World Café 3:
Medication Management / Deprescribing

Tuesday, November 28, 2017
3:30 - 4:45 pm
In this interactive session, delegates will have a chance to network directly with presenters and attendees.
Delegates can expect to pick up practical tools and resources, and have the opportunity to explore diverse perspectives and change ideas.


A clear stream ahead: Reviewing PHO’s UTI Program and associated resources
Many stakeholders approached Public Health Ontario (PHO) with concerns about the misuse and overuse of antibiotics for presumed urinary tract infections (UTIs) in long-term care homes (LTCHs) and about the associated antibiotic-related harms. As a result, PHO created the UTI program to assist LCTHs in improving the management of UTIs in non-catheterized residents. This program supports homes in the implementation of organizational and individual practice changes required to curb unnecessary urine collection and antibiotic prescriptions. The UTI Program consists of practice changes, strategies to support the adoption of these changes and associated supportive resources and tools for use by LTCH staff, families and residents. The UTI Program includes an implementation guide that supports LTCHs as they plan for implementation and the use of the available resources to achieve the desired practice changes. This session will explore tools and resources and will equip participants with foundational UTI messaging to take back to their homes.

GeriMedRisk, a geriatric pharmacology consultation service to prevent adverse drug events among older adults in long-term care
Medications are one of the leading causes of death and disability in Ontario. Co-morbidities and medications in addition to age-related changes to drug metabolism put seniors at heightened risk of adverse drug events and their complications. There is a paucity of clinicians with expertise in geriatric medicine, clinical pharmacology, geriatric psychiatry and geriatric pharmacotherapy in Canada, particularly in rural areas. Therefore there is a need for a scalable, cost-effective solution. Guided by a needs assessment for the existing capacity and demand for geriatric pharmacotherapy in Waterloo-Wellington region, GeriMedRisk was launched April 2017. First of its kind in Canada, GeriMedRisk is an independent, not-for-profit interdisciplinary geriatric pharmacology technology-based consultation service that supports physicians, pharmacists and nurse practitioners to optimize their patients’ medications, cognition, mobility and function. It leverages telemedicine (e-consult) over the Ontario Telemedicine Network (OTN) and telephone, to support referring clinicians from long-term care, and also, primary and acute care.

Speaker: Joanne Ho

Reducing Antipsychotics Using DementiAbility Methods
Antipsychotic medications have serious side effects, including increased risk for falls and reducing quality of life. For antipsychotic use without a diagnosis of psychosis, HQO reported a provincial average of 25.2% for quarter two 2015/16 with a trend to continue downwards. Avalon Care Centre's quarter two 2015/2016 performance was 23.22% which was just below the provincial average. The Team decided to set a goal target of 19 % for 2016. This Quality Improvement initiative was tasked to the Responsive Behaviour Committee, as residents can be prescribed antipsychotics to control behaviours. Our Responsive Behaviour Committee is multidisciplinary involving managers from various departments, Registered Staff, PSWs, BSO PSW, Physicians, Nurse Practitioner, Pharmacist, as well as community resources such as our local Psychogeriatric Resource Consultant (PRC) as required. Residents and families are involved case by case. This multidisciplinary team completes a holistic assessment including PIECES and a WOW assessments of the resident who is currently receiving and prior to implementing antipsychotics to determine if other alternative interventions can be implemented. The team then develops comprehensive plans of care to minimize responsive behaviours. Avalon has also committed to train staff on the DementiAbility Program to support using a holistic approach and utilizing the skills learned to implement non-pharmacological interventions. The outcome of this initiative has meant better care and quality of life for our residents. According to HQO as of September 2016, the home performance was 18.32%. With the continued push of using DementiAbility methods and meeting individual needs of the residents, the team has a current performance of 10.58% as of June 2017 according to PCC data.

A Glimpse into the World of Medical Cannabis: What it is and How it Translates to Resident Centered Care in a Long-Term Setting
Medical cannabis has been used therapeutically for thousands of years all over the world and is becoming an alternative therapy option for patients. Participants will get insight into medical cannabis and how it affects seniors, especially those in long-term care. This interactive session will provide practical tools and resources for participants interested in learning more about medical cannabis as an alternative therapy option for improving the quality of life for residents. The session will provide participants with an open forum to ask questions, provide insight and learn through the first-hand experiences of a current long-term care home with a medical cannabis program in place. A round table discussion will educate and create awareness while collaborating with the many stakeholders involved to address medical cannabis in a complex environment.

Speaker: Donna Scully