through this collaborative effort that we can ensure a safer, healthier future for individuals with I/DD as they enter their golden years.”

 

For more information on how Guardian partners with I/DD community service providers to improve indepence and quality of life for individuals with disabilites, visit guardianpharmacy.com/idd