The Rise of Age-Friendly Healthcare
As our society's population continues to age, the need for healthcare professionals with specialized knowledge in geriatric care is increasing. The Age-Friendly Health Systems (AFHS) movement, pioneered by the Institute for Healthcare Improvement (IHI), provides a framework to ensure reliable, evidence-based care for older adults. While traditionally focused on hospitals and clinics, a recent initiative is leveraging pharmacists as critical "Age-Friendly Champions," recognizing their vital role in medication management for the aging population.
The Age-Friendly Pharmacist and the 4Ms Framework
At the core of the age-friendly approach is the 4Ms Framework. An age friendly pharmacist utilizes this framework to provide care that is aligned with what older adults and their caregivers value most. This model ensures comprehensive and tailored care that goes far beyond simply dispensing medication. The 4Ms include:
What Matters
This principle focuses on understanding and aligning care with the older adult's specific health goals and care preferences. It’s about more than just their health conditions; it's about their quality of life. For the age friendly pharmacist, this means:
- Discussing personal priorities, such as maintaining independence or being able to attend family events.
- Collaborating with the patient to ensure medication regimens align with their life goals.
- Creating a plan that respects the patient's wishes for daily activities, comfort, and advanced care planning.
Medication
Older adults often take multiple medications (polypharmacy), which increases the risk of side effects and adverse drug events. The age friendly pharmacist is an expert in managing these complexities. Their work includes:
- Conducting comprehensive medication reviews to eliminate potentially inappropriate or unnecessary medications.
- Using evidence-based tools, such as the American Geriatrics Society's Beers Criteria, to identify high-risk medications.
- Deprescribing when appropriate to reduce the medication burden and improve safety.
- Educating patients and caregivers on proper medication use, potential side effects, and adherence strategies.
Mentation
Cognitive function and delirium are key concerns for older adults. An age friendly pharmacist understands that certain medications can affect a person's mental state. Their role involves:
- Screening for cognitive impairment and delirium risks associated with medications.
- Identifying and suggesting alternatives for medications that may cause confusion, sedation, or other mental side effects.
- Collaborating with other healthcare team members to monitor and manage changes in mentation.
Mobility
Ensuring older adults can move safely and independently is crucial for their quality of life. The age friendly pharmacist assesses the impact of medications on mobility, focusing on reducing the risk of falls. Actions include:
- Reviewing medications that can cause dizziness, drowsiness, or unsteadiness.
- Educating patients on how their medications might affect their balance.
- Recommending non-pharmacological interventions or collaborating with physical therapists to support safe mobility.
Age-Friendly Care vs. Traditional Pharmacy Services
| Feature | Traditional Pharmacy Services | Age-Friendly Pharmacy Care |
|---|---|---|
| Focus | Dispensing prescriptions and basic counseling. | Holistic, person-centered care aligned with patient goals. |
| Medication Review | Typically reactive; addresses immediate questions. | Proactive, comprehensive review to minimize polypharmacy and harm. |
| Care Planning | Limited to medication instructions. | Integrated into a broader care plan that includes mobility and mentation. |
| Patient Engagement | Minimal; often a brief transaction. | Deep, collaborative relationship built on trust and shared decision-making. |
| Knowledge Base | General pharmacology. | Specialized geriatric pharmacology and the 4Ms framework. |
How to Find and Work with an Age Friendly Pharmacist
As the AFHS movement gains momentum, finding age-friendly services is becoming easier. The American Society of Consultant Pharmacists (ASCP) and the John A. Hartford Foundation are leading efforts to train and recognize pharmacists as Age-Friendly Champions through a digital badging program.
- Look for credentials: Ask your pharmacist if they have completed specialized training or obtained an "Age-Friendly Pharmacist" badge through programs from ASCP or similar organizations.
- Seek out certifications: Some pharmacists may have a Board Certified Geriatric Pharmacist (BCGP) credential, indicating an advanced level of expertise in senior care.
- Check with your healthcare system: Inquire if your hospital or clinic is a recognized Age-Friendly Health System and if they have pharmacists who are part of that initiative.
- Communicate openly: When working with a pharmacist, openly discuss your health goals, concerns, and lifestyle. This helps them tailor their care to what matters most to you.
- Utilize medication reviews: Proactively schedule medication review appointments to discuss your entire medication list, including over-the-counter drugs and supplements.
The Impact of Age-Friendly Pharmacists
Engaging with an age friendly pharmacist can have a profoundly positive impact on an older adult's health and well-being. By focusing on the 4Ms, these professionals help to reduce medication-related harm, prevent falls, improve cognitive function, and ensure that care respects the individual's personal priorities. The Centers for Medicare and Medicaid Services (CMS) have even added age-friendly measures to hospital quality reporting, underscoring the importance of this integrated approach. Pharmacists are a critical part of the care team, working collaboratively with doctors and other providers to achieve optimal outcomes.
The Institute for Healthcare Improvement provides comprehensive resources on the AFHS framework and how to get involved, including toolkits and educational materials. The initiative aims to ensure that older adults receive the best possible care, and pharmacists play a crucial role in that mission. You can find more information about the initiative at the Institute for Healthcare Improvement website.
Conclusion
An age friendly pharmacist is a specialized expert who applies the 4Ms Framework to deliver person-centered care for older adults. Their role extends far beyond dispensing prescriptions to include proactive medication optimization, safeguarding mobility, supporting mentation, and prioritizing what matters most to the individual. By seeking out these professionals, older adults can ensure a higher standard of integrated care, leading to improved health outcomes and a better quality of life.
