Abstract
There has been an unprecedented growth in population ageing across the world in recent years. In 2017, the Census and Statistics Department of Hong Kong predicted that the number of older adults aged 65 and over will increase from 18% of the whole population in 2020 to 32% in 2050. Medication management in older patients will, therefore, become even more challenging in the years ahead. Nowadays, pharmacists are being integrated into multidisciplinary teams to provide extensive clinical services, including evidence-based medication optimisation, drug therapy-related problem identification, as well as medication adherence and monitoring, in order to provide more holistic and humanistic care to older adults. This chapter first describes the role of a geriatric clinical pharmacist in a multidisciplinary team. Then, the relevance of pharmacists’ role in the practice of polypharmacy including de-prescribing is illustrated. Furthermore, the utilisation of innovative technology, or “telepharmacy”, to communicate and provide counselling is demonstrated. The appliance of newer technology such as Facial Recognition Technology (FRT) and Artificial Intelligence (AI) to verify medication adherence is introduced, as well as the use of Transdermal Optical Imaging (TOI) to measure vital signs such as blood pressure after taking the medications. Lastly, the use of technology to help in fall detection and prevention, and the adoption of eye movement patterns in face recognition to assess cognitive decline in the older adults is revealed. All these new and innovative initiatives further enhance and demonstrate the important role of clinical pharmacists in the multidisciplinary care for older adults in the pursuit of ageing with dignity.
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References
Al-Aama, T. (2011). Falls in the elderly spectrum and prevention. Canadian Family Physician, 57(7), 771–776. https://pubmed.ncbi.nlm.nih.gov/21753098/
American College of Clinical Pharmacy. (2020). About clinical pharmacists. https://www.accp.com/about/clinicalpharmacists.aspx
American Geriatrics Society. (2019). American geriatrics society 2019 updated AGS beers criteria®for potentially inappropriate medication use in older adults. https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.15767
American Society of Health-System Pharmacists. (2020). ASHP guidelines on preventing medication errors in hospitals. https://www.ashp.org/-/media/assets/policy-guidelines/docs/guidelines/preventing-medication-errors-hospitals.ashx
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., ... & Ziaeian, B. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation, 140(11), e563–e595. https://doi.org/10.1161/CIR.0000000000000677
Arora, P. (2021). What is the cockcroft-gault formula for estimating creatinine clearance (CrCl) and how is it used in patients with chronic kidney disease (CKD)? https://www.medscape.com/answers/238798-105315/what-is-the-cockcroft-gault-formula-for-estimating-creatinine-clearance-crcl-and-how-is-it-used-in-patients-with-chronic-kidney-disease-ckd8
Artificial Solutions. (2020). What is a chatbot? https://www.artificial-solutions.com/chatbots
Batra, G., Queirolo, A., & Santhanam, N. (2018, January 8). Artificial intelligence: The time to act is now. https://www.mckinsey.com/industries/advanced-electronics/our-insights/artificial-intelligence-the-time-to-act-is-now
Brahma, D., Wahlang, J., Marak, M., & Sangma, M. (2013). Adverse drug reactions in the elderly. Journal of Pharmacology and Pharmacotherapeutics, 4(2), 91. https://doi.org/10.4103/0976-500x.110872
Cameron, J. (Director) (1991). Terminator 2: Judgment Day [Film]. Carolco Pictures.
Census and Statistics Department. (2017). Hong Kong population projections 2017–2066. https://www.statistics.gov.hk/pub/B1120015072017XXXXB0100.pdf
Chan, C., Chan, A., Lee, T., & Hsiao, J. (2018). Eye-movement patterns in face recognition are associated with cognitive decline in older adults. Psychonomic Bulletin & Review, 25, 2200–2207. https://doi.org/10.3758/s13423-017-1419-
Cheong, S. T., Ng, T. M., & Tan, K. T. (2018). Pharmacist-initiated deprescribing in hospitalised elderly: Prevalence and acceptance by physicians. European Journal of Hospital Pharmacy, 25, 35–39. https://doi.org/10.1136/ejhpharm-2017-001251
Chui, K., Chong, G., & Chu, W. (2017, December 5). Effectiveness of identifying drug-related problems (DRPs) at an outpatient hospital pharmacy in Hong Kong [Poster presentation]. Midyear Clinical Meeting and Exhibition 2017, Orlando, USA. https://www.eventscribe.com/2017/ASHP-Meeting/ajaxcalls/PosterInfo.asp?efp=WUFORk1KUU8yMDk5&PosterID=117676&rnd=0.2697316
Craft, L. (2017, June 30). Emerging applications of AI for healthcare providers. https://www.gartner.com/en/documents/3753763/emerging-applications-of-ai-for-healthcare-providers
Duncan, P., Duerden, M., & Payne, R. (2017). Deprescribing: A primary care perspective. European Journal of Hospital Pharmacy, 24(1), 37–42. https://doi.org/10.1136/ejhpharm-2016-000967
Food and Health Bureau. (2008). Projection of Hong Kong’s healthcare expenditure. https://www.fhb.gov.hk/beStrong/files/consultation/projecthealthexp_eng.pdf
Forbes, E. (2020, May 24). Artificial intelligence—A potential game-changer for the pharmacy sector!. http://thetechnews.com/2020/05/24/artificial-intelligence-a-potential-game-changer-for-the-pharmacy-sector/
Garfinkel, D., Ilhan, B., & Bahat, G. (2015). Routine deprescribing of chronic medications to combat polypharmacy. Therapeutic Advances in Drug Safety, 6(6), 212–233. https://doi.org/10.1177/2042098615613984
Gillespie, L., Robertson, M., Gillespie, W., Sherrington, C., Gates, S., Clemson, L., & Lamb, S. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database Systematic Reviews, 12(9), 1–3. https://doi.org/10.1002/14651858.CD007146.pub3
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., ... & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). The Journal of the American Medical Association, 311(5), 507–520. https://doi.org/10.1001/jama.2013.284427
Karani, M., Haddad, Y., & Lee, R. (2016). The role of pharmacists in preventing falls among America’s older adults. Frontiers in Public Health, 4(250), 1–4. https://doi.org/10.3389/fpubh.2016.00250
Kloberdanz, K. (2018). Selfies against hypertension? This smartphone app could measure blood pressure just by scanning your face and hand. https://www.ge.com/news/reports/ai-hypertension-smartphone-app-measure-blood-pressure-just-scanning-skin
Kore.ai, Inc. (2020). Personalized care: Virtual assistants trigger innovation in healthcare. https://kore.ai/solutions/industries/healthcare/
Labovitz, D., Shafner, L., Gil, M., Virmani, D., & Hanina, A. (2017). Using artificial intelligence to reduce the risk of nonadherence in patients on anticoagulation therapy. Stroke, 48(5), 1416–1419. https://doi.org/10.1161/STROKEAHA.116.016281
Lexicomp. (2020a). Alendronate: Drug information. https://www.uptodate.com/contents/alendronate-drug-information?search=bisphosphonates&selectedTitle=1~133&usage_type=panel&display_rank=1&kp_tab=drug_general&source=panel_search_result
Lexicomp. (2020b). Terazosin: Drug information. https://www.uptodate.com/contents/terazosin-drug-information?search=terazosin&source=panel_search_result&selectedTitle=1~27&usage_type=panel&kp_tab=drug_general&display_rank=1
Luo, H., Yang, D., Barszczyk, A., Vempala, N., Wei, J., Wu, S., Zheng, P., Fu, G., Lee, K., & Feng, Z. (2019). Smartphone-based blood pressure measurement using transdermal optical imaging technology. Circulation: Cardiovascular Imaging, 12(8), e008857. https://doi.org/10.1161/CIRCIMAGING.119.008857
Marsh and McLennan Companies’ Asia Pacific Research Center. (2020). Advancing into the golden years: Cost of healthcare for Asia Pacific’s elderly. Marsh and McLennan Companies. https://www.mmc.com/content/dam/mmc-web/Files/APRC/APRC%20Ageing%20report%20EXEC%20SUMM.pdf
Marvin, V., Ward, E., Poots, A., Heard, K., Rajagopalan, A., & Jubraj, B. (2017). Deprescribing medicines in the acute setting to reduce the risk of falls. European Journal of Hospital Pharmacy, 224(1), 10–15. https://doi.org/10.1136/ejhpharm-2016-001003
Miller, P. (2020). Osteoporosis in patients with chronic kidney disease: Management. https://www.uptodate.com/contents/osteoporosis-in-patients-with-chronic-kidney-disease-management
National Institutes of Health. (2016). World’s older population grows dramatically—NIH-funded Census Bureau report. https://www.nih.gov/news-events/news-releases/worlds-older-population-grows-dramatically
Nie, J., Qiu, Q., Phillips, M., Sun, L., Yan, F., Lin, X., … Li, X. (2020). Early diagnosis of mild cognitive impairment based on eye movement parameters in an aging Chinese population. Frontiers in Aging Neuroscience, 12, 221. https://doi.org/10.3389/fnagi.2020.00221
O’Mahony, D., O’Sullivan, D., Byrne, S., O’Connor, M., Ryan, C., & Gallagher, P. (2015). STOPP/START criteria for potentially inappropriate prescribing in older people: Version 2. Age and Ageing, 44(2), 213–218. https://doi.org/10.1093/ageing/afu145
Patient-Centered Primary Care Collaborative. (2012). The patient-centered medical home: Integrating comprehensive medication management to optimize patient outcomes resource guide. http://www.pcpcc.org/sites/default/files/media/medmanagement.pdf
Pharmaceutical Care Network Europe. (2020). New version (9) PCNE DRP-Classification. https://www.pcne.org/news/87/new-version-9-pcne-drp-classification
Rai, S. (2018). Cognitive computing and artificial intelligence systems market in healthcare. BCC Publishing. https://www.bccresearch.com/market-research/healthcare/cognitive-computing-artificial-intelligence-systems-market-healthcare.html
Reddy, A., Jogendra, M., & Rosendorff, C. (2014). Blood pressure measurement in the geriatric population. Blood Pressure Monitoring, 19(2), 59–63. https://doi.org/10.1097/MBP.0000000000000021
Slawomirskii, L., Auraaeni, A., & Klazingai, N. (2017). The economics of patient safety (OECD Health Working Papers, No. 96). OECD Publishing. https://www.oecd-ilibrary.org/social-issues-migration-health/the-economics-of-patient-safety_5a9858cd-en
Syno Global. (2018). Artificial intelligence for fall detection and proactive care. https://syno.global/artificial-intelligence-for-fall-detection-and-proactive-care/
The Board Certified Geriatric Pharmacist. (2020). Geriatric pharmacy. https://www.bpsweb.org/bps-specialties/geriatric-pharmacy/#1517761118361-6c02bae3-f5a01517848269340
The Board of Pharmacy Specialties. (2020). Pharmacotherapy. https://www.bpsweb.org/bps-specialties/pharmacotherapy/#1517746856979-c1fe2e04-8ffb15177800157771517854077689151785833382515178634536801517864316733
The Pharmacy Forum Northern Ireland. (2016). Clinical check guidance. Pharmaceutical Society of Northern Ireland. https://www.pfni.org.uk/wp-content/uploads/2017/05/Pharmacy-Forum-Clincial-Guidance.pdf
The Royal Pharmaceutical Society. (2020). Clinical checks—Quick reference guide. https://www.rpharms.com/resources/quick-reference-guides/clinical-checks
Tinetti, M., & Kumar, C. (2010). The patient who falls “it’s always a trade-off.” The Journal of the American Medical Association, 303(3), 258–266. https://doi.org/10.1001/jama.2009.2024
Vejar, M., Makic, M., & Kotthoff-Burrell, E. (2015). Medication management for elderly patients in an academic primary care setting: A quality improvement project. Journal of the American Association of Nurse Practitioners, 27(2), 72–78. https://doi.org/10.1002/2327-6924.12121
World Health Organization. (2011, October). Global health and aging. National Institutes of Health Publication. https://www.who.int/ageing/publications/global_health.pdf
World Health Organization. (2019, June). Medication safety in polypharmacy. The WHO Document Production Services. https://apps.who.int/iris/bitstream/handle/10665/325454/WHO-UHC-SDS-2019.11-eng.pdf?ua=1
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Chu, W.W.S., Chong, G.C.H. (2022). The Role of Clinical Pharmacists in the Multidisciplinary Care of Geriatric Patients: Now and the Future. In: Law, V.T.S., Fong, B.Y.F. (eds) Ageing with Dignity in Hong Kong and Asia. Quality of Life in Asia, vol 16. Springer, Singapore. https://doi.org/10.1007/978-981-19-3061-4_30
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