Medication reviews were key activities in all models, but each had distinct characteristics in relation to the comprehensiveness, who is eligible, and how frequently residents receive medication review activity. Four major pharmacist practice models were identified and formed the focus of the review: (1) the NHS’s Medicine Optimisation in Care Homes (MOCH) program from England (2) the Australian model utilising visiting accredited pharmacists (3) the Centers for Medicare and Medicaid (CMS) pharmacy services in long-term care from the USA and (4) the Medication Therapy Management (MTM) program from the USA. Thirty-six documents met the inclusion criteria and were included in the review. Additionally, experts from the selected countries were consulted to obtain further information about the practice models in their respective countries. A search strategy using key terms was performed in peer-reviewed databases, as well as the grey literature. This narrative review aimed to explore pharmacist practice models in aged care in Australia, England and the USA, and identify key activities and characteristics within each model.
Pharmacist practice models and services have emerged internationally to address medication-related issues in RACFs. Medication management in residential aged care facilities (RACFs) is complex and often sub-optimal. Given the frequency of pharmacy-related citations and the lack of standardization in pharmacists’ roles in nursing homes, further research is needed to better understand how pharmacist services can affect inspection compliance. In multivariable analysis, nursing home characteristics significantly associated with receiving any pharmacy-related deficiency included less geographic competition (adjusted odds ratio : 0.68), registered nurse hours (aOR: 0.66), occupancy (aOR: 0.67), for-profit status (aOR: 1.27), and Midwest (aOR: 1.50) or West (aOR: 2.95) location. The most commonly cited pharmacy-related deficiencies ( N = 11,678) were related to labeling/storage (comprising 25.1% of pharmacy-related deficiencies), unnecessary psychotropic medications (20.5%), and routine pharmacy services (16.8%). A retrospective analysis of data from Nursing Home Compare and was conducted on pharmacy-related deficiencies (including pharmacy services, drug regimen review, unnecessary medications, medication errors, and labeling/storage).
#K tag deficiency cms nursing home compare fire update
The scope, frequency, and nursing home characteristics associated with pharmacy-related deficiency citations following the Centers for Medicare and Medicaid Services 2016 “Mega-Rule” update are described.
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