1. An Innovative Approach to Medication Management Presenter: Mary Anne Foley, RN, MSN Chief Operating Officer, Jewish Association on Aging AgeWell Pittsburgh Collaboration

2. AgeWell Pittsburgh A coordinated effort of
Jewish Community Center of Greater Pittsburgh
Jewish Family & Children’s Service
Jewish Association on Aging
Provides a broad range of community-based services to seniors living in the Pittsburgh community
Helps older adults continue to live independently in their own homes by identifying seniors at risk of losing their independence and helping them connect to services that will allow them to remain safely at home

3. HomeMeds℠ Program
“Any symptom in an elderly patient should be considered a drug side effect until proved otherwise.” (Gurwitz et al. 1995)

4. HomeMeds℠ Endorsement
HomeMeds℠ is an approved Disease Prevention and Health Promotion program
Included in the National Registry for Evidence-based Programs and Practices (
HomeMeds℠ is also included with a strong evidence rating on the US Agency for Healthcare Research and Quality (AHRQ) Innovation Exchange (
The HomeMeds℠ system has been implemented in over 45 sites and 18 states
In the past four years, 11,000+ older adults have had their medications screened for potential risks;
40-50% of those screened had potential problems, the majority of which were resolved through pharmacist collaboration with physicians, patients, families and care managers
Successfully implemented in area agencies on aging, senior centers, post-acute care transitions programs, home-delivered meals programs, fall prevention collaboratives, care management programs, housing and assisted living

5. HomeMeds℠ Workflow Comprehensive in-home medication assessment
Electronic file created and data verified
Pharmacist notified of potential problem alert
Pharmacist sends med list & recommendation
to MD; intervention is documented
Tracking of status and MD response
Changes to meds & conditions are documented and alerts are resolved
Pharmacist advises patient and/or staff, if needed

6. HomeMeds℠ – Proven Solutions
Four important problem areas affecting seniors:
Unnecessary therapeutic duplication
Falls and confusion related to possible inappropriate psychoactive
medication use
3. Cardiovascular problems such as continued high/low blood
pressure or low pulse
4. Inappropriate use of non-steroidal anti-inflammatory drugs
(NSAIDs) in those with high risk of peptic ulcer/gastrointestinal
bleeding

7. Medications – From Help to Harm The Problem
Medication Errors are:
Serious: 1.5 million Adverse Drug Events (ADE’s) annually;
Over 700,000 people go to ED each year for ADE’s
7,000 deaths/year
Costly: Drug-related morbidity/mortality > $170 billion (ER, hospital/readmissions, SNF use, etc.)
Common: Up to 48% of community-dwelling elders have medication-related problems
Preventable: At least 25% of all harmful adverse drug events are preventable
IOM , To Err is Human: Building a Safer Health System. Washington, D. C. National Academy Press.
IOM, Preventing Medication Errors. Washington, D.C. National Academy Press

8. Phase I
HomeMeds was originally rolled out in Riverview Towers, a more controlled environment with specific safety controls built in:
Case management resources were already available to all residents in the building
Riverview Towers is adjacent to the campus of one of the AgeWell Pittsburgh Partners – Jewish Association on Aging (JAA)
AgeWell Pittsburgh had an affiliate relationship with Riverview Towers and was already providing some services in this building
Many of the residents were already clients of AgeWell Pittsburgh

9. Phase II Phase II - Part I Assessments in additional facilities
West Homestead HUD facility/Large percentage of Russian speaking clients
Beacon Place apartments/privately owned & managed
JAA’s Adult Day Program

10. 6-Month Pilot Data HomeMeds Assessments Completed

11. Alerts Generated

12. Phase II Phase II - Part II Senior Center Pilot
Targeting 200 older adults in senior center community environments
Bring medications/lists in to receive assessments
Even though the program is called HomeMeds℠, it doesn’t change the efficacy of it being an Evidence-Based Program whether in the home or in a community-based setting
Other cities across the country are currently using this program in a community center model

13. HomeMeds℠ Pilot Senior Center
In 2015, AgeWell at the JCC received a grant from PA Dept. of Aging to implement a pilot program in a Senior Center environment
An MOU was established with Duquesne University’s Non-Profit Pharmacy to serve as the Pharmaceutical partner
Use of Pharm Interns, as well as Program personnel for screens
Couple screens with education seminars, health fairs and “meet the pharmacist” tables
The Pilot consists of:
An in-Center review of a comprehensive medication list with notes on how each drug is to be taken, plus other indicators of adverse effects;
vital signs, falls, symptoms, etc.
Use of evidence-based protocols and processes to screen for risks and deploy consultant pharmacist services appropriately
Electronic medication risk assessment and alert process with report system
Consultant pharmacist addresses problems with prescribers, seniors, families & staff

14. How The Program Worked in a Senior Center Environment
Process
Participants were recruited through our Senior Center programs, word of mouth, flyers, and website information
Time/date set to meet with pharmacy students or staff
If signed up in person, the client will receive an informational packet and an AgeWell brown bag
The packet will include the appointment card with date, time; informational consent form; business cards for the Duquesne Pharmacy; and a reminder letter on what to bring to the appointment
Meet to complete assessment at the senior center
Follow-up
Pharmacists/Pharmacy Students vs. staff
Register for other programs within the center

15. 6-Month Pilot Data HomeMeds Assessments Completed

16. Partnership Added Value Services

17. Experience an Assessment

18. HomeMeds℠ Assessment

19. HomeMeds℠ Assessment

20. HomeMeds℠ Assessment

21. HomeMeds℠ Assessment

22. HomeMeds℠ Assessment

23. HomeMeds℠ Assessment

24. HomeMeds℠ Assessment

25. Questions