Transitional Care Unit April 19, 2006 Barbara Goldman, R.N., J.D. Director, LTC Licensing and Certification NJDHSS PO Box 367 Trenton, New Jersey 08625-0367 Dear Ms Goldman, I am writing you to let you know how valuable Consultant Pharmacists are in the care of our Senior Citizens. I have worked closely with our Consultant Pharmacist for the TCU the past 8 years since we opened in 1998. He has been instrumental in making recommendations and educating the physicians in specific dosing guidelines, renal dosing protocol implementation and avoidance of high-risk medications in the elderly. His recommendations are valued and although not always followed, at least result in discussion or consideration of alternate drugs. Last year the leader of the Pharmacy and Therapeutics Committee requested our Consultant Pharmacist, Frank Breve, to join as a member. Frank’s report focuses on the TCU but is also global because he has the opportunity to discuss medications that contribute to patient falls and medications that appear on the Beer’s List that should be avoided. The proposed Assisted Living Regulations that were recently published in the New Jersey Register under N.J.A.C. 8:36 do not separate the provider pharmacist from the consultant pharmacist. Although probably an oversight, I’m writing you to support the proactive decision to amend this regulation. The focus is different. Provider Pharmacy’s are most concerned with drug allergies or drug-drug incompatibilities but are not generally patient specific. Personally, I asked our Consultant Pharmacist for assistance with my mother. She is a community dwelling widow who lives in a condominium about 5 miles from my home. Her attending physician, a geriatrician and a renal specialist were seeing her on a regular basis. My mother who is 82 still drives and is independent in all ADL’s. However, she was turning into a Failure to Thrive person. She couldn’t or wouldn’t eat; she suffered from dizziness and was having trembling spells. Her physicians told me to expect it – she is 82. I contacted Frank Breve and gave him the list of 22 medications that my mother was taking. I

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Page 1: Value of consultant pharmacist 2006

Transitional Care UnitApril 19, 2006

Barbara Goldman, R.N., J.D.Director, LTC Licensing and CertificationNJDHSSPO Box 367Trenton, New Jersey 08625-0367

Dear Ms Goldman,

I am writing you to let you know how valuable Consultant Pharmacists are in the care of our Senior Citizens. I have worked closely with our Consultant Pharmacist for the TCU the past 8 years since we opened in 1998. He has been instrumental in making recommendations and educating the physicians in specific dosing guidelines, renal dosing protocol implementation and avoidance of high-risk medications in the elderly. His recommendations are valued and although not always followed, at least result in discussion or consideration of alternate drugs. Last year the leader of the Pharmacy and Therapeutics Committee requested our Consultant Pharmacist, Frank Breve, to join as a member. Frank’s report focuses on the TCU but is also global because he has the opportunity to discuss medications that contribute to patient falls and medications that appear on the Beer’s List that should be avoided.

The proposed Assisted Living Regulations that were recently published in the New Jersey Register under N.J.A.C. 8:36 do not separate the provider pharmacist from the consultant pharmacist. Although probably an oversight, I’m writing you to support the proactive decision to amend this regulation. The focus is different. Provider Pharmacy’s are most concerned with drug allergies or drug-drug incompatibilities but are not generally patient specific.

Personally, I asked our Consultant Pharmacist for assistance with my mother. She is a community dwelling widow who lives in a condominium about 5 miles from my home. Her attending physician, a geriatrician and a renal specialist were seeing her on a regular basis. My mother who is 82 still drives and is independent in all ADL’s. However, she was turning into a Failure to Thrive person. She couldn’t or wouldn’t eat; she suffered from dizziness and was having trembling spells. Her physicians told me to expect it – she is 82. I contacted Frank Breve and gave him the list of 22 medications that my mother was taking. I gave him her personal history, with my Mom’s consent and asked if he could help. Frank recommended discontinuing six of the medications, reducing another three and changing the dosing schedule for two. I gave the Attending Physician the recommendations. He agreed to give it a try. Within 48 hours there was some improvement seen and now 6 weeks later, my Mom is driving and enjoying life again. Frank saved my mother’s life.

I was my Mother’s advocate. I see the Consultant Pharmacist as our resident’s advocate when it comes to medication administration. They have access to the big picture, not just the drug profile. I would be happy to speak with you regarding this issue at your convenience.

Sincerely,

Karen Rodemer, RN, BSN, MS, LNHAAdministrator, Transitional Care [email protected](856) 853-2114