After having proven itself in Quebec, an innovative approach to fight once morest the perverse effects of excessive medication in the elderly will soon be introduced in new CHSLDs in the province.
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The PEPS project, for Pharmaceutical care personalization evaluation project, was launched in the Capitale-Nationale in 2017, where it is now implemented in the majority of CHSLDs.
The professional autonomy of pharmacists and nurses is increased, care is reorganized for greater efficiency, and above all, the list of medications for each patient is combed through.
Experience shows that the cases of “excessive polypharmacy”, that is, taking more than 10 drugs by a person, are reduced by half.
Weigh the benefits
“The pharmacist will become one of the main prescribers of pharmacotherapy for the person in long-term care, therefore, we will be able to take each of the drugs, weigh the benefits for them in a precise way, the risks, and decide with them or their representatives what we’re doing, ”explains Rachel Rouleau, coordinator of this initiative and deputy head of the pharmacy department at the CIUSSS de la Capitale-Nationale.
Often, we find that drugs no longer have the desired effects or that their side effects outweigh their benefits.
“It happens at a certain point in time when conditions change, when pathologies change,” explains Mme Roller. Drug therapy should be re-evaluated periodically, frequently. “
Soon to be extended
According to the pharmacist, the Quebec government wishes to extend the project to the whole of the province from January 2022. “There is a committee which is busy preparing for this deployment, therefore all the CHSLDs, alternative homes and seniors will be able to benefit from this approach, ”she emphasizes.
With this method, pharmacists not only remove drugs, but can also prescribe drugs to quickly relieve common ailments. Several beneficial effects on the comfort of residents have been observed.
From an operational point of view, the duplication of tasks between professionals is avoided as much as possible, bringing efficiency gains in the context of the scarcity of manpower.
Encouraging results
- 50% decrease the number of patients taking 10 or more medications
- 25% decrease the number of potentially inappropriate drugs prescribed