For older patients, developing a relationship with a pharmacist and using one pharmacy can help ensure consistency in care. A pharmacist can help prevent drug-related problems, which are a particular risk for older adults.
For older patients, pharmacists are sometimes the most accessible health care practitioner. In addition to dispensing drugs, pharmacists provide drug information to patients and providers, monitor drug use (including adherence), and liaise between physicians or other health care practitioners and patients to ensure optimal pharmaceutical care. Pharmacists also provide information about interactions between drugs and other substances, including over-the-counter drugs, dietary supplements (eg, medicinal herbs), and foods. In many states, pharmacists may also provide some types of clinical care (eg, immunizations, diabetes testing, drug counseling and advising).
Pharmacists are responsible for medication reconciliation, which is a formal process for creating the most complete and accurate list possible of a patient’s current medications and comparing the list to those in the patient record or medication orders. Reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions. It should be done at every transition of care in which new medications are ordered or existing orders are rewritten.
(See also Overview of Geriatric Care.)
Patient adherence
Pharmacists can help improve patient adherence by doing the following:
Assessing the patient’s ability to adhere to a drug regimen by noticing certain impairments (eg, poor dexterity, lack of hand strength, cognitive impairment, loss of vision)
Teaching patients how to take certain drugs (eg, inhalers, transdermal patches, injectable drugs, eye or ear drops) or how to measure doses of liquid drugs
Supplying drugs in ways that are accessible to patients (eg, easy-open bottles, pills without wrappers)
Making sure that drug labels and take-home printed materials are in large type and in the patient’s native language
Teaching patients how to use drug calendar reminders, commercially available drug boxes, electronic drug-dispensing devices, and pill splitters or crushers
Eliminating unnecessary complexity and duplication from the overall drug regimen
Completing a medication reconciliation when patients transition to and from various care settings
Settings
Many pharmacists work in a community pharmacy. But they may also work in any health care setting, including hospitals, long-term care facilities, the home (with a home health care agency), mail service and online pharmacies, organized health care systems, and hospice settings ( see Table: Various Duties of Pharmacists).
