Jun 18 2020

Pharmacy Technology - A Crucial Tool in Combatting Adverse Drug Interactions

Pharmacists are often referred to as "the last line of defense" in ensuring patient safety in myriad ways ranging from opioid abuse to medication non-adherence to harmful drug interactions.  And indeed, the nation's pharmacists are well-deserving of this title, as they play increasingly important roles in managing patient heath, and in helping to secure the safety of the nation's drug supply chain.

In some instances though, pharmacists might be forgiven for thinking they are fighting an uphill battle.  Nowhere is this more evident, than among elderly patients, who often take multiple medications each day, often prescribed by several physicians.

This use of multiple medications is referred to as "polypharmacy," and a 2019 report by The New York Times called it a "hidden drug epidemic among older people."  The article cited research by the American Society of Consultant Pharmacists, that found people aged 65-to-69 take an average 15 prescriptions a year, while individuals aged 80-to-84 average 18 prescriptions a year.  These prescriptions do not include the numerous over-the-counter drugs, herbal remedies, vitamins and minerals these individuals may also take.

Research presented in the Canadian Pharmacists Journal noted instances of elderly patients taking as many as 60 doses of medication each day, with many unsure of the reasons for the drugs.  "They tell us they hate taking these drugs," the researchers noted, with many medications prescribed by physicians who "inherit" the patient's medication history and "struggle" to keep up with changes made during multiple hospital stays and specialist visits.

The Times article cited as an example the use of anti-Parkinson therapy for symptoms caused by anti-psychotic drugs, with the anti-Parkinson drugs in turn causing new symptoms such as a sharp drop in blood pressure or delirium, that results in yet another prescription.

"Further contributing to this problem is the fact that doctors do not routinely question patients about their use of non-prescription remedies, and patients rarely volunteer this information unless asked directly," the article noted.

It's no wonder then, that a "pharmacist to the rescue" mentality has taken hold, with one emDOCs analysis noting: "Pharmacist driven-medication review may prove to be a critical patient care application."

As pharmacists work to address the consequences of polypharmacy, many will find their technology system can be an essential partner in this fight.

Two things to note though:

1.  Not all technology systems have the same capabilities, so a pharmacy manager must be sure to invest in a system that specifically addresses adverse interactions.

2.  A system is only as good as the accuracy of its data.  This means a pharmacy must prioritize patient records and ensure staff members understand the need for timely     updates, and accurate records management.

PrimeRx™ from Micro Merchant Systems offers "best in class" capabilities to help combat fallout from conflicting medications. 

Key features include:

  • "Red Flag Warnings." The system intuitively recognizes potential medication conflicts and alerts the pharmacist to the potential problem.
  • Electronic health records. Users can easily access and update patient records and capture critical notes and observations about patient well-being.  This expanded capability allows pharmacists to make note of any non-prescription drugs or supplements a patient may be taking, which may be in conflict with a prescribed medication.  PrimeRx™ allows pharmacies to seamlessly transfer patient updates to other members of the healthcare team, so all prescribers will have this important information.
  • Access to National Drug Code and other databases. Pharmacies have long recognized the need for immediate access to the National Drug Code (NDC) directory as a way to verify prescribed medications and list proper drug codes on all documentation.  Going forward, the NDC directory will be an integral part of the federal government's "supply chain certification" requirements. In addition, pharmacies must have access to the required FDA databases to validate trading partners' proper licensing and certification. PrimeRx™ offers seamless access to this information and allows pharmacy staff to quickly confirm and document all required information.
  • Drug Reference Guide: PrimeRx™ includes an interface to Clinical Pharmacology, which is a leading medical search engine and drug reference guide offered by Elsevier.  Powered by ClinicalKey®, the system integrates with the pharmacy's daily workflow to assist pharmacists' in their dispensing decisions. 

Key capabilities include:

  • Drug Class Overviews
  • Custom Reports
  • Drug Monographs
  • Drug Images
  • IV Compatibility
  • Toxicology Resource
  • Advanced search technology with automatic suggestions that rapidly present relevant information.

PrimeRx™ also interfaces with PDR by ConnectiveRx which provides seamless access to the Physicians' Desk Reference, a trusted reference source for all medical professionals.

  • Packaging. PrimeRx™ includes seamless access to adherence packaging providers, including RxSafe and TCGRx, which allow medications to be dispensed in patient-friendly containers, with user-friendly usage instructions.
  • Prescriber Validation Service. PrimeRx™ includes a Prescriber Validation Service (PVS) which allows pharmacies to seamlessly verify the federal and state licensing credentials of a physician who prescribes a controlled substance.  This is a required prerequisite for dispensing controlled substances, but PrimeRx™ goes beyond to also determine if a prescriber is listed on the Office of the Inspector General's List of Excluded Individuals, or on any state licensing exclusionary lists.  This allows a pharmacist who may have a history of over-prescribing medications for elderly patients.

As important as technology may be in the battle against adverse drug reactions, it is no match for the power of one-on-one, pharmacist/patient interactions. Pharmacists will continue to be on the front lines in helping patients understand their medications and sounding the alarm when an inappropriate or conflicting medication has been prescribed.  But with technology to fall back on, pharmacists have an important ally in winning this fight.