PharMerica

PharMerica clinicians regularly contribute to the Clinical Articles section. Remember to bookmark this page and check back frequently for the latest clinical contributions.

Consultant Pharmacists: Needed Now More Than Ever
Steve Hord, RPh, FASCP and David B. Barker, RPh, MBA, FASCP
Everyone in the long-term care industry is still learning how to operate effectively and efficiently in the world of PPS. Evan as facilities learn to manage their risk under this new system, new challenges lie ahead. Now more than ever, consultant pharmacists can be smart, valuable partners for long-term care facilities, identifying weak spots and tailoring programs to help facilities manage costs and improve health outcomes.

Herbal Medicine: An Introduction
Diane Bloechl, PharmD, CGP
Herbs are "Crude drugs of vegetable origin used to treat various diseases (usually chronic) in order to attain or maintain health." The popular notion of herbs is that they are a benign and "natural" alternative to expensive pharmaceutials.

Gastrointestinal Disorders, the Elderly and Long-Term Care
PharMerica
The incidence of gastrointestinal (GI) tract disorders increases with age. Physiological changes associated with aging, including impaired esophageal peristalsis, reduced lower esophageal sphincter (LES) tone, and delayed gastric emptying can produce upper GI motility disorders and gastroesophageal reflux disease (GERD) causing uncomfortable, even disabling, symptoms.

Quality Indicators and the Nursing Facility Survey: Implications for the Consultant Pharmacist
Thomas R. Clark, RPh, MHS
This ASCP analysis, adapted by PharMerica, was originally intended for the Consultant Pharmacist profession but is equally useful to nursing home administrators, medical directors, nurses and others responsible for quality of care in long-term care settings.

Consultant Pharmacists Help Residents Age in Place
Rodney A. Beckstead, R.Ph.
Many elderly Americans choose assisted living with the hope of "aging in place" in an environment as close as possible to the homes they left behind. But, with increased numbers of frail elderly entering assisted living, facilities face the challenge of maintaining the feel of a residential setting (the industry's hallmark) while providing supportive services that enable care for evolving acuity needs.

Managing What the Doctor Ordered
Diane Benton, R.Ph., Consultant Pharmacist
One of the foremost reasons an individual chooses to reside in an assisted living facility is that he or she needs help with medication management. On average, a typical assisted living resident takes 12 different medications, including prescription and over-the-counter medications. The regulations affecting medical management and distribution vary from state to state. In addition, most assisted living facilities have specific policies and procedures regarding medications. While the purpose of this article is to explore the challenges assisted living facilities face distributing medication, state regulations and policies should be considered when seeking possible solutions.

Your Elderly Patient Needs IV Therapy ... Can You Keep Her Safe?
Fran Powers, M.A., M.Ed., CRNI
She's especially vulnerable to fluid overload, phlebitis, and a host of other complications. Here's how to protect her from harm.

Flu Vaccine Season - Is it Time for the Pneumococcal Vaccine as Well?
Harvey Swenson, R.Ph.
Health care providers have long been frustrated with the dichotomy presented by the limits on revaccination with the Pneumococcal vaccine (PPV). Serious local and systemic reactions to revaccination have resulted in recommendations against this. Oftentimes, we simply don't know if our residents have ever been vaccinated, much less when. Although PharMerica is not in a position to alter manufacturer labeling, we have contacted both manufacturers of the vaccine and the Centers for Disease Control and have reviewed literature on the subject in order to provide as much information as we can.

Stroke Rehabilitation: The Nurses Role
Linda Timmons, RN, BA, CRNI
The goal of the rehabilitation nurse is not to cure an individual, but to improve the quality of life for people with disabilities.

The Step Method Toward Titration of Discontinuance of Medication
Lawrence A. Lemchen, R.Ph., FASCP

Tracking Drug Use to Improve Care
Ronald G. Perry, R.Ph., FASCP
Residents in long-term care facilities take an average of six to 10 different medications. Long-term care facilities need to take steps to ensure these drugs are being used for the right diagnoses and in the right doses. Consultant pharmacists can help caregivers improve drug therapy outcomes through DUEs.

Pain Management in Long-Term Care
PharMerica
Chronic pain states in nursing home residents; need for an aggressive, multidisciplinary approach to managing pain. Describes a PharMerica initiative using pharmacologic and non-pharmacologic interventions to achieve optimal comfort and quality of life for residents.

Diabetes Mellitus: Epidemiology, Etiology, Pathophysiology
PharMerica
Discusses the incidence of DM in the U.S. Explains the current classification scheme for DM and summarizes the causes, symptoms and complications associated with each type of DM.

Diabetes Mellitus: Diagnostic Criteria and Goals of Therapy
PharMerica
Currently accepted methods of diagnosing DM (casual plasma glucose test, fasting plasma glucose test, oral glucose tolerance test); guidelines for diagnosis; overall goals of DM medical management and recommended plasma glucose goals for glycemic control.

Diabetes Mellitus: Complications
PharMerica
Chronic and acute major complications of Type 1 and 2 DM, from etiology to prevention and treatment. Complications discussed include macrovascular, microvascular, renal, ocular, and diabetic neuropathy.