Clinical Intervention Case Study
Neil Medical Group interventions produce an improved quality of life for patients.
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QUALITY OF LIFE
BACKGROUND
Neil Medical Group is a trusted pharmacy services partner for long-term/post-acute care and assisted living providers across the southeast. Serving as an extension of our partner care teams, our highly trained Consultant Pharmacists often make many recommendations to both nurses and physicians. Sometimes, the outcome of these interventions are not immediately apparent. Sometimes, however, these interventions can be quite compelling.
CLINICAL INTERVENTIONS
SW, a 78 YO male was admitted to a Long Term Care (LTC) facility with a diagnosis of DM. He was noted to be “intellectually disabled” and while hospitalized, had been declared legally incompetent by the court. On admission, the NMG Consultant Pharmacist was concerned about his orders for Mellaril 150mg qhs and Vistaril 50mg qhs as there were no supporting diagnoses for either medication— and the resident was noted to be lethargic. The Pharmacy Consultant notified the LTC attending physician, and since both medications had recently been added in the hospital, they agreed to discontinue both meds.
GOING THE EXTRA MILE
Within 2 weeks, the resident literally began to “wake up” and started inquiring as to where he was. The Consultant Pharmacist began digging deeper into the resident’s history, and discovered the following:
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This gentleman, prior to hospitalization, was living at home alone. He was having difficulty sleeping and had received a new Rx from his physician for Restoril 30mg and was also taking Benadryl at bedtime for sleep. The combination of the two caused him to become confused—and he stopped taking his diabetes meds.
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He ended up in the ER due to hyperglycemia and was confused and extremely agitated. The hospital immediately sedated him with the Mellaril and the Vistaril was added later to deal with his continued agitation. Once the blood sugar was under control, the gentleman was ready for discharge but extremely sedated and unable to care for himself. An IQ test was performed at the hospital (while sedated) and he was deemed “intellectually disabled”. He was declared legally incompetent by the court and his ex-wife was appointed as his guardian.
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The consultant pharmacist encouraged the facility social worker to enquire about this resident’s past, and it was discovered that SW was by no means mentally challenged; he had actually been an owner of 4 restaurants in the city and had over $500,000 in the bank (that his ex-wife was now in charge of).
OUTCOME
After 6 weeks of going back through the court system to declare competency, SW was discharged back to his home where he lived independently for many years.