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Decreased disease risks due to more successful stewardship in long-term care

February 26, 2018
by I Advance Senior Care
| Reprints

Long-term care facilities (LTCFs) help to provide both medical and personal care services to millions of Americans each year. As the population of adults over age 65 increases, this number is predicted to rise over 21% of the US population by 2040; there will be a corresponding increase in patient enrollment in LTCFs.

Disease risk factors lead to approximately 1 million to 3 million infections occurring each year in LTCF residents, consisting mostly of urinary tract infections, respiratory tract infections, skin and soft tissue infections, and gastroenteritis, according to a report from Contagion Live. Roughly 63% of all LTCF deaths can be attributable to infections. Approximately 79% of all residents of these facilities receive systemic antibiotics each year, with close to 75% of these antibiotics inappropriately prescribed. This results in an increased number of adverse drug events (second only to antipsychotics), including the development of antibiotic-resistant organisms and Clostridium difficile (C. diff) infection.

Recently, there have been a number of resources released from the US Centers for Disease Control and Prevention (CDC), American Society of Consultant Pharmacists (ASCP), and the Agency for Healthcare Research and Quality (AHRQ) to aid LTCFs in creating antimicrobial stewardship programs (ASPs). Additionally, the Centers for Medicare & Medicaid Services issued a mandate in October 2016 stating that all LTCFs must fully implement an ASP by November 2019. However, many facilities lack access to the resources that are available to help them develop a strong program. This limitation can be the result having clinical providers located off-site, which leads to difficulty in appropriately diagnosing infections; relying on front-line staff to provide information on which to base clinical decisions; and lacking access to lab and microbiology reports and sufficient funding to hire staff, both physicians and pharmacists.

Read the full report at Contagion Live.