Reducing Avoidable Medication-Related Health Problems Among Older Adults in Long-Term Care
Special Projects Fund
October 15, 2019
The proportion of Americans older than age 65 is expected to grow from about 16% of the current population to 20% by 2030.
As the population ages, treating older adults presents health care providers with numerous unique challenges, including managing the high number of medications that many eldery patients take. Multiple medications are associated with a higher risk of adverse drug events that can result in harm to patients (e.g., increased risk of falls and fractures, decreased physical and cognitive functions), higher rates of hospitalizations, and higher rates of emergency room admissions. In addition to the health consequences, the cost of adverse drug events can be very high, reaching more than $20 billion annually across the country. In 2019, NYSHealth awarded the Research Foundation for the State University of New York a grant for SUNY Upstate to pilot a deprescribing program for elderly patients in long-term care facilities in Central New York.
Under this grant, SUNY Upstate will evaluate the pilot’s impact to determine whether it reduces avoidable adverse drug events, hospital/emergency department admissions, and Medicaid costs, while also improving health outcomes. SUNY Upstate will test an evidence-based deprescribing program among long-term care patients at Central New York nursing facilities, rolling out the program through monthly trainings for all clinical staff. A consulting pharmacist will review all patient medications monthly and send any recommendations on changes to individual clinicians. SUNY Upstate will also develop and share education programs and materials for patients and caregivers on medication management and risks, as well as messages and scripts to support clinicians in talking with patients about deprescribing. Patient and caregiver focus groups will provide input on best formats, timing, and approaches to providing this information. To evaluate the program’s impact, SUNY Upstate will collect data and compare outcomes between a cohort of patients who received the deprescribing program intervention and a cohort that did not. SUNY Upstate will disseminate its research findings on the potential cost savings of deprescribing programs and its education materials statewide and nationally to policymakers, health care providers, and long-term care organizations.