Key takeaways:
- Adverse drug events (ADEs) are a serious issue in nursing homes, with statistics showing that they lead to significant harm and cost.
- Current medication review practices in long-term care (LTC) facilities have limitations, such as delays in conducting reviews and inconsistency in high-risk cases.
- The integration of technology, like PINC AI™ Clinical Surveillance powered by TheraDoc®, can significantly reduce ADEs, as shown in a University of Pittsburgh study where it led to a 92 percent decrease in ADEs, highlighting its potential to improve patient safety in LTC facilities.
Most nursing home residents use at least one or more prescription drugs, many of which increase their risk for adverse drug events (ADEs) that can result in complications or even death. Statistics show that the average nursing home containing 105 beds has up to 135 ADEs each year. That’s about 2 million annual events nationwide.[1]
ADEs include bleeding, hypoglycemia, mental status changes and acute kidney failure. The cost of these events is an estimated 93,000 lives lost and more than $4 billion wasted each year. However, multiple studies have shown that 66 percent of these ADEs are preventable. [2]
Existing Regulations
To combat this problem, a multifaceted approach is needed, involving additional research and fundamental changes in health policy and education. Government agencies and individual long-term care (LTC) facilities have taken steps to reduce ADEs in nursing homes. For instance, regulations now mandate consultant pharmacists (CPs) to perform a medication regimen review (MRR) for each resident every month as part of their standard care.
However, standard care has many limitations, including:
- MRRs typically happen only after a resident has been in the home for several weeks already, thereby losing the opportunity for prevention.
- Pharmacists are usually not involved with residents at admission, so they can’t perform a reconciliation at the transition of care.
- For residents who stay less than 30 days, the MRR often doesn’t occur until after discharge.
Advancements in technology, such as PINC AI™ Clinical Surveillance tools, accelerate the MRR process and offer promising ways to enhance resident safety.
The Role of Clinical Surveillance Technology
The PINC AI™ Clinical Surveillance solution, powered by TheraDoc, notifies CPs about resident admissions or readmissions, summarizes medication and clinical profiles, conducts ongoing monitoring to prevent and detect ADEs, and documents pharmacist interventions. This monitoring involves pre-developed and customizable clinical surveillance alerts delivered to CPs in real time. These alerts are actionable, indicating the resident is still present in the nursing home and the medication is associated with the alert.
PINC AI™ Clinical Surveillance in Action
A recent study [3] by the University of Pittsburgh research team examined the impact of pharmacist-led telemedicine services, supported by the PINC AI™ Clinical Surveillance technology, on LTC facility residents. The study involved 2,127 residents across four nursing homes, with some receiving proactive medication reviews and telemedicine interventions, while others received standard care.
Pharmacists utilized PINC AI™ Clinical Surveillance to monitor medication and clinical profiles, resulting in a significant 92 percent reduction in ADEs specific to alerts in the intervention group compared to standard care. This study showcases the success of integrating PINC AI™ Clinical Surveillance technology in LTC, enabling early ADE detection and improved patient safety.
Final Thoughts
Despite the heightened risk of ADEs in LTC residents, this study demonstrates that improvement is attainable. LTC facilities should consider adopting PINC AI™ Clinical Surveillance technology to address pharmaceutical challenges in high-risk patients and significantly reduce ADEs, ultimately saving lives and reducing healthcare costs.
For more on this topic:
- Learn more about PINC AITM Clinical Surveillance solution and services.
Citations:
[1] Gurwtiz JH t al. J Am Geriatri Soc. 2008;56:2225; Handler SM et al. Am J Geriatr Pharmacother. 2006;4:264
[2] National Action Plan for ADE Prevention | Health.gov. (n.d.). https://health.gov/about-odphp/previous-initiatives/national-ade-action-plan
[3] Kane‐Gill, S. L., Wong, A., Culley, C. M., Perera, S., Reynolds, M., Handler, S. M., Kellum, J. A., Aspinall, M. B., Pellett, M. E., Long, K., Nace, D. A., & Boyce, R. D. (2020). Transforming the medication regimen review process using telemedicine to prevent adverse events. Journal of the American Geriatrics Society, 69(2), 530–538. https://doi.org/10.1111/jgs.16...
The insights you need to stay ahead in healthcare: Subscribe to Premier’s Power Rankings newsletter and get our experts’ original content delivered to your inbox once a month.
Daisy Jackson, CIC
Director of Member Engagement, Premier
Daisy has over 20 years of experience in hospital infection control and epidemiology, seven of which she managed an infection prevention program at a large teaching hospital with a Level 1 trauma center.