Drug Topics - January 14, 2008 - (Page 29) www.drugtopics.com JANUARY 14, 2008 DRUG TOPICS 29 Long-Term Care Revised SOM guide for surveyors bolstering role of consultant R.Ph.s Sandra Levy he Centers for Medicare & have a change in condition when Medicaid Services’ (CMS) they are in a nursing home for less revised survey guidance to than 30 days or have a change of the Nursing Facility State Operacondition that may be affected by tions Manual (SOM) has been in the medication they are on, an ineffect for one year. terim medication regimen review The survey tags include tag (IMRR) has to be done within 72 F329, covering unnecessary medhours of the event. You don’t ications; tag F425, covering pharwant the condition to continue to maceutical services; tag F428, Nancy Losben and Gene Memoli deteriorate and not have a pharcovering medication regimen re- believe that the revised SOM guide macist look at their drug regihas elevated the role of consultant view; and tag F431, addressing pharmacists. men. You want them to act on it storage, labeling, and controlled quickly so that the prescribers can medications. (See Drug Topics, Jan. 24, 2005 and Dec. make a change. This gets the consultant pharmacist 11, 2006.) more involved as part of the clinical team with the preHow have the new requirements changed the practice scribers. This enhances the consultant pharmacist’s valof consultant pharmacists? ue and role.” Nancy Losben, R.Ph., chief quality officer at Omnicare, said, “The guide has advanced pharmaceutical care and the position of consultant pharmacists. It has elevat- Now there is true dialogue between ed their responsibilities and allowed them to interact more—with some regulatory oversight—with physi- the physician and the pharmacist—a more cians. It lays out more specifically the duties of a consult- interactive role that makes them both part ant pharmacist in assisting a nursing home to make sure that pharmaceutical care continues on a daily basis even of the pharmaceutical care process.” when the consultant pharmacist isn’t there.” Nancy Losben Losben praised the medication regimen review guidelines, stating, “Before [the new guide], the physician Losben credited the guidelines with forestalling many would always have to answer Yes or No to a consultant adverse drug events. “It’s not just that a resident might pharmacist’s recommendation. Now, if the physician become dizzy but that he or she may fall and break a leg, disagrees with the consultant pharmacist’s recommenda- and that will affect the total well-being of that resident tion, the burden is on the physician to comment on why in a more permanent fashion. It has really put into place he/she is disagreeing. Now there is true dialogue be- some mandate for the nursing facility to know about the tween the physician and the pharmacist—a more inter- medications—with the assistance of the pharmacist— active role that makes them both part of the pharmaceu- and to continually monitor what seniors might be at risk tical care process.” for when they use multiple medications. It allows the Commenting on the tag covering unnecessary med- consultant R.Ph. to be a leader in adverse drug reactions ications, Losben said, “The emphasis is on preventing and in preventing adverse drug consequences.” adverse drug reactions and being able to recognize these Losben said the tag for labeling, storage, and security reactions as soon as possible—to create not only a good of medications helps to establish a chain of custody in atmosphere for pharmaceutical care but a safe one.” the nursing facility. “It makes sure the drugs that are deGene Memoli, R.Ph., president-elect of the Con- livered are appropriately distributed and accounted for necticut chapter of the American Society of Consul- and that there are periodic reconciliations done. It realtant Pharmacists (ASCP), echoed Losben’s sentiments. ly minimizes drug diversion and allows the nursing fa“The guide has increased consultant pharmacists’ in- cility to identify it as soon as they possibly can through volvement in providing care to patients. If patients this reconciliation process.” DT T Photo (on right): Reid Paul http://www.drugtopics.com
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