Texas Health and Human Services reported that Pharmacy Services was the 3rd most cited deficiency for fiscal years 2015-2017, primarily dementia and unnecessary medications. An unnecessary medication is any medication when used in an excessive dose, for an excessive period of time, without adequate documentation or monitoring, in the presence of adverse effects, and or without a diagnosis. Here are 3 ways a consultant pharmacist can help improve pharmacy services in dementia care.
1. Confirm diagnosis for antipsychotic medication used in patients with dementia.
The consultant pharmacist should confirm that the resident has an approved diagnosis for antipsychotic therapy and that the diagnosis is appropriately documented in the resident's chart.
2. Review supportive documentation for antipsychotic medication used in patients with dementia.
The consultant pharmacist should confirm that additional documentation such as prescriber notes, psychiatric consultation, nursing notes, and PASSR forms are present and provide the supportive documentation necessary to substantiate an approved diagnosis and antipsychotic therapy.
3. Identify and discourage the use of medications that exhausterbate cognitive impairment.
Certain medications are known to to impair cognition and are not recommended in patients over 65. The consultant pharmacist should identify these medications and provide prescriber recommendations discouraging their continued use.
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