Consultant pharmacists and long-term care 101

Resources for education about senior citizens and long-term care


Pharmaceutical manufacturers are well-versed in the post-acute care industry. However, a niche role that often goes unnoticed is that of a consultant pharmacist, who contracts with post-acute care providers to deliver expert guidance on the safe, effective and appropriate use of medications to older adults.

The term “consultant pharmacist” became part of federal regulation in 1974 when Medicare required that every skilled nursing facility patient receive a monthly drug-regimen review by a pharmacist. Leading up to that milestone, the American Society of Consultant Pharmacists (ASCP) was founded in 1969. Today, ASCP represents more than 9,000 consultant pharmacists and other pharmacy professionals, including students, serving the unique medication needs of the senior population. It has a vital and growing role to play in working with pharma manufacturers as well.

Back in the 1970s, nursing facilities, for the most part, provided end of life care. Today more than a million seniors are admitted to skilled nursing centers following an acute event and discharged back to their homes following rehabilitation. By 2018, it is expected that 7 out of 10 patients admitted to nursing homes will move back to the community.

With mismanagement of medication being one of the leading causes of avoidable re-hospitalizations, the role of consultant pharmacists has expanded to include sub-acute care and assisted living facilities, psychiatric hospitals, hospice programs, correctional facilities, and in-home and community-based care—wherever seniors reside.

Seniors discharged from hospitals to nursing homes have on average 14 medication orders that are required to treat multiple chronic disease states. These are the same seniors being discharged back to the community. Beginning in 2018, nursing homes will be penalized for frequent avoidable re-hospitalizations, increasing the demand for collaboration among pharmacists, prescribers and caregivers to optimize medication therapy and patient safety. In this patient-centered care reimbursement model, providers will be rewarded for positive outcomes. A pharmacist role in reducing a patient’s length of stay while simultaneously reducing re-hospitalizations is a better measure of a positive performance than the lowest cost of medication per patient day. ASCP members, who are skilled consultant pharmacists, are trained in medication therapy management and are experts at providing recommendations on complex drug regimens to optimize medication therapy.

In the ever-changing environment of post-acute care, including value-based metrics, quality measures and new CMS guidance, ASCP offers a wide variety of services ranging from education for Board Certified Geriatric Pharmacists to post-acute care business and market training suitable for brand teams introducing new medications. ASCP has been providing industry education programs to pharmaceutical brand teams and pharmacists for more than 47 years. Learn more about ASCP, consultant pharmacists and the long-term care industry at www.ascp.com.

ABOUT THE AUTHOR
Frank Grosso, RPh, has been executive director and chief operating officer of the American Society of Consultant Pharmacists since 2014. Grosso has 35 years of long-term care pharmacy experience, most recently as corporate VP of Pharmacy Services at Genesis HealthCare, LLC, one of the nation’s largest long-term care providers. Previously, he served as senior vice president of pharmacy operations for NeighborCare Pharmacy and director of long-term care pharmacy at Fay’s Drugs. He is a graduate of Albany College of Pharmacy.