CHS Pharmacy News 

March 2020

Diversion of Controlled Substances

With full awareness of the opioid crisis, it is important to put into place various barriers to detour individuals from the diversion of controlled substances (CS). These barriers could include, but not limited to:

• Implement an anonymous reporting system for staff to inform administration of concerns.
• Develop a “for cause” drug testing policy for staff
• Implement policy and procedures that exceed minimal state and federal requirements
• Never leave CS unattended and locked at all times.
• Develop a count back procedure for shift change
• Consider random “for cause” drug testing policy for patients to verify medication is administered
• Destroy, as legally defined and in accordance with state and federal regulations, any expired, discontinued, or used CS medications or delivery devices.

Intervention Ideas for Mealtimes in LTC*

Families and residents ranked “dining environment” as their top priority for identifying ways to make the long-term care centers more like home. Of these, ideas included:

• Play quiet, instrumental music during meals
• Do not rush the mealtime
• Offer fresh, seasonal fruit or offer treats
• Improve staff knowledge on how to engage in safe practices

Antihypertensives and Fall Risk**

Residents may be at a higher risk for falls with aggressive blood pressure control, or when treated to goals of less than 120/80 or 130/80. Results have shown, that when a resident with antihypertensives has been identified for dosage reduction, the resident had a lower 30-day fall risk compared to those without the dosage reduction. It is important to record and report trends to the treating provider for appropriate dosage adjustments to reduce likelihood of a medication related fall.

Administration Tips: Rybelsus***

Semaglutide (Rybelsus®) is an oral GLP-1 antidiabetic medication to assist with improving blood glucose levels with type 2 diabetes mellitus. This medication has specific requirements for administration to allow for maximum benefits.

• Patients must take on an empty stomach
• Take with no more than 4 ounces of water
• Wait 30 minutes before the first food, beverage or other oral medication
• Must be swallowed whole, may NOT be split, crushed or chewed

Optimizing Sleep for Residence in LTC****

Sedative medications have been associated with potential harm to the elder population, specifically with more complex comorbidities. Utilization of sleep logs and developing and auditing individual sleep patterns, a resident-centered educational intervention can result in a trend toward reduced sedative use and significantly improved sleep patterns. Given the high prevalence of sleep issues among frail elders, nonpharmacologic interventions should be incorporated into the long-term care setting as clinically appropriate.

NEW: Online Payment Options

A Make Payment link is now offered on our chspharmacy.net website to pay with a debit or credit card. Currently, it is an option to pay only. A blank field is presented for the patient/resident name to be entered, which is required for payment to move forward. After entering the patient/resident name and clicking the pay now button, you will be directed to a third party vendor, Transaction Express, to enter card info, address, email, etc. Future updates to this service will include the option to review current balances, current statement, past statements, etc.

1. * Ann Longterm Care. 2019;27(6):e8-e12. doi:10.25270/altc.2019.03.00062 Received March 6, 2018; accepted June 29, 2018. Published online April 3, 2019.
2. ** Antihypertensive De-intensification May Lessen Fall Risk. (n.d.). Retrieved from managedhealthcareconnect.com
3. *** Rybelsus®. (n.d.). Retrieved from rybelsuspro.com
4. **** Ann Longterm Care. 2019;27(12):e7-e12, s1-s3. doi:10.25270/altc.2019.09.00086 Received December 3, 2018; accepted January 29, 2019. Published online October 1, 2019.