Senior-care specialists are quickly becoming a necessity rather than an option in today's rapidly changing healthcare environment.
The US healthcare system is undergoing monumental change due to an increasing population of seniors and the introduction of
Medicare Part D, the new prescription drug benefit that will be administered by Centers for Medicare and Medicaid (CMS) in
2006. These factors are placing the geriatric pharmacist in a position of paramount importance and will continue to do so
in the future.
Growing Senior Population
For years, we have seen demographic projections indicating that the senior population in the United States is not only growing
at a dramatic rate, but is also living longer. According to the American Society of Consultant Pharmacists (ASCP), there are
38 million seniors in the United States. But by 2030, the ASCP projects that the number will rise to 75 million. Seniors are
expected to continue to live longer. "If we can change the aging process—by eliminating aging-related diseases—in the next
10-20 years, the average life span could be in the 90s," says Donald Louria, MD, professor at the department of Preventive
Medicine & Community Health, UMDNJ-New Jersey Medical School.
Despite their increasing longevity, very few senior patients have access to geriatric pharmacists or those who are most qualified
to optimize their therapeutic outcomes. The creation of the Medicare Prescription Drug benefit will undoubtedly serve as a
catalyst driving increased demand for specialists trained in handling the unique needs of geriatric patients. Many anticipate
that it will also increase prescription drug utilization within the senior segment and spark an upward trend in the number
of geriatric pharmacists. As a result, partnerships with geriatric pharmacists will be critical for brand teams that market
products specifically to the senior population.
Unique Needs of Seniors
The medication needs of seniors are very different from those of other segments of the population. According to a study published
in Health Affairs in 2001, more than 77 percent of seniors between the ages of 65 and 79 suffer from one or more chronic diseases. That number
rises to 85 percent for those over the age of 80. "It is common for senior patients to be afflicted with multiple conditions
such as coronary heart failure, hyperlipidemia, hypertension, and diabetes," says Mona Chitre, director of clinical services
for FLRx and pharmacy benefits administrator for Excellus BlueCross BlueShield. Visual and/or cognitive impairment and decreased
renal clearance are other conditions commonly found in seniors that can interfere with patients' ability to adhere to appropriate
drug therapy regimens, and may contribute to drug overdoses and interactions.
Furthermore, "physiological changes place seniors at a greater risk of adverse reactions when taking some medications," says
Tom Clark, director of policy for the ASCP. The metabolic rate changes, organ function declines, and sensitivity to some drugs
can be altered. When these variables interact in an older patient, individualized drug therapy is often required.
With this in mind, it's not surprising that seniors represent a significant portion of prescription medication use. Statistics
released by ASCP indicate that while the elderly account for approximately 13 percent of the population, they consume approximately
40 percent of the total number of prescription drugs.
As a result, the government is taking steps to build programs to counterbalance the excessive use of prescription drugs by
seniors. The Medicare Modernization Act mandates the implementation of Medication Therapy Management (MTM) services or programs
that optimize therapeutic outcomes for Medicare beneficiaries who receive medication for multiple chronic diseases. Specifically,
the legislation requires that all prescription-drug plan sponsors and Medicare Advantage plans offer an MTM program to ensure
that drugs are used to optimize therapeutic outcomes and reduce the risk of adverse drug reactions in high-risk patients.