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Shared Care CommitteePolypharmacy Initiative            Dr. Keith White            “Awesome” Physician Lead,            SC...
What is Polypharmacy?      Too many inappropriate medications?      Too many appropriate medications?      More than 5 med...
Our Definition   When the theoretical benefits of multiple  medications are outweighed by the negative         effect of t...
Polypharmacy is a stand-  alone risk factor for       morbidity
Polypharmacy:                What We KnowAverage number of meds in RC = 9Affects Quality of Life & Resident SafetyDecrease...
Adverse                          Drug EventsLead to increased transfers to acute care   • 5 or more                 10%   ...
Hospitalization-      Associated Disability    Hospitalization is a sentinel event that oftenprecipitates disability. This...
Polypharmacy itself should beconceptually perceived as “a disease,”    with potentially more serious   complications than ...
Discharge SummaryAdmission Dx:          DeliriumDischarge Diagnosis:   UrosepsisPMH:   1)   Alzheimer’s   2)   COPD   3)  ...
And No Mention of…1)   POLYPHARMACY2)   HOSPITALIZATION-ASSOCIATED DISABILITY
MedReviewsWhen we do MedReviews…… we still look at the appropriateness of each individual med inthe context of the Residen...
ChemopreventionDoes not alter the All  Cause Mortality!
Summary  Count the Pills!
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Shared Care Committee Polypharmacy Initiative

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On January 18, 2013, the BC Patient Safety & Quality Council invited key stakeholders from across the province to join together in a day of meaningful discussion around:
1. The meaning of dignity in care, with a special focus on more appropriate use of antipsychotics;
2. The current state of antipsychotic use by people living in residential care in BC;
3. An overview of work currently underway throughout BC, nationally and internationally to identify opportunities for alignment as well as learning from others;
4. Envisioning an ideal state whereby more appropriate use of antipsychotic medications can be achieved; and
5. Framing a call to action that will ask teams from residential care facilities in BC to join our initiative.

This is a presentation from the event delivered by Keith White, who is the BCPSQC’s Clinical Lead for Medication.

Learn more about this initiative at http://www.bcpsqc.ca

Published in: Health & Medicine
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Shared Care Committee Polypharmacy Initiative

  1. 1. Shared Care CommitteePolypharmacy Initiative Dr. Keith White “Awesome” Physician Lead, SCC Polypharmacy Initiative Clinical Lead, Medication Reconciliation BCPSQC
  2. 2. What is Polypharmacy? Too many inappropriate medications? Too many appropriate medications? More than 5 medications? More than 10 medications?
  3. 3. Our Definition When the theoretical benefits of multiple medications are outweighed by the negative effect of the sheer number ofmedications, regardless of class of medication or “appropriateness” thereof.
  4. 4. Polypharmacy is a stand- alone risk factor for morbidity
  5. 5. Polypharmacy: What We KnowAverage number of meds in RC = 9Affects Quality of Life & Resident SafetyDecreases in: • Global Health • Cognitive FunctionIncreases in: • ADE’s • Risk of Falls
  6. 6. Adverse Drug EventsLead to increased transfers to acute care • 5 or more 10% • 7 or more 20% • 9 or more 30%Increase in transfers to acute care
  7. 7. Hospitalization- Associated Disability Hospitalization is a sentinel event that oftenprecipitates disability. This results in the subsequent inability to live independently and complete basic activities of daily living (ADLs). This hospitalization-associated disability occurs inapproximately 1/3 of patients >70 years of age and may be triggered even when the illness that necessitated the hospitalization is successfully treated.
  8. 8. Polypharmacy itself should beconceptually perceived as “a disease,” with potentially more serious complications than those of the diseases these different drugs have been prescribed for.
  9. 9. Discharge SummaryAdmission Dx: DeliriumDischarge Diagnosis: UrosepsisPMH: 1) Alzheimer’s 2) COPD 3) IHD 4) Hypertension 5) Diabetes 6) Remote CVA
  10. 10. And No Mention of…1) POLYPHARMACY2) HOSPITALIZATION-ASSOCIATED DISABILITY
  11. 11. MedReviewsWhen we do MedReviews…… we still look at the appropriateness of each individual med inthe context of the Resident and fail to address theinappropriateness of the actual Number of Meds in the contextof the Resident’s Dignity and Quality of Life.
  12. 12. ChemopreventionDoes not alter the All Cause Mortality!
  13. 13. Summary Count the Pills!

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