Four methods to limit redundant and unnecessary prescribing

Accreditation Insider, August 30, 2016

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The Hospitals & Health Network recently published an article on the issue of polypharmacy, which occurs when a patient is given redundant or unneeded medications. Tamping down on polypharmacy is crucial as many facilities face drug shortages, as well as the fact that inappropriate prescriptions can result in addiction  or drug-resistant disease. The author of the article, Todd Kislak, points out it’s not difficult for inaccuracies to appear on a patient’s medication list.

 “When a patient is transferred among facilities, [primary care providers] PCPs tend to lose connection with the patient's medications regimen,” he writes. “New additions to the medications list may be buried in the details of a discharge notification. There may also be physician specialists adding prescriptions without notifying the PCP. Additionally, in many cases, PCPs lose track of over-the-counter medications and other supplements in the patient’s medicine cabinet.”

Four steps to reduce polypharmacy are:

1.    Build a comprehensive polypharmacy management plan directly into the patient’s transition-of-care program. The discharging physician needs to have direct responsibility for approving and reviewing their patient's medications list.

2.    Include polypharmacy into the medications therapy management program. Pharmacists should review patients’ current medications list, line-by-line, and give their recommendations to the discharging physician. The optimized medications list should then be communicated to the patient's PCP and their admitting physician if they’re sent to another facility.

3.    Educate patients as early as possible on their current medications. When possible, review with the patient their current prescriptions, expired prescriptions still in the cabinet, over-the-counter medications and other supplements. This can be done with family members or caregivers in attendance, or done via email or phone.

4.    Hire a medication consultant to conduct polypharmacy management. If you have the funds, hire a physician whose primary duty is reviewing medication records for inconsistencies.

“Facilities that assume a proactive role in polypharmacy management with meaningful physician engagement will enjoy a competitive advantage in managing the health of their local populations,” Kislak writes. “They will profit from improved outcomes for their patients while delivering a benefit to all stakeholders across the care continuum.”


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