July 17, 2014
PACE Case: Controlling Pain - ESRD and Diabetes 

   

A 65 y/o patient with ESRD and advanced Type 1 Diabetes complains of severe pain in lower extremity secondary to lack of blood flow and necrosis.  She has been taking oxycodone/acetaminophen (Percocet) 10mg/325mg TID scheduled, which is providing her no relief. The physician considered adding fentanyl 50mcg in addition to the Percocet to help relieve her symptoms, and sought a recommendation from the CareKinesis clinical pharmacist...

 

Click here for the CareKinesis Clinical Pharmacist intervention. 
Summer Participant Safety Reminders
Medications can increase your participants' risk of heat stress. These medications include beta blockers, amphetamines, diuretics, antidepressants, and anticholinergics.  Participants taking these medications and complaining of heat stress may require a targeted or comprehensive medication review.

 

Studies also show increased risk of falls in the elderly during the summer months due to blood pressure changes, medication effects, and lack of proper footwear. Here are a few safety reminders to share with your participants this summer:

  • Drink plenty of water
  • Reduce alcohol and caffeine intake, including tea 
  • Wear supportive shoes (not sandals, flip flops, bare feet, crocs)
  • Note urine color, and alert the clinic to any darkness
  • Stay cool
Quote of the Month
 
 "Thank you for all you do! It is refreshing that I do not have to worry about frustrations for my team within the medication arena. Participants are receiving their medications at home, and there has been so much improvement in their compliance."
 - Sharon Washington-Hilton, Program Director
   Cherokee Elder Care PACE
OMS Reporting: APAP   

CareKinesis has released the new OMS - Acetaminophen Report! This report shows PDE/billing information available to CareKinesis Pharmacy as pertains to acetaminophen (APAP)-containing medications for participants with dates of service from Jan 1, 2013 through the end of the previous billing month. Direct access to this dispense history allows you to prospectively review for potential overutilization. Additional review is required to assess true total daily acetaminophen dosing. The CMS Overutilization Monitoring System (OMS) is designed to flag beneficiaries who may be taking more than 4 grams/day of acetaminophen for >30 days.

 

CareKinesis is happy to assist clients with additional APAP utilization review (as well as opioid review - see our OMS Opioids report!) by contacting OMS@carekinesis.com. 
PGx Update 
Some PACE partners are engaged with the CareKinesis Precision Prescribing initiative, which uses pharmacogenomics (PGx) data to help ensure safe and effective personalized drug regimens for participants. 
 
Thus far, 100% of PACE participants tested had at least one variant gene, and more than a quarter had four or more. The most common variants were CYP2C19 and VKORC1, which are involved in the activation and inactivation of frequently used drugs such as clopidogrel (Plavix�), certain antidepressants, proton pump inhibitors, and warfarin (Coumadin�). In response, CareKinesis clinical pharmacists have provided PACE clinicians with therapeutic monitoring guidance and drug alternatives. We are pleased to be able to provide this service to our clients!
NPA - October 2014

 

This year, the National PACE Association's Annual Conference is in San Diego. More information is on the NPA website, here. Planning to attend? So are we. CareKinesis will be hosting a PACE appreciation dinner on Sunday, Oct. 26. 

 

Please save the date! More information will follow. 

 

We are passionate about improving lives for PACE participants through medication risk mitigation. For more information, visit www.CareKinesis.com or call 888-974-2763.
  
Happy Summer!