The case for pharmacist intervention

In this edition of The Collaborative Practice, we spotlight a particularly insightful case from a pharmacist in our network. Our aim? To showcase the critical impact of pharmacist interventions in enhancing patient care and healthcare efficiency. Here’s this month’s highlight:

Patient Case: Navigating Complex Medication Management

A recent case involved a 74-year-old male struggling with multiple health concerns, including hypercholesterolemia, allergic rhinitis, anxiety, and type 2 diabetes, yet without a history of cardiovascular events. His medication regimen raised several concerns:

• Allergy Management: He was taking cetirizine and diphenhydramine for allergy symptoms. However, his allergy symptoms were poorly controlled, and the diphenhydramine potentially contributed to drowsiness, increasing his risk of falls.
• Aspirin Use: He was also on low-dose aspirin for primary prevention of cardiovascular disease. However, recent guidelines by the US Preventive Services Task Force (USPSTF) advise against routine aspirin use for primary prevention in adults over 70.

Pharmacist’s Recommendations:

• Optimizing Allergy Treatment: Consider adding fluticasone propionate nasal spray for better allergy control and contemplate discontinuing diphenhydramine to reduce drowsiness and fall risk.
• Reevaluating Aspirin Therapy: Given the patient’s age and lack of cardiovascular history, discontinuation of aspirin was suggested.

Outcome:

Following the pharmacist’s intervention, there was a significant shift in the patient’s medication management. The recommendations for optimizing allergy treatment were adopted, leading to the discontinuation of diphenhydramine. This change aimed to reduce the patient’s drowsiness and subsequently lower his risk of falls, a crucial consideration for his age group. Additionally, the patient’s aspirin therapy was reevaluated and discontinued in alignment with current USPSTF guidelines, reflecting a more tailored approach to his cardiovascular health prevention strategy. These adjustments exemplify the impact of thoughtful medication management in enhancing patient well-being and safety.

This case highlights the invaluable role pharmacists play in optimizing medication regimens, ensuring that treatments align not only with clinical efficacy but also with patient-specific needs and the latest health guidelines.