Kudos to the CHAMP team for the amazingly comprehensive Geriatric Medication Management Toolkit they’ve put together! It’s divided into sections for Screening/Evaluation; Intervention; Communication; and Guidelines/Best Practices. Tools also are grouped by those focused toward Homecare Professionals and/or Patients/Caregivers. There’s something here for everyone!

As I dipped into the toolkit, here are some of my thoughts:

1. Evaluation and Screening Tools

• “The ARMOR Tool” could be helpful to agencies with nurse practitioner, physician, and/or pharmacist support, or as a training tool for staff nurses.
• The “HbL Medication Risk Questionnaire” could help to identify high-risk clients and those who might benefit from further medication review. CMS is encouraging beneficiaries with Part D Medicare to have an annual Comprehensive Medication Review (CMR) that’s part of their Medicare benefit. Clients screened with this instrument can follow-up with their Part D Pharmacy Benefit Manager plans, or ask their dispensing pharmacist how they can schedule a CMR. A number of large managed care health plans like Humana and Kaiser Permanente now have Medication Therapy Management pharmacists.
• The updated Beers Criteria can also be beneficial for identifying high-risk patients (Click here to read my previous blog post about the 2012 Beers Criteria for Potentially Inappropriate Medication Use in Older Adults).

2. Intervention Tools

• The American Geriatrics Society has really stepped up to address medication management issues with their updated Beers Criteria and tools oriented to patients/caregivers. Their tools may be more appropriate for high-literacy homecare patients/caregivers and could have a place in staff training.
• I’ve used patient/caregiver tools from the National Council on Patient Information and Education (NCPIE) for years. They are oriented to lower-literacy level consumers and are translated into numerous languages.
• For medication/pill lists, I suggest the materials disseminated by the Agency for Healthcare Research & Quality (AHRQ), including “How to Create a Pill Card’.

3. Communication Tools

• “Your Medications – What to Ask” might be more useful for higher literacy patients/primary caregivers.  I suggest looking at NCPIE’s materials for lower literacy patients and caregivers, such as “NCPIE Questions to Ask Before You Leave the Doctor’s Office” (included in the Toolkit).

Please come back and post a comment below to let the CHAMP team and Community know what you think, and what you’ve found to be useful!

Dennee Frey, CHAMP Pharmacy Expert

P.S. Be on the lookout! CHAMP’s partners at the Home Health Quality Improvement (HHQI) National Campaign are scheduled to release a Medication Management Focused Best Practice Intervention Package (BPIP) in a few months, and it will be a great complement to this Toolkit! In the meantime, you can find many useful free resources by registering with the Campaign at www.homehealthquality.org.