Is it safe to add an antidepressant to the medication mix of a senior doing battle with a host of other chronic conditions?
GeriMedRisk, a non-profit partnership launched to support primary care providers prescribing for older patients, aims to answer questions like this one by investigating the specific medications involved in order to avoid adverse reactions. Fewer hospitalizations, fewer falls, and decreased cognitive impairment is the goal of the free-to-the-industry service available online and by phone.
“Our mandate is to build capacity in the patient’s local circle of care. We don’t insert ourselves in the patient’s care or become additional prescribers,” says Dr. Joanne Ho, GeriMedRisk founder. A geriatrician, internist, and clinical pharmacologist, Dr. Ho is assistant professor in the Department of Medicine, Division of Geriatrics, McMaster University.
“We encourage clinicians to ask us about medications for their senior patients. They often don’t have time to do research and literature searches. We have the time and the expertise and if we don’t already know the answer, we have the infrastructure to find answers quickly.”
Clinicians can access the GeriMedRisk team of geriatric pharmacists, psychiatrists, and clinical pharmacologists by phone at 1-855-261-0508. Online, and with membership with the Ontario Telemedicine Network (OTN), providers can request an eConsult from the specialty group “Geriatric Clinical Pharmacology” through the Ontario eConsult Program, accessible through the OTNhub at https://otnhub.ca.
“It’s a one-stop consultation to get the answer to a simple question – how can I prescribe safely, if at all?” says Dr. Ho. The GeriMedRisk team responds within five business days. “Clinicians don’t have to consult a variety of experts or sources. Our team talks it through and provides one coordinated recommendation.”
Questions range from which anti-depressant to prescribe – if any – to when to de-prescribe statins, how medications interact, and correct dosages.
Already supporting family doctors, specialists, nurse practitioners, and pharmacists, GeriMedRisk is currently evaluating the results of a stepped¬-wedge randomized control trial (RCT) to determine if it can be implemented in long-term care homes. The study, in four Ontario long-term care homes, is co-led by Dr. Sophiya Benjamin, a geriatric psychiatrist associated with McMaster. Stepped-wedge RCTs study individuals or groups at different times in randomized order. By the end of the trial, all participants will have experienced the intervention.
GeriMedRisk partners include OTN, the Schlegel-UW Research Institute for Aging, Canadian Mental Health Association Waterloo Wellington, McMaster University, St. Joseph’s Health Centre Guelph, Grand River Hospital, Waterloo Wellington Local Health Integration Network, Regional Geriatric Program of Ontario, and the Ontario Poison Centre. GeriMedRisk is funded in part by the Ministry of Health and Long-term Care.