Accreditation Statement: AMDA – The Society for Post-Acute and Long-Term Care Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: AMDA – The Society for Post-Acute and Long-Term Care Medicine 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.
ABPLM Designation Statement: This Internet Enduring Material has been pre-approved by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) for a total of 1.5 clinical hours toward certification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. The CMD program is administered by the ABPLM. Each physician should claim only those hours of credit actually spent on the activity.
Session Description: The University of Louisville Department of Family Medicine and Geriatrics provides care and medical directors for multiple skilled facilities, intermediate care facilities, assisted living facilities, and personal care residents. One of our missions, in addition to education, is fostering a heightened level of quality assurance in our facilities. This session will review, educate, and discuss the important but not often emphasized topic of altered solid oral medication dosage forms in the LTC setting. This is a topic which University of Louisville Geriatrics have had a special interest in for some years, inspired by an extraordinary case study (a patient we had) who was a short-term nursing home resident who literally came weeks from death due to just one crushed medication (of the two medications) she was receiving. Once the problem was discovered, her recovery and discharge from our facility was remarkable. This led us to conduct a four facility quality survey which yielded startling results. In addition to the presentation of our own experience and studies of altered dosage forms, the session will review the current literature, biopharmaceutics principles, common situations necessitating consideration of altered dosage forms (change in food texture which is a tip that medications are not being swallowed whole, NG tubes which has other considerations, i.e. warfarin dose sticks to tube), barriers and motives for medication alteration, IDT coordination failures, and what to do, including model program ideas. This session will include active learning exercises to stimulate shared discussion between attendees.
Identify healthcare system gaps leading to inappropriate medication crushing and tablet splitting.
Describe three potentially harmful consequences of inappropriate dosage form alteration and administration.
Explain the intended drug delivery design of two different oral solid medication dosage forms.
Review best practices which can be implemented to avoid altered medication dosage form harm.
Speaker(s): Demetra Elizabeth Antimisiaris, PharmD, CGP Rangaraj Gopalraj, MD, PhD