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 Internet Enduring Material 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 management 1.5 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
Session Description: This session will present the findings from a patient- centered quality improvement project in collaboration with the Michigan Peer Review Organization. The project is an innovative interdisciplinary team (IDT) approach to address polypharmacy and the use of psychotropics in long-term care. The pilot study included five long-term care facilities, where A.R.M.O.R (the Assess, Review, Minimize, Optimize, Reassess) protocol was systematically applied to address psychotropic medication usage in the nursing home setting. The process involved a physician-led IDT reviewing charts and discussing patient care plans. The focus of each team meeting is to review cases for evidence-based use of medication to: a) address polypharmacy, b) optimize medication usage, and c) improve/maintain the functional outcome for the patients. The presentation will discuss the emerging data and results of the pilot program and its impact on the quality indicators. The presenters will also share the experience of team building, identifying barriers and strategies for effective team communication.
Explain the system based nature of polypharmacy and psychotropic use in long term care facilities.
Analyze the data obtained from an interdisciplinary team-based approach using the A.R.M.O.R tool.
Discuss the role of physician led IDT to address poly-pharmacy and reduce psychotropics in long term care.
Enhance communication skills and abilities to collaborate with and/or lead the long term care interdisciplinary team and implement effective strategies to reduce psychotropics.
Reference(s): 1. Bernabei R, Gambassi G, Lapane K, et al. Characteristics of the SAGE data- base: A new resource for research on outcomes in long-term care. SAGE (Systematic Assessment of Geriatric drug use via Epidemiology) Study Group. J Gerontol A Biol Sci Med Sci 1999;54:M25-M33. 2. Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: A systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatric Soc 1999;47(1):30-39. 3. Bootman JL, Harrison DL, Cox E. The health care cost of drug-related morbidity and mortality in nursing facilities. Arch Intern Med 1997:157:2089-2096. 4. Klein D, Turvey C, Wallace R. Elders who delay medications because of cost: Health insurance, demographic, health and financial correlates. Gerontologist 2004;44:779-787. 5. Rochon PA, Gurwitz JH. Optimising drug treatment for elderly people: The pre- scribing cascade. BMJ 1997;315:1096-1099 6. Haque R. ARMOR: A Tool to Evaluate Polypharmacy in Elderly Persons. Annals of Long-Term Care June 2009