by PGx Medical | Oct 19, 2016 | Aging Services
Getting through the transitions in life…
Help ease the transition for your loved one by being educated on the tools and resources that can help them live a long, healthy life!
When you are young, you dream of growing up, getting married and having children….but you never dream about taking care of your elderly parents. That isn’t part of the ten year plan. But things happen, life happens, and it is inevitable, we all get older and some of us will require a caregiver to take care of us as we age.
Those who work in eldercare understand and interact with caregivers on a day-to-day basis. Some are part of the “sandwich generation” who are caring for kids, grandkids and parents all at the same time. As you can imagine, this lifestyle can wear you down and take a toll on the caregivers health.
Becoming a caregiver for someone you love sometimes comes sudden due to an illness or accident. When that time comes, will you be prepared? There is no handbook, or step-by-step instructions on what to do, how to do it – or if you are even doing it correctly. You step in and do what you consider the best you can do. But so many choices.
One problem with elderly adults is the amount of medications they are taking. Some go from doctor to doctor, with a different diagnosis each time, and a whole new stack of prescriptions. Some even jump around to different pharmacies making it difficult for any clinical caregiver to keep track. This is dangerous.
Polypharmacy (the use of four or more medications by a patient, generally adults aged over 65 years) can cause falls and a whole host of other problems. Not to mention, do you even know if the medications they are taking are giving them therapy? Are they experiencing one reaction after another because their medications are interacting with each other? How would you know?
At PGx Medical, we have a sayIng, “You don’t know, what you don’t know.” Even a physician or pharmacist can’t predict how your body will respond to certain medications. So how would you know?
According to the AACP, polypharmacy has a high price tag. The economic impact of medication-related problems is estimated at $177.4 billion per year, rivaling that of Alzheimer’s disease, cancer, diabetes and heart disease. Plus adverse effects brought on by the combination of multiple drugs are thought to be responsible for nearly a third of all hospital admissions. Each year 32,000 seniors suffer hip fractures caused by medication-related problems. Its simple: They are overmedicated, feel dizzy when they stand up, and fall. Or worse, get behind the wheel of a car.
Now there is a simple test, pharmacogenetics, that can help guide healthcare professionals when dosing medications. Pharmacogenetics aligns current and future medications with each persons unique genetic profile. In other words, it will tell your physician what medications your body can metabolize, which medications might need a dosage change, and which medications are interacting…all personalized for each individual. Right drug, right dose, for the right person.
So why aren’t more healthcare professionals using pharmacogenetics in their day-to-day patient care? That is a good question. Some say it is because it is too new. Pharmacogenetics has been around for decades. And along the way, the FDA has added pharmacogenetic information (black box warnings) on certain medications suggesting a pharmacogenetic test be done prior to prescribing the medications.
We also hear from clinical caregivers that these tests are draining medicare dollars. Yes, this once in a lifetime test is fully reimbursed by Medicare, but this is based on cost savings. In fact, performing a pharmacogenetic test on elderly patients who are on multiple medications can save medicare dollars. Think about it…if you reduce a patients medications to “only” the ones that the pharmacogenetic report says they can metabolize and should give them therapy, you are saving money on unnecessary medications, and you are helping prevent future falls or re-hospitalization due to drug-on-drug interactions.
According to the CDC, in 2015, costs for falls to Medicare alone totaled over $31 billion. Medications play a big role in falls in elderly patients.
The more educated healthcare professionals are on pharmacogenetics, the more they understand the value and impact it can have on improving the quality of care in elderly adults. Our most fragile patients who are dependent on us to make sure we provide them the best care possible. All of this starts with the caregiver. Whether you are a family member, friend, or POA for an elderly adult, check into pharmacogenetics and other available tools and resources that can help provide a longer, healthier life – and make your job as caregiver a lot easier.
For more information on pharmacogenetics, contact PGx Medical, info@pgxmed.com or 405-509-5112
source: cdc.gov, AACP.com
by PGx Medical | Sep 21, 2016 | Uncategorized
More than half of nursing facility residents have some form of dementia, many of whom experience behavioral and psychological symptoms associated with dementia (BPSD).
How will you be proactive and jump out ahead of New Quality Measures?
According to an online article from the American Society of Consultant Pharmacists, over 25% of patients in nursing facilities in the United States receive antipsychotic medications. These drugs have many legitimate uses including treatment for psychotic disorders such as schizophrenia, psychotic symptoms such as delusions and hallucinations, and BPSD in certain situations. However, they are often used inappropriately in nursing facilities to treat BPSD (behavioral and psychotic symptoms of dementia), and evidence documenting their clinical efficacy for BPSD is variable.(1)
In elderly residents who have dementia, antipsychotics are only appropriate in a small number of instances. Yet, despite the Food and Drug Administration’s warnings of increased mortality, the use of antipsychotics as a chemical restraint in nursing home residents who have dementia still persists. Significant morbidity – including higher blood sugar and cholesterol levels, weight gain, increased risk of falls, and decreased cognition – also are associated with the use of antipsychotics. These complications can lead to or cause a worsening of other primary diagnoses known to affect older adults.(2)
CMS plans to monitor the reduction of antipsychotics, as well as the possible consequences, review the cases of residents whose antipsychotics are withdrawn to make sure they don’t suffer an unnecessary decline and add the antipsychotic measure to the calculations that CMS makes for each nursing home’s rating on the agency’s Five Star Quality Rating System.
Coming in 2017 and beyond:
Avoiding potentially inappropriate medications in older adults remains important for quality of care for Medicare beneficiaries, according to CMS, Centers for Medicare and Medicaid. (3) Medications will continue to be at the forefront when it comes to star quality measures.
So what are you doing to be proactive? Are you implementing programs to help stay ahead of the game? Pharmacogenetic testing is a fully reimbursed diagnostic test that is easy to implement and gives you scientific-based evidence on how each individual person receives therapy from the medication they are taking today, and a roadmap for medications in the future.
At PGx Medical our consultants travel around the country educating and implementing pharmacogenetics into aging services communities. Our team stays up-to-date on CMS guidelines, the best labs and services that offer your community the most detailed information your clinical staff needs to make informed therapeutic decisions.
Beginning October, 1, 2016, PGx Medical is accepting a select number of nursing and assisted living facilities across the country to be part of their PILOT PROGRAM. Our team will educate your team on this no-cost program, and work alongside you to implement results. Pharmacogenetic testing is a great way to reduce unnecessary medications and can be added as part of your admissions process for all new residents with medical necessity.
For more information about the PILOT PROGRAM, or to request information on pharmacogenetic testing, contact us at: info@pgxmed.com or 405-509-5112.
Source: (1) ascp.com, (2) dads.state.tx.us, (3) cms.gov
by brant bullard | Aug 8, 2016 | News
Pharmacogenomics can play an important role in identifying responders and non-responders to medications, avoiding adverse events, and optimizing drug dose. Drug labeling may contain information on genomic biomarkers and can describe:
- Drug exposure and clinical response variability
- Risk for adverse drug events
- Genotype-specific dosing
- Mechanisms of drug action
- Polymorphic drug target and disposition genes
The table below lists FDA-approved drugs with pharmacogenomic information in their labeling. The labeling for some, but not all, of the products includes specific actions to be taken based on the biomarker information. Pharmacogenomic information can appear in different sections of the labeling depending on the actions. For more information, please refer to the appropriate labeling guidance.
Biomarkers in the table include but are not limited to germ-line or somatic gene variants, functional deficiencies, expression changes, and chromosomal abnormalities; selected protein biomarkers that are used to select patients for treatment are also included.
This table does not include non-human genetic biomarkers (e.g., microbial variants that influence sensitivity to antibiotics), or biomarkers that are used solely for diagnostic purposes (e.g., for genetic diseases) unless they are linked to drug activity or used to identify a specific subset in whom prescribing information differs. For drugs that are available in multiple dosage forms, salts, or combinations, a single representative product is listed. In the case of combination products, the single agent associated with the biomarker is listed unless the agent is only approved as a combination product, in which case all agents are listed. ~FDA
See complete list of drugs at: FDA.com
For more information on pharmacogenetic testing, contact:
PGx Medical
info@pgxmed.com
405-509-5112
by brant bullard | Jul 6, 2016 | News
There is a high percentage of patients for whom drugs are ineffectiveIn October 2013, the Food and Drug Administration cited a study on the percentages of patients for whom drugs are ineffective. The study explained that some of that ineffectiveness could be attributed to errors in dosing, drug-interactions, or non-compliance, researchers estimated that up to 50 percent of those inappropriate responses were likely related to genetic factors.
- Depression 38%
- Asthma 40%
- Cardiac Arrhythmias 40%
- Diabetes 43%
- Migraine 48%
- Arthritis 50%
- Osteoporosis 52%
- Alzheimer’s 70%
- Cancer 75%
Source: genomemag.com, fda.gov
by brant bullard | Jul 4, 2016 | Journal articles
As many as 10 percent of people do not receive pain relief from opioids.
The pain was too intense to ignore. Sixteen years later, Tony Cirrincione still remembers it. He was on a weekend ski trip, and he staggered into the ski lodge, leaving his wife in charge of their son and the five other Cub Scouts they’d brought along. Wincing at the dull ache in his back, he tried to stretch away what had to a muscle cramp. But the bursts of pain grew only more intense, erupting at more frequent intervals. Soon he was in the emergency room in Chicago. Kidney stones that had him doubled over the triage station. Waiting for the prescription opioid Dilaudid (hydromorphone) to take hold. But it never did.
According to Genome Magazine, as many as 10 percent of people do not receive pain relief from opioids. That’s a staggering statistic in a country where more than 75 million people live with chronic pain. Many individuals, like Cirrincione, who don’t respond to certain prescription pain relievers have no idea why. But a type of genetic testing is bringing answers to a growing number of them. (more…)
