Emerging Medication Management Trends in Long-Term Care

When you think of medication management, particularly as a pharmacist or clinician, you tend to immediately think about the literal, and more clinical aspects of it, including ordered medications being appropriate for their medical conditions, optimal dosing to provide the most benefit while minimizing adverse effects, and adherence to the medication regimen. When you consider medication management that must occur in a long-term care (LTC) setting, where community staff are caring for sometimes hundreds of individuals, it becomes much more complex and therefore, leveraging data and technologies that allow care staff to focus on those clinical aspects related to the individual can significantly improve resident care, enhance clinical outcomes, and reduce the risk for adverse drug events.

Adverse drug events have led to 3.5 million doctor’s office visits, 1 million emergency room visits and 125,000 hospital admissions annually—yet nearly half of these events are preventable.

Systems to improve safe use of medications can be as simple as the way medications are dispensed. LTC pharmacies are acutely aware of the burdens of medication administration in this setting and utilize ground-breaking automation technologies to provide consistency and accuracy. Guardian pharmacies have invested in specialized automation that allows for dispensing of medications in easy-to-handle unit-dose or multi-dose packaging, with barcoding technology to ensure that the correct medication is administered to the right resident at the right time.

In the last decade, there have been huge strides made in the technology available and used in LTC settings, including electronic health records, electronic medication administration records, and HIPAA- secure direct messaging. Many of these technologies integrate between the pharmacy and the LTC community, allowing LTC staff to request refills of medications, view electronic prescriptions, track the flow of a new order through the pharmacy system, and improve efficiency as well as the accuracy of orders on the MARs. This is particularly beneficial where staffing challenges exist or when the end user is non-clinical staff. While many of these technologies were available prior to 2020 and the COVID pandemic, LTC facilities were thrust into maximizing the technologies available to them since then due to the restrictions imposed during that time.

Looking to the Future

As we move into the future, where many LTC residents are enrolled in Medicare Advantage plans and metrics such as hospitalizations, emergency department visits, lengths of stay, and medication adherence drive reimbursement, it will be imperative to collaborate with all interested parties including the community staff, the resident and/or their family, the providers, therapy, the pharmacy and the payors. At Guardian, the clinical team and the data analytics team work together closely to develop clinical initiatives and programs that are data-driven and designed to integrate as seamlessly as possible with both our pharmacies’ and communities’ existing processes. An example of this is the Clinical Intervention program, part of our GuardianShield^TM suite of services, that we implemented a couple of years ago that captures the medication therapy issues intercepted by our pharmacists prior to dispensing an ordered medication. This program is dedicated to resident safety and improving health outcomes and is designed to be proactive and preventative rather than reactive.

I’d be remiss not to mention other evolving technologies like A.I. and its potential role in the LTC environment when discussing promising trends in med management. If used responsibly with an understanding of its limitations and in conjunction with the knowledge of a clinician, I believe there is opportunity for incorporating A.I. modeling to aid in clinical decision making. It will be very interesting to see how this develops in healthcare generally in the coming years.

While great strides have been made, there is still work to do. There is still much room for improvement in data accessibility. While keeping healthcare data secure is a top priority, all parties involved in a person’s care should have access to the same data.

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