Uncategorized | October 17, 2019
Comfort Keepers is excited to announce its partnership with Heart Pharmacy in an exciting new program called Heart@Home. Heart@Home is a medication adherence service that aims to ensure great care every day. In this partnership, Heart@Home sends a Registered Care Aide (RCA) from Comfort Keepers to our patients’ homes every day to support and assist with medication administration. This program is designed for patients who will benefit from consistent visits to optimize medication adherence.
Many patients are non-adherent to their medications due to physical and cognitive limitations (as opposed to indifference or avoidance). Limitations include dexterity issues, limited sight, declining memory/cognition, and mental health issues. After careful consultation with patients, caregivers and family members, this program was created to provide the best possible pharmacy care to our community, with the goal of enabling patients to live healthier lives, at home, for longer.
If a patient is recommended for the program (by their doctor, a family member, VIHA nurse, etc.) a Heart pharmacist will meet with the patient to conduct an initial medication review and adherence assessment. If the pharmacist feels that the patient is a good candidate for the program, she will confirm with their doctor, request new prescriptions (with the critical instruction: “Daily Dispense” handwritten on each prescription), and schedule a time and date to begin administration.
The results of optimized medication adherence include significant improvements in blood markers (INR, blood glucose, blood pressure), decreased medication side effects (such as dizziness and stomach upset), and stabilized MMSE scores. Since medications are delivered daily, the Heart@Home program is also able to eliminate accidental exposure and repeat dosing. Daily visits allow our caregivers to provide companionship to patients, many of whom suffer silently from loneliness. Our RCAs are also well positioned to identify and attend to other areas of concern, such as falls or hygiene issues. In situations where these concerns are identified, the family and care team are immediately informed of findings, and patients are directed to the appropriate care (hospital
visit, MD visit, family check-in etc.). In many instances, patients utilizing our services have also been able to access other personal care services during home visits (including meal preparation, showers, etc.) for a fraction of what this would cost patients who are not in the program. Together these actions have dramatically reduced current and potential future risks that often result in
This program will allow you to eliminate the question of whether or not ongoing health issues and/or frequent medication changes are a result of non-adherence.
For example, one patient was seemingly unsuccessful on her warfarin therapy and her practitioner had advised switching to a higher cost brand alternative to try to protect her from a clotting event. Under the Heart@Home program, it was suggested that daily medication administration be conducted in order to offer an understanding of whether medication adherence was perhaps the problem, or if metabolic issues necessitated alternative therapy.
After two weeks of daily visits, the patient’s INR was within range, and medication adherence was at 100%. The patient also reported an improvement in overall well-being because the social interaction with the RCA provided her some respite from her loneliness. The program allowed the healthcare team to ensure that the patient was not only on the right medication at the right dose at the right time, but was also taking the right medication at the right dose and at the right time!
In short, the design of the program is to bring the caregiving and healthcare teams closer together. If a patient has a sudden change in their health status, the doctor is notified right away so that proper care can be coordinated.