The Consultant Pharmacist's Role in Long-term Care Facilities

Abstract

As the elderly portion of the US population continues to grow at an alarming rate, it is expected that the extent of their drug utilization will also escalate proportionately. The typical geriatric patient often presents with multiple medical disorders that are being treated with multiple drugs. With the elderly, as the number of medications increase numerically, the incidence of adverse drug reactions may increase exponentially. At times, one drug may be prescribed to treat the adverse effects of another medication. Studies show that the cost benefits of having consultant pharmacists conduct drug regimen reviews on patients in long-term care facilities resulted in a savings of $220 million. These cost savings resulted from the influence of consultant pharmacists decreasing the number of drugs per patient, amount of nursing time spent on drug administration, number of hospitalizations resulting from adverse effects, and overall cost of medical care. These data influenced the development of federal regulations that now require pharmacists to perform monthly drug regimen reviews on all patients residing in either intermediate or skilled nursing facilities. In addition to clinical drug therapy monitoring, the consultant pharmacist also participates in the infection control and pharmaceutical services committees and presents in-service training programs to the nursing staff. In performing various clinical and administrative functions, the consultant pharmacist must be able to work with other health care personnel in improving pharmaceutical services and patient care. As a result, there will be an even greater need in the near future for pharmacists who have been clinically trained to evaluate drug therapy in the elderly.