VIEWPOINT: Revolutionizing Long-Term Care at Home Pharmacy Services

An aging patient, living alone and confused by the complex regimen of medications she must take, gets help from a pharmacist. Another patient, unhappy with the results he is getting from his prescriptions, has a visit with an in-home pharmacist for help with medication-therapy management. Both patients (and many more like them) are benefitting from long-term care at home pharmacy services. Long-term care at home pharmacy — a comprehensive health-care model designed to meet the needs of aging patients in their homes — has emerged at a critical point in U.S. health-care history. While studies show that the U.S. health-care system is underperforming to a tragic degree, the U.S. population is reaching a point where more aging patients than ever need help. Long-term care at home pharmacy is bridging the gap by ensuring safety, convenience, and high-quality care for those struggling to get assistance for their health concerns. While long-term care at home pharmacy is not a new practice, it is undergoing a revolution that promises to further enhance the assistance it can provide patients. By integrating the latest technological advances, long-term care at home pharmacy gains the ability to be more precise and provide more personalized service while reducing the burden on pharmacists.

Personalized medication management

For many patients, and especially aging patients, managing medication is a challenge that threatens the effectiveness of their health care. Key struggles include taking medications at scheduled times, taking the correct dose, and pairing medication with health monitoring, such as required with some pain-management medications. As medication regimens become more complex, patients are often left on their own to identify dangerous interactions or combinations that can lead to ineffectiveness. What many need is personalized medication management that considers their unique combination of prescriptions. To provide an adequate level of medication-management support, pharmacists providing long-term care at home pharmacy services can opt to leverage the power of artificial intelligence (AI). AI offers the potential to conduct detailed analyses of patient data to create personalized medication plans. In the area of medication management, AI-powered tools can: • Send patients personalized reminders. • Monitor medication intake, alerting pharmacists or other health-care professionals when prescriptions are not followed. • Monitor vital signs to detect abnormalities. AI is poised to support the revolution of long-term care pharmacy at home, advancing far beyond simple reminders, monitoring, and alerts. A recent study published in the Journal of Medical Systems highlights the promise of generative AI as a sophisticated tool for managing complex medication regimens. In this study, researchers evaluated ChatGPT’s ability to handle the challenges of polypharmacy and assist in deprescription. They concluded that “AI-based tools can play an important role in ensuring safe medication practices for older adults.” This breakthrough aligns perfectly with the goals of long-term care at home pharmacy, which focuses on delivering comprehensive and tailored medication management to patients who require skilled-level care in the comfort of their homes. For these patients, polypharmacy and chronic conditions are often the norm, making the integration of AI-driven tools a game changer. Generative AI could enhance the care provided by long-term care at home pharmacies in several transformative ways: Proactive Medication Reviews: AI tools could assist pharmacists in conducting thorough medication reviews and analyzing regimens for potential interactions, duplications, or medications that no longer align with the patient’s current health status. This aligns with the long-term care at home model’s commitment to ensuring optimal and safe medication use. Support for Deprescription: Deprescription is often a critical, yet challenging, component of care for aging patients. AI can provide evidence-based recommendations to help pharmacists and prescribers identify medications to taper or discontinue, improving patient safety and reducing the risk of adverse effects. Personalized Care Plans: Long-term care at home pharmacies prioritize individualized care. AI can complement this by generating tailored recommendations based on a patient’s unique medical history, current health conditions, and goals. This ensures the pharmacy’s interventions are clinically sound and patient-centric. Enhanced Care Coordination: Effective collaboration among health-care providers, caregivers, and families is a cornerstone of long-term care at home pharmacy. AI can bridge communication gaps by synthesizing patient data, summarizing recommendations, and creating actionable insights for care teams. Medication Adherence and Education: AI can empower patients and caregivers with personalized education on medication use, side effects, and lifestyle adjustments. For long-term care at home patients, this level of support can foster better adherence and reduce medication errors. The integration of generative AI into long-term care at home pharmacy also has the potential to address systemic challenges. As the population ages and the demand for skilled-level care in the home increases, managing medications for these patients will become more complex. AI-driven tools can help scale the capacity of long-term care at home pharmacies, allowing them to serve more patients without compromising on safety or quality. The study’s findings signal that AI is no longer just a future concept but an emerging partner in health care. For long-term care at home pharmacy, this partnership represents an exciting opportunity to further elevate the standard of care, improve outcomes, and support patients aging in place.

Remote patient monitoring

Telehealth technologies are another advancement that is allowing pharmacists to increase their capabilities. Those providing long-term care at home pharmacy services can use telehealth tools in several ways, including managing medications, coordinating care, and providing personalized delivery and education. Wearables, which generally fall under the umbrella of remote patient monitoring, are one example of telehealth tools that are helping pharmacists provide better care. These tools allow pharmacists to monitor patients’ vital signs remotely, alerting them to changes that could indicate medication is not being administered correctly or not having its desired effect. To date, studies suggest that wearables have the potential to positively affect outcomes for those with chronic diseases. Telehealth tools that allow remote video interactions also improve pharmacists’ capabilities to provide care by enabling real-time, face-to-face consultations, improving the quality of communication and care they can offer patients. For example, a patient who may need support administering injections can now receive personalized guidance via video communication with a pharmacist. Furthermore, face-to-face video consultations let pharmacists build stronger relationships with patients. With video communication, pharmacists can see changes in conditions being treated and read nonverbal cues, which can give them a better understanding of the impact of treatment. By fostering stronger relationships, video-driven telehealth can also facilitate open communication about medication concerns, side effects, and adherence. Long-term care at home pharmacy services have become a critical piece of the health care puzzle for many aging patients. By leveraging emerging technologies, pharmacists can further improve the impact of those services, giving patients higher chances of experiencing positive care outcomes.      

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Lindsay Dymowski is co-founder and president of Centennial Pharmacy Services, a long-term care-at-home pharmacy, and co-founder and president of the Long Term Care at Home Pharmacy Quality Commission.