June 23, 2015
PACE Case: Neuropathy + Pain Management

A CareKinesis clinical pharmacist was conducting a PACE comprehensive medication review (CMR) for a 57 y/o male participant with a past medical history of anxiety, bipolar disorder, peripheral neuropathy, chronic back pain, and insomnia.  Of the 24 medications that were active on the participant's profile, 5 were focused on pain management: 

  • Gabapentin 600mg TID
  • Baclofen 5mg BID
  • Hydrocodone/APAP 5/325mg TID, scheduled
  • Voltaren 1% gel to affected area TID
  • Cymbalta 60mg QAM

Considering the age of the participant and no history of diabetes, the two stated pain conditions (chronic back pain and peripheral neuropathy) indicated to the pharmacist that this participant likely was suffering from post-herpetic neuropathy (PHN).   

 

Click here for the full case and clinical pharmacist intervention.  

 

Quote of the Month
 
" CareKinesis has helped our team become more efficient and, above all, has provided excellent pharmacy services to our participants."

 - Karren Weichert
   President/CEO, Midland Care
Maximum SAFE Daily APAP Dose
In accordance with the FDA's report:  "Recommendations for FDA Interventions to Decrease the Occurrence of Acetaminophen Hepatotoxicity," CK staff may be contacting prescribers to double-check current chronic (scheduled) orders over 3 grams but less than 4 grams. For PRN acetaminophen prescriptions, CK may include a 3 gram warning on the label directions.

Considerations for clinicians:
        • Reduce tablet strength for immediate-release formulations to 325mg (or less) and limit the single adult dose to 650mg (or less).
        • Limit tablet strength for extended-release formulations commensurate with total daily dose and the dosing increment.
        • There is limited evidence that efficacy is greater with 1000mg vs 650mg, and that difference is clinically very small. A 650mg dose is effective and increases the margin of safety.
New CareKinesis Pharmacy Director
Dr. Bob Alesiani, CareKinesis Chief Pharmacotherapy Officer, is pleased to announce that Michael Awadalla, PharmD, is our new Director of Clinical Pharmacy Operations.

Dr. Awadalla has made invaluable internal contributions to our clinical infrastructure, including the development of clinical therapeutic reporting as well as the development of polypharmacy medication reviews. These reports have been shared with our clients and have demonstrated cost reductions and improved therapeutic outcomes. Dr. Awadalla is well-respected by his colleagues and has mentored many of the pharmacists at CareKinesis.
EireneRx Certifications
In 2014, EireneRx achieved ONC HIT 2014 Edition Modular Ambulatory EHR certification. This certification means that our software supports eligible providers with meeting the Stage 1 and Stage 2  Meaningful Use (MU) measures required to qualify for funding under the American Recovery and Reinvestment Act of 2009 (ARRA). And, we are excited to begin planning for Stage 3! If you have any questions about EireneRx and MU, or about MU generally, please email Joe Filippoli, CIO with CareKinesis OR email Sam Kunjukunju, Senior Associate of Strategic Policy Initiatives with NPA.

We anticipate that EireneRx will be granted electronic prescribing of controlled substances (EPCS) certification within the next few weeks. For questions or to sign up, email Craig Barton at CareKinesis.

October 1 is not far away!  Rest assured, we are prepared. Our software developers have been preparing for ICD-10 for years. If you have general questions, visit CMS.gov. For questions about CareKinesis / EireneRx preparations, email Brett Hancox
Can CareKinesis help us with Part D Auditing?

This is a question frequently asked by CareKinesis clients. We also receive questions like, "Does this Part D memo affect me?" and "What is the PDE deadline?" and "What OMS requirements concern us??????" While we are always able to assist, when we need Part D expertise, we turn to our sister company, Capstone Performance Systems. Their services range from as-needed trainings to comprehensive, organization-wide Part D gap analysis. Email Matt Zimmerman at Capstone for more information.

Educational Opportunities

 

EireneRx 101 Webinar:  

July 9 @ 11am ET  

 

 Clinical Decision Support Tools Webinars: 

June 24 @ 3pm ET

June 25 @ 3pm ET

July 2 @ 3pm ET  

We are passionate about improving lives for PACE participants through medication risk mitigation. For more information, visit www.CareKinesis.com or call 888-974-2763.
  
Happy Summer!