As the population ages and complex health conditions become more common, the risks associated with multiple medication use present significant challenges for elderly patients. Understanding these risks and implementing effective pharmacy management strategies is crucial for helping ensure patient safety and optimal health outcomes.

For elderly patients, the risks associated with taking multiple medications simultaneously can be particularly severe. According to Humana’s expertise in this area, older adults face increased vulnerability due to age-related changes in drug metabolism and heightened sensitivity to medication effects.

“Older adults are more susceptible to the adverse effects of these medications due to age-related changes in drug metabolism and increased sensitivity,” explained TJ Gibb, President of Medicare Part D for Humana. “The combination of opioids and benzodiazepines can lead to serious drug interactions, potentially resulting in respiratory issues, cognitive impairment, and depression.”

This dangerous combination represents just one of many potential medication interactions that can occur when patients see multiple healthcare providers or manage several health conditions simultaneously. The risks extend beyond just opioids and benzodiazepines to include anticholinergic medications, which can be particularly problematic for seniors managing multiple common conditions like depression, nausea, allergies, and bladder issues.

“The use of multiple medications increases the risk of falls, fractures, and hospitalization among older adults,” Gibb noted. “It is crucial for healthcare providers to carefully assess the necessity and appropriateness of prescribing these medications, considering the unique needs and vulnerabilities of this population.”

For injured patients, similar risks exist, particularly when pain management involves powerful medications that may interact with existing prescriptions or lead to dependency issues.

Best Practices for Managing Pharmacy Use in Injured Patients

TJ Gibb, President of Medicare Part D, Humana

Effective pharmacy management requires a comprehensive approach that balances pain management needs with safety considerations. Based on Humana’s experience with medication management, several best practices emerge:

• Implement Robust Monitoring Systems: Establishing plans that track medication dispensing across multiple providers is essential. This prevents situations where patients might receive conflicting or potentially dangerous drug combinations from different specialists. “Consider a scenario where a patient is visiting different doctors for various health concerns, such as gastrointestinal issues, sleep disorders, and pain management,” Gibb explained. “Each of these doctors may prescribe medications independently, potentially leading to drug interactions.” While prescribing providers should ideally review medication histories before adding new prescriptions, this doesn’t always happen. A comprehensive monitoring system serves as a critical safety net.
• Establish Clear Communication Channels: Ensuring all stakeholders—patients, providers, pharmacies, and insurers—communicate effectively is vital to preventing medication errors and adverse interactions. “Our system is designed to take on the burden of managing the complexities in the dispensing pharmacy process,” said Gibb. “We work with all parties involved – the patient, the prescriber, and the pharmacy – to communicate effectively with each other.” This communication framework allows for verification that medications being dispensed are clinically appropriate for each patient’s unique situation.
• Utilize Prior Authorization Appropriately: For high-risk medications like opioids, implementing prior authorization processes can prevent dangerous prescribing patterns while still ensuring patients receive necessary treatment. “Prior authorization is an important step, especially if a patient is already on certain medications before being prescribed a new medication,” Gibb noted. “We want to ensure that there are no adverse drug-to-drug interactions, and the individual is able to tolerate the prescribed therapy.” This process isn’t meant to create barriers but rather to facilitate important clinical conversations that protect patient safety.
• Prioritize Patient Education: Many patients may not feel comfortable questioning their providers about medication concerns. Effective pharmacy management includes robust education components. “Educating patients is absolutely crucial,” emphasized Gibb. “Many individuals simply follow their doctor’s instructions without fully understanding the purpose of the medication. They may not feel comfortable asking questions and partnering with their provider in their healthcare journey.”

Humana’s Approach to Supporting Medication Safety

Humana has developed a comprehensive approach to medication management that addresses these challenges head-on, focusing on three key areas:

• Oversight and Coordination

Humana serves as an important coordinator in the medication management process, particularly for patients seeing multiple providers. “We play a critical role in helping ensure medication safety and preventing potential drug interactions for patients seeing multiple providers,” Gibb explained. “We act as a safety net, by covering drugs on the health plan’s drug formulary and monitoring the medications being dispensed at pharmacies.”

This oversight function helps prevent situations where patients might receive conflicting or potentially dangerous drug combinations from different healthcare providers. “Humana serves as a wrapper for the entire process, helping ensure that all the pieces fit together properly,” added Gibb.

• Leveraging Medicare Star Measures for Quality Improvement

The Medicare program has a measurement system to maintain high standards of quality and accountability in medication management. “Stars is a system used by the Medicare program to hold health plans accountable for delivering a certain level of quality service and to improve health outcomes for members,” explained Gibb. “Two of the relatively new Star measures focus on the use of multiple anticholinergic medications and concurrent use of opioids and benzodiazepines.”

These measures help identify potential issues with medication use, including triggers to monitor medication use and prompt interventions when necessary.

• Multi-Channel Support and Education

Recognizing that patients have different preferences for receiving information, Humana offers support through various channels. “Humana offers a range of tools to support these measures, which are available through telephonic and digital means to meet the customer where they are,” said Gibb.

Additionally, Humana works with dispensing pharmacies to help ensure they have the proper information to provide the patient with a positive experience. Their system can flag potential medication issues and advise pharmacies to coordinate with prescribers about any potential issues. “When patients stay on properly prescribed therapy, they have the best chance to stay healthy and live their best life,” Gibb emphasized.

The Role of Brokers in Promoting Medication Safety

Insurance brokers play a vital role in this ecosystem by helping clients understand the importance of medication management programs.

“Brokers are part of the solution,” suggested Gibb. “Reminding their customers of things like the importance of primary care provider visits, verifying drugs covered on the formulary and medication adherence can make a real difference. These are the things that help people maintain their health.”

By understanding the Stars and Humana’s approach to medication safety, brokers can better serve their clients and contribute to better health outcomes.

Looking ahead, the focus on medication safety will only increase as the population ages and complex health conditions become more common. For organizations and individuals ready to address these challenges, the benefits include improved patient outcomes, reduced healthcare costs, and enhanced quality of life.

To learn more, visit www.humana.com.

This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Humana. The editorial staff of Risk & Insurance had no role in its preparation.