PharmScript Offers Skilled Care Facilities Tips on How to Avoid an ‘Unnecessary Drugs’ Deficiency (F329)

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As new healthcare guidelines seek to reduce the use of ‘off-label medication use’ in long-term care facilities, leading long-term care pharmacy PharmScript offers tips on how long-term care providers can stay in compliance.



As new healthcare guidelines seek to reduce the use of ‘unnecessary drug’ use in long-term care facilities, leading long-term care pharmacy PharmScript offers tips on how long-term care providers can stay in compliance.

Federal law and regulations for nursing centers emphasize the importance of limiting the use of ‘unnecessary drugs’ to individuals with a documented need. When a drug is used in a way that is different from that described in the FDA-approved drug label, it is said to be an ‘off-label’ use. One common area of ‘off-label use’ is antipsychotics, which some healthcare providers use for treatment of behavior-related issues as opposed to their approved use for chronic psychiatric conditions.

The regulations are very clear about the correct use.

F329, the Center for Medicare and Medicaid Services guidance to nursing homes on dementia care and unnecessary drug use states that: “a facility must ensure Residents... are not given these drugs unless antipsychotic drug therapy is necessary to treat a specific condition as diagnosed and documented...”

As a leading pharmacy provider to the long-term care industry, PharmScript assists client facilities in reducing expenses while maintaining compliance.

“Ensuring the quality, efficiency and compliance of our client facilities is always our #1 goal — which is why we make it our priority to stay up to date on matters that concern our clients most,” said Saul Greenberger, founder of PharmScript.

To help long-term care communities stay in compliance with F329 guidelines, PharmScript offers seven steps to reduce the unauthorized use of antipsychotics.

1. Identify Potential Misuse
Review all residents on low doses of antipsychotics. This may be an indication that it’s being used as a way to control behaviors associated with dementia. Have your pharmacy set you up to receive an auto-alert any time a low dose is prescribed.

2. Non-Drug Interventions
Reinforce training on non-drug interventions. Behavioral therapy, reality orientation, and validation therapy are just a few examples of methods proven to treat dementia-related behavior.

3. Consult the Family
There may be something going on in the resident’s family life that’s at the root of behavioral occurrences. The insight you gain from speaking with them may be invaluable.

4. Improve Documentation on Attempted Interventions
As the saying goes, “It didn’t happen if you didn’t document it.” If you’ve tried the interventions described above, make sure your staff is properly updating care plans and progress notes.

5. Encourage Ultra-Short Use or Stat Dose in place of PRNs
Some health care professionals advocate against PRNs as they can often be used as a crutch for staff instead of working on other interventions. Instead, lean towards a program of a 3-day dose followed by further evaluation. (Remember to document.)

6. Evidence of Tapering is a Must
If all else fails and antipsychotic drugs are necessary, stay updated on the case. You must show evidence of attempts to taper the medication. Remember, this should not be a long-term plan.

7. Involve a Consultant Pharmacist
There’s no reason to go about this on your own. Have your pharmacy consultant work with you to identify any areas of concern and organize a plan of action.

To read more helpful tips on how to maximize the pharmacy experience, visit PharmScript’s learning center at

About PharmScript:
The unique principles upon which PharmScript was founded were based on years of invaluable experience in the long-term care industry. Comprised of a reputable and experienced management team, PharmScript is geared toward providing the ultimate pharmacy experience utilizing cutting-edge technology, impeccable customer service, and assisting facilities in saving on pharmacy costs. Pharmscript currently services New York, New Jersey, Pennsylvania, Delaware, Washington DC, Maryland, Florida and Texas.

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