Characterizing the Complexity of Senior Care Pharmacy.

Professional practice in any complex health care delivery can proceed at a hectic pace. There are often competing demands for the allocation of time and expertise. Senior care pharmacists are among several subsets within the pharmacy profession who shoulder the responsibility to provide care for and to protect older people who can be at grave risk for health problems from a variety of sources, in particular: medication-related problems. This was elegantly elaborated by influential pharmacy practitioners in practice and academia a little more than 30 years ago.

Can Pharmacists Outperform Machines? A Critical Turing Test.

Just as practitioners in the 1980s were blissfully unaware of what the future held, today's new practitioners can only speculate about the future of the profession. To move the profession forward will require singular focus upon the core values of what pharmacists can and should represent in the health care system.

The Reality of Delirium Is Frightening, Dangerous, and Preventable.

In fact, there is evidence to suggest that a sizable proportion of older people who are at substantially increased risk from the effects of medications acting in the central nervous system are indeed prescribed opioids, antipsychotics, and other drugs that may cause delirium as a side effect. In many instances, this prescription occurs in a dearth of evidence for any worthwhile benefit, and, at the same time, in full knowledge of the fact that the medications may cause harm. Even worse is that, in some cases, the older people who are given these medications are commonly affected by disorders of cognition, unable to communicate their symptoms effectively, and may have a diminished capacity to report side effects associated with the drugs. For health care practitioners who have spent time working in long-term care facilities or hospitals that provide care for older people, this phenomenon is only too well known.

Access to Medicines Is Critically Important for Consumers.

In modern times, there has been an enormous explosion of therapeutic options for various conditions, conferring what would, at times, be a bewildering spectrum of choices for prescribers. In some ways, the issue has moved beyond whether a treatment is available or not, beyond the subtleties of choice in terms of efficacy, and even beyond the balance of potential benefit compared with the possibility of treatment-related harm. For many, the primary consideration is simply: access.