CPE
Briana L. Skalski-Gallagher, PharmD
According to the Lown Institute, 750 older adults age 65 and older living in the United States are hospitalized every day due to serious adverse effects from one or more of their medications.
Over the last decade, older people sought medical treatment more than 35 million times for adverse drug events (ADEs) and were hospitalized more than 2 million times due to ADEs. More than 40% of older adults take 5 or more prescription medications per day, a 200% rise over the past 20 years. When OTC drugs and supplements are included, two-thirds of older Americans take 5 or more medications.
How did we get to this state of medication overload? The Lown Institute suggests 3 main causes:
1) Culture of prescribing
2) Information and knowledge gaps
3) Fragmentation of care
The notion that there’s “a pill for every ill” has fostered a culture of “quick fixes” for patients’ chief complaints. Additionally, it is not uncommon for clinicians and patients alike to not do their due diligence when making decisions as to whether to start or stop medications. Lastly, the lack of interprofessional communication between providers caring for the same patient can exacerbate the prevalence of polypharmacy, as one provider may be treating the adverse effect of another medication within a patient’s regimen. Consequently, when a medication is used to treat such adverse effects, it can lead to or perpetuate a prescribing cascade.
See Table 1 for examples of common prescribing cascades.
Pharmacists, as the experts on medication, are a vital part of the health care system with the skills needed to conduct comprehensive medication reviews and implement dose reduction and/or discontinuation strategies to avoid ADEs. In other words, pharmacists are the ideal health care team members to identify prescribing cascades and initiate deprescribing, the “antidote” for the polypharmacy plague and prescribing cascade epidemic wreaking havoc across the United States. With a focus on reducing polypharmacy via deprescribing, the Lown Institute estimates a potential savings of $62 billion in unnecessary medical care over the next decade.
CPE assessment
This assessment must be taken online; please see “CPE information” below for further instructions. The online system will present these questions in random order to help reinforce the learning opportunity. There is only one correct answer to each question.
CPE information
To obtain 1 hour of CPE credit for this activity, complete the CPE exam and submit it online at www.pharmacist.com/education. A Statement of Credit will be awarded for a passing grade of 70% or better. You have two opportunities to successfully complete the CPE exam. Pharmacists and technicians who successfully complete this activity before October 1, 2027, can receive credit. Your Statement of Credit will be available online immediately upon successful completion of the CPE exam.
This policy is intended to maintain the integrity of the CPE activity. Learners who successfully complete this activity by the expiration date can receive CPE credit. Please visit CPE Monitor for your statement of credit/transcript.
To claim credit
1. Go to http://apha.us/CPE.
2. Log in to your APhA account, or register as a new user.
3. Select “Enroll Now” or “Add to Cart” (click “View Cart” and “Check Out”).
4. Complete the assessment and evaluation.
5. Click “Claim Credit.” You will need to provide your NABP e-profile ID number to obtain and print your statement of credit.
Assistance is available Monday through Friday from 8:30 am to 5:00 pm ET at APhA InfoCenter by calling 800-237-APhA (2742)
or by e-mailing infocenter@aphanet.org.