Accreditation The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: The American Medical Directors Association designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AMDCP Credit Designation: This session has been approved for a total of 1.5 Management credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
Session Description: This session presents a systematic approach to medication evaluation, with attention to reducing adverse polypharmacy while retaining medications known or having potential to improve outcomes. Educational strategies will include a didactic presentation to set context and provide baseline information. The presentation will highlight regulatory statutes, the risks of polypharmacy, medications associated with withdrawal and other adverse reactions, and published criteria, such as STOPP and ACOVE-3, that physicians can use as guides to identifying inappropriate drug use. Cases will then be presented to illustrate each step in the polypharmacy reduction process, highlighting critical but common examples of inappropriate drug use. The format will allow attendees to learn discontinuation strategies as illustrated by cases. The session concludes with opportunity for questions, answers and shared insights.
Illustrate key examples of problematic prescribing.
Delineate specific processes for reducing potentially inappropriate prescribing.
Speakers(s): Thomas Lynch, PharmD; Daniel A. Bluestein, MD, MS, CMD; William N. Hovland, MD, CMD
Disclosure(s): Daniel A. Bluestein, MD, MS, CMD has no disclosures to report. William N. Hovland, MD, CMD, FACP has no disclosures to report. Thomas Lynch, PharmD has no disclosures to report.
References: Bain KT et al. Discontinuing medications: a novel approach for revising the prescribing stage of the medication-use process. J Am Geriatr Soc 2008;56:1946-52. Centers for Medicare & Medicaid Services (CMS). Pub. 100-07 State Operations. Transmittal 22, December 15, 2006. 346-426. Gallagher p, O;Mahony. STOPP: application to acutely ill elderly patients and comparison with Beers' criteria. Age and Ageing 2008;37:673-79. Rudolph JL et al. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med 2008;168:508-13. Shrank WH, Polinski JM, Avorn J. Quality indicators for medication use in the vulnerable elders. JAGS 2007;55:S464-87.