Erie County: Brown Bag Medication Reviews
According to data compiled by the Centers for Disease Control and Prevention (CDC), 88% of Americans older than 60 use at least one prescription medication, and most older Americans take an average of three to five medications.
Adverse reactions to medication are correlated with the risk of avoidable hospital readmissions, according to CDC data, and also have an impact on balance and falls, nutritional intake and can sometimes mimic symptoms of cognitive impairment.
To combat misinformation and prescription drug abuse due to a lack of knowledge, the Erie County Department of Senior Services and the University at Buffalo School of Pharmacy and Pharmaceutical Sciences have been partnering since late 2011 to bring Brown Bag Medication Reviews to area Senior Centers. There have been eight events held to date.
One to two weeks prior to each event, the Health & Wellness Coordinator for the Erie County Department of Senior Services does a brief presentation for potential attendees at the review site. The presentation includes information about the upcoming medication review, the need for the event (the prevalence of problems associated with taking multiple medications and what other things can interact with prescription medication; such as; vitamins, food, herbal supplements, etc) and tips for safe and effective medication use. Attendees receive a tip sheet, instructions on what to bring to the review, a brown bag for carrying their medication to the review, and a form that they can fill in with their medication information if they are not comfortable bringing their medication to the event.
At the event, participants meet with third and fourth year pharmacy students for personal consultations. All consultations are done under the supervision of a Doctor of Pharmacy from the University. During the consultation the participants' medications, herbal supplements, and vitamins are reviewed via a computer program to check for any possible problems. If a potential problem is discovered, it is discussed with the participant, and documented. A form is given to the participant to bring to their health care provider for follow up.
The reviewer also discusses each medication with the participant to ensure that the participant understands the purpose of each medication and when and how the medication should be taken. Reviewers also address any problems the participant may be experiencing with each medication - including side effects, effectiveness and cost issues. Possible solutions to any issues uncovered are also discussed with the participant.
The main partners in the Brown Bag Medication Reviews are the Erie County Department of Senior Services and the University at Buffalo School of Pharmacy and Pharmaceutical Sciences. Minor partners are the senior sites where the events are held. Erie County Department of Senior Services secures the sites, coordinate and promotes the events. The University at Buffalo School of Pharmacy and Pharmaceutical Sciences provides the student reviewers as well as the supervising Doctor of Pharmacy. The minimal costs of the events are covered by both partners.
A Sensible Solution
Medication reviews allow for the identification of opportunities for changes to medication regimens to achieve optimal effectiveness and reduce or resolve undesirable side effects and medication interactions. A review also allows for the opportunity to create a Personal Medication Record (PMR) - a complete list of all medications (including Rx, over-the-counter, dietary and herbal supplements) with dosing schedule and health information. Additionally, medication reviews can bring about improved medication literacy, enhancing understanding and adherence to dosing schedules.
Not only does Medicare recommend a yearly medication review, there is considerable evidence suggesting that an annual medication review can lead to better health outcomes for older people ¹ ² ³. The Brown Bag Medication Reviews fit into that prevention plan.
Stats: Improving the Lives of Older Erie County Residents
In 2012 the Erie County Department of Senior Services began to record and tally all findings of the Brown Bag Medication Reviews. Here are a few examples of the important information being shared at these events. Data has been combined from all eight events held so far in Erie County.
|Not taking medication as prescribed due to misunderstanding instructions||13||Explained instructions|
|Not taking medication as prescribed due to affordability (taking at reduced level)||11||Given Patient Assistance|
|Not taking medication as prescribed due to forgetfulness||21||Discussed strategies|
How Can You Attend a Brown Bag Event?
Additional Brown Bag Medication Reviews are planned for Erie County this fall and winter. For more information interested persons can check the Erie County Department of Senior Services web site or call Kelly J. Asher, Health & Wellness Coordinator at (716) 858-8081.
Did You Know?
There are many resources to learn more about prescription drug use and abuse in New York State. Several that you may find helpful are linked below.
- The Prescription Drug Use Alert - Published by the NYS Department of Health
- Household Drug Collection Schedule - DEA Take Back Initiative (NYSDEC web site)
- FAQ: Proper Disposal of Prescription Drugs - NYSDEC web site
- Stafford AC, Tenni PC, Peterson GM, et al. Drug-related problems identified in medication reviews by Australian pharmacists. Pharm World Sci. 2009;31;216-223.
- Roughead EE, Semple SJ, Gilbert AL. Quality use of medicines in aged-care facilities in Australia. Drugs Aging. 2003;20;643-653.
- Ruths S, Strand J, Nygaard H. Multidisciplinary medication review in nursing home residents: what are the most significant drug-related problems? The Bergen District Nursing Home (BEDNURS) study. Qual Safe in Health Care. 2003;12;176.