by PGx Medical | Dec 19, 2016 | Uncategorized
Between 2000 and 2014, opiate-related overdose deaths in the U.S. increased 200%
Opioid-related hospitalizations and ED visits spike in US. photo courtesy of healthcare dive
The rate of opioid-related hospitalizations and ED visits varied significantly by state, with the highest hospitalization rate occurring in Maryland and the highest rate of ED visits in Massachusetts.
According to an article in Healthcare Dive, Opioid-related hospitalizations and ED visits spike in US.
Between 2005 and 2014, the rate of opioid-related hospital stays increased 64.1% while opioid-related ED visits increased 99.4%.
But not all states were the same. Opioid-related hospitalizations and ED visits varied by state with the highest ED visits being in Massachusetts and the highest hospitalization being in Maryland.
An opioid epidemic was declared in the U.S. by the HHS (U.S. Department of Health & Human Services) this past October due to a marked increase in the misuse of opioids over the past decade. The new statistical brief provides detailed, state-by-state data on overdose deaths, the rate of opioid-related hospitalizations and the rate of opioid-related ED visits. The brief did not differentiate between illegal opioid use, misuse of prescription opioids and compliant use of opioids.
HHS has urged providers to alter their prescribing practices, essentially making opioid medications a last resort. Meanwhile, hospitals and healthcare systems have started their own initiatives to address this national challenge, such as focusing on pain management alternatives or requiring across-the-board reductions in the number of opioid prescriptions.
Pharmacogenetics and Opioids:
Patients with CYP450 pharmacogenetic variations may respond differently to opioids, ranging from drug unresponsiveness to toxicity with elevated serum levels. The administration of opioids may be associated with adverse drug reactions including sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. By performing pharmacogenetic testing, patients can be dosed appropriately to avoid experiencing dose-dependent side effect or lack of drug efficacy.
Results of pharmacogenetic tests allow patients to be dosed appropriately. Pharmacists can play a role in providing information to patients on selecting opioids where genetic testing may be useful. ~medscape.com
For more information on Pharmacogenetic Testing, contact: PGx Medical, info@pgxmed.com or 405-509-5112.
Read entire article at: healthcaredive.com
by PGx Medical | Nov 15, 2016 | Uncategorized
More and more patients are being screened to help cut out ineffective medicine and avoid harmful drug interactions
More patients are taking five or more prescription medications at once, putting them at risk for side effects and drug interactions. Amid concern about the potential harm of taking too many drugs, more doctors are deprescribing, getting patients off prescriptions that are no longer necessary.~WSJ
According to a recent article in the Wall Street Journal, nearly 40% of patients in their 60s take more than five medications.
“What was good for you once might not be as good for you now,” says Cara Tannenbaum, a geriatrician and the scientific director of the Institute of Gender and Health at the Canadian Institutes of Health Research in Montreal. “On a regular basis, patients should be asking their health-care providers, ‘Is this still the right drug for me, and if not, what other drug or nondrug therapies are safer and equally effective?’ ”
Dr. Tannenbaum and pharmacist Barbara Farrell have developed a website, deprescribing.org, which is maintained by the Canadian Deprescribing Network, a group that includes health professionals, policy makers and patient advocates. The site, used by doctors in both the U.S. and Canada, provides information to help patients determine if they should consider stopping certain medications that may be unnecessary or cause harm, including a common medication for heartburn or reflux called a proton pump inhibitor and certain diabetes drugs that increase the risk for low blood sugar.
Medication use can start to pile up in middle age or earlier, especially in patients being treated for diabetes, heart disease or cancer. People may see different doctors who don’t coordinate care with each other. Soon, they are in a situation known as polypharmacy, defined as five or more drugs.
The body processes many drugs less efficiently as it ages, leading to problems with long-term medications. Statins, prescribed to control cholesterol, may not be needed over age 75, and they can cause muscle weakness and increase the risk of falls.
The American Geriatrics Society last year updated its Beers Criteria, a list of 40 medications or classes of drugs that are potentially inappropriate for older adults. An expert panel is working on an update for 2018.
“The goal is to keep patients as healthy as possible on the least number of medications.”
VIDEO: When Patients Take Too Many Pills, Doctors Deprescribe
Pharmacogenetics is a tool used by doctors across the country to provide evidence-based results on how a person metabolizes medications. This simple swab of the cheek is a guide to help clinicians with current medication regimen, as well as a roadmap for future medications.
“Knowing that a medication doesn’t have the ability to give a patient therapy is a great way to deprescribe. You have evidence that person is not receiving therapy because their body does not metabolize that particular drug the way the drug manufacturer intended you to – making it easier to deprescribe, or discontinue that medication,” said Clay Bullard, President of PGx Medical a pharmacogenetic consulting firm headquartered in Edmond, OK.
“We work within the field of aging services across the country educating them on the benefits and value pharmacogenetics brings to not only the patient, but the caregiver and the community when dealing with a nursing home or assisted living facility, Our job is to be experts in the field of pharmacogenetics and then educate and help implement the test in communities, clinics and pharmacies across the U.S.”
Pharmacogenetics is fully reimbursed by Medicare B and in select states, Medicaid. As stated in the WSJ article, by eliminating multiple drugs, you help reduce the chance of falls, drug interactions, and many other clinical concerns.
For more information about pharmacogenetic testing, contact:
PGx Medical
info@pgxmed.com or 405-509-5112
or go to www.pgxmed.com
Read entire article at WSJ.com
More Patients Are Taking More Prescription Medications At Once
by PGx Medical | Nov 9, 2016 | Aging Services
Managing behaviors in individuals suffering from dementia is challenging
When dementia patients get to a stage where they become very agitated, “people are looking for an easy fix.
Historically, antipsychotics have been used in an attempt to address challenging behaviors, but they are now not only in question, but the dangers associated with these medications are coming to light.
As stated on the Medicare.gov website: “Antipsychotic drugs are an important treatment for patients with certain mental health conditions. However, the FDA has warned that antipsychotic medications are associated with an increased risk of death when used in elderly patients with dementia and the medications have side effects.”
In a recent article in Waugh Consulting, LLC, it states, “Professionals are looking at the dangers and working diligently to stop the use of those medications when dealing with elderly individuals suffering from dementia. Knowing the person and using the social aspects of their lives can be successful while lowering or eliminating antipsychotic medications.”
So how do you decrease antypsychotics in dementia care?
Aging services providers across the country are now implementing pharmacogenetics as part of their “medical plan of action” to address this problem.
Pharmacogenetics aligns current and future medications with each persons unique genetic profile. This medication management program, via pharmacogenentic testing, is a simple swab of the cheek that provides clinical caregivers with an individualized report for each resident. The report provides them with evidence-based information on many medication classes, including antipsychotics. While the goal is to eliminate unnecessary medications, pharmacogenetics is also a good starting point to help guide physicians in adjusting dosages based on metabolization, or changing a medication due to a drug-on-drug interaction.
Nothing takes the place of one-on-one care from those who know them best, to be involved in their care. Making sure the resident or loved one is on the proper medications that can give them therapy, makes the caregivers job a little bit easier and helps the resident live a better quality of life.
These personalized reports are also a great tool to show that you are doing everything in your power to help your residents, decrease unnecessary medications, and manage dosages that may not be appropriate for each individual.
For more information on pharmacogenetics and how you can implement it in your senior community, contact: PGx Medical, info@pgxmed.com or 405-509-5112.
**We are presently enrolling provider organizations and communities in a pilot program. For more information on this pharmacogenetics pilot program, contact, Bill Shell at bill@legacymarketservices.com or 952-960-0806, or visit www.LindaShell.com/pharmacogenetics.
by PGx Medical | Nov 3, 2016 | Aging Services
Medicare and Medicaid say antipsychotics are still used too often in nursing home dementia units
When dementia patients get to a stage where they become very agitated, people start looking for an easy fix.
In an article in MedPageToday, Leonard Gelman, MD, CMD, president of the board of directors of the American Medical Directors Association was interviewed on dementia patients and the use of antipsychotics.
When dementia patients get to a stage where they become very agitated, “people are looking for an easy fix. So these medications are used,” even though in many cases they don’t help,” Gelman continued. On the other hand, “the things we know work the best are most difficult logistically, and that is, essentially, having someone be with the patient … all the time.”
“Many people think that most of the medications nursing home patients take have been prescribed by the nursing homes, but that’s not the case, said Gelman. “They get prescribed in the hospital [or by the patient’s primary care physician]. In essence, the nursing home doctors rarely prescribe these things, but we continue them for many different reasons, unfortunately. It’s a merry-go-round that keeps going ’round and ’round but it’s difficult to push the horse off the merry-go-round, because everyone has told the family and the patients they need [the medications].”
Reducing antipsychotics is part of a larger approach on nonpharmacologic treatment for these patients, according to Gelman. “In general, this is one of things we’ve been internally talking about, and also talking with CMS and others,” he said. “There are many instances where medications can be reduced, not just antipsychotics — certainly benzodiazepines, also blood pressure medications and cholesterol medications.”
The agency also released a fact sheet with state-by-state data on antipsychotic reductions. States varied in how much they reduced use of these medications over a 21-month period ending with the first quarter of 2014 — Hawaii reduced use in that state by 31.4%, while Nevada reduced antipsychotic use by 1.6%.
Even though this data is several years old, it gives you an idea of what states are dealing with and which ones met their reduction goal. Along with anti-psychotic medication monitoring, updated CMS regulations coming in 2018 increase the scrutiny of medication review. A simple, straightforward solution is needed – one that offers providers an effective tool that aligns prescribed medications to the unique needs of each resident.
Most nursing homes are being proactive – setting programs in place to be ahead of any future mandates or regulations. That’s where PGx Medical comes in. Our fully reimbursed diagnostic test can help guide healthcare professionals when dosing residents. Right drug, right dose, for the right person. Pharmacogenetics aligns current and future medications with each persons unique genetic profile – individualized treatment that can give them the therapy they need.
If you don’t have a medical plan of action to help reduce antipsychotics along with other medications, contact us and we’ll help you get started.
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
source: medpagetoday
by PGx Medical | Oct 31, 2016 | Aging Services
More than one in five U.S. nursing home residents are given antipsychotic medications
What is your medical plan of action to reduce antipsychotics in your LTC community?
The prescribing of antipsychotic medications persists at high levels in U.S. nursing homes despite extensive data demonstrating marginal clinical benefits and serious adverse effects, including death,
The analysis included 1,402,039 individuals overall, as well as a subset of 561,681 with at least 3 months of continuous observation.
A total of 308,449 of the residents had been given at least one prescription for an antipsychotic.
In more than two-thirds of cases, the agents used were from the atypical class of antipsychotics, which are primarily indicated for the treatment of schizophrenia and bipolar disorder.
“The most common antipsychotics prescribed are often used for off-label indications related to dementia, and the extended durations of use raise concerns about the care of frail elders residing in [nursing homes],” the researchers stated.
In addition, among the observed subgroup, only 7.5% had been given just one antipsychotic prescription, and the median number of such prescriptions was 10.
Even though this data dates back a couple of years, the use of antipsychotics is still prevalent in long-term care communities. In fact CMS will be coming out with new mandates for 2018 so communities should start planning now to be ahead of the mandates.
Even though some states met the original reduction guidelines, we are finding they are having trouble meeting new mandates – and have been told more are coming in 2018.
One tool used in homes across the country to help make sure residents are on medications that are actually giving them therapy, is pharmacogenetic testing.
Pharmacogenetics aligns current and future medications with each persons unique genetic profile. This simple, fully reimbursed test, will help guide healthcare professionals when prescribing medication. It takes the “guess work” out of it and provides your clinical team with evidence-based results allowing right drug, right dose, for the right person.
PGx Medical is presently enrolling provider organizations and communities in a pharmacogenetic operational pilot program. If you would like to be part of this program, please contact us at, info@pgxmed.com or 405-509-5112.
source: medpagetoday.com
