Deploying Community Paramedics To Address Medication Complexity At Home

by Caitlin Thomas-Henkel Sandi Groenewold: For More Info, Go Here…

Complicated drug regimens are often a challenge for people with complex health and social needs, including individuals with physical and behavioral health comorbidities, seniors, and those dually eligible for Medicare and Medicaid. It is not uncommon for people with complex needs to take 20 or more medications daily, typically prescribed by multiple providers, and often with complicated dosing schedules and confusing instructions.

Outside of clinic walls, people are left to interpret and develop their own medication schedules with little to no ongoing support, which is where things get tricky, if not downright dangerous. In the US, 119,000 deaths are attributed to medication errors annually. The more complicated the medication regimen, the higher the probability of a patient not following it correctly, increasing the likelihood for largely preventable adverse drug events to occur. Additionally, each medication added to a drug regimen is linked to a 10 percent increase for adverse drug events, which can lead to increased hospitalizations, exacerbations of disease, and even premature death—not to mention the impact on patients’ quality of life and adverse drug event expenses, which are estimated to cost up to $180 billion annually.

Unlike a traditional paramedic, whose goal is to quickly triage and process an emergency situation, a community paramedic builds a therapeutic rapport with patients to understand what is going on “below the surface.”

Community paramedics are able to go where clinicians typically do not—into the patient’s home—where they may discover unexpected barriers and underlying factors that affect health outcomes. Barriers related to medication complexity may include prescription drugs being stored incorrectly, patients taking expired medications or over-the-counter supplements that have not been reported to their provider(s), or patients having difficulties adhering to complicated medication instructions. A community paramedic can investigate these issues firsthand and seek ways to solve them through patient education (such as needing to take food with certain medications, developing reminders for medication schedules, or special packaging), connecting the patient with community resources, or both. This approach is a paradigm shift that differs from the traditional one-way model of medication prescribing and dispensing to a patient-centered approach.

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