Pharmaceutical services: Optimizing medication checks for nursing home residents
The doctor's letter following a medication analysis is always kept as brief as possible. Privilegierte Adler-Apotheke has templates for the most important medication-related problems. / © PZ/Daniela Hüttemann
Nursing home residents often suffer from multiple morbidities and therefore receive numerous medications, sometimes from different (specialist) practices. All prescribed medications are consolidated at the home pharmacy upon ordering.
"We check all patients anyway to see if there are any interactions or duplicate prescriptions and if the dosages and times of administration are correct – this is our core competency and not yet a PDL for us, but rather everyday business," explain Kathleen Hellmig and Britt Kaulen from the pharmaceutical service of the Privilegierte Adler-Apotheke Hamburg-Wandsbek.
The pharmacy is one of the larger providers in the Hanseatic city and has expanded its software to identify candidates for the extended medication consultation (PDL) for polypharmacy and to monitor their processing status. A pharmacist verifies eligibility before the comprehensive pharmaceutical assessment is conducted for several residents at once.
How does everyday business become a pharmaceutical service? "We bill for a pharmaceutical service when, in addition to the standard interaction check from the health insurance provider, we have conducted an extended one using the AMTS MediCheck program," explains Hellmig. The results are then not only documented and sent to the physician if necessary, but also made available online to nursing staff.
Advocating for more AMTS for residents: Britt Kaulen, Lars Oetken and Kathleen Hellmig (from left) / © PZ/Daniela Hüttemann
"With the pDL, we focus primarily on new arrivals and patients after hospital stays, tube-feeding patients, and, of course, when we notice something during the request," says the pharmacist. The long-term goal is to offer the comprehensive checkup regularly, i.e., once a year, to all eligible patients. There are already nursing homes that have commissioned the pDL from the pharmacy for all their residents.
Since the Privileged Adler Pharmacy blisters individual medications for residents, the entire medication plan has always been maintained and pharmaceutically reviewed. What was missing was a tool that could systematically document and bill the medication analyses and interventions performed.
The pharmacy can generally rely on the medication plan being up-to-date and complete. "The medical service of the health insurance companies strictly monitors this, and it is also a prerequisite for us to admit new patients and blister pack their medication," says Kaulen. In addition, the responsible physician checks the medication during visits to newly admitted residents.
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