November 14, 2014
PACE Case: Treating Infection in the Complicated Participant

A 85-year old participant presented to the PACE clinic with large skin abscess and a fever of 101 F. Past medical history is significant for Stage 5 chronic kidney disease, with an estimated GFR of 13 mL/min, and psoriasis for which she takes chronic daily prednisone. Because of past medical history, the PACE physician decided to hold initial antibiotic treatment, perform an incision and drainage, and order skin cultures and sensitivities. 

Enterobacter cloacae was the infectious etiology of this skin infection, and the sensitivity panel helped to narrow therapeutic treatment options. Further insight was sought from the CareKinesis clinical pharmacist. Click here for the clinical pharmacist's intervention

Quote of the Month
"CareKinesis is one of the best things
that has happened to our PACE organization...
 - Debra Berg, MD
   Medical Director, ArchCare SeniorLife PACE
New Evidence - Atypical Antipsychotics and Acute Kidney Injury
Study: "Atypical Antipsychotic Drugs and the Risk for Acute Kidney Injury and Other Adverse Outcomes in Older Adults: A Population-Based Cohort Study"
A recent study found that among older adults, atypical antipsychotic drug use was associated with a higher risk for hospitalization with AKI. Medications found responsible for problems (Quitiapine, Risperidone & Olanzapine) are commonly seen and dispensed by CareKinesis. While direct causation is unclear, it could be due to incidents of hypotension (decreased profusion) or urinary retention (anticholinergic ADEs), both of which can cause renal problems. Additionally, because this class is highly dependent on the CYP2D6 enzyme for clearance, one can surmise that those that are poor or intermediate metabolizers are at increased risk due to "accidental overdose." For more information about this article, email us. Or, read the abstract here.
Survey Results: PACE Execs "stuck" with Pharmacy Vendors

A theme among non-client PACE organizations surveyed last month is that they feel "stuck" with their current provider. Reasons included:
  • They have an in-house pharmacy
  • They are required to keep the $$ within the system
  • They have a "long-standing relationship" and will feel guilty
  • Their management organization dictates their pharmacy
But many of these pharmacies have deficiencies with delivery, timeliness and medication accuracy. We ask: should organizational politics trump patient medication safety?
If you feel "stuck" with your pharmacy provider, and you seek improvement in medication safety (errors, on-call service failures, on-site medication access challenges, etc.) we can help craft a solution. Contact us today!
Technology Updates
  •  EireneRx 101 Webinars: 11/13 & 12/11
  •  Report Portal has a new participant allergies report for clients.
  •  EireneRx has a new refill functionality for acute / PRN (non-cycle) medications that will be released to clients in November 2014.
  •  A new EireneRx feature allows medications to be hidden from the MAR
If you have questions about these or any other new features, kindly contact your client liaison.
NPA 2014 - another successful conference!


This year we were excited to be in San Diego, where PACE Organizations had the opportunity to do site tours with our partner, St. Paul's PACE. We also enjoyed co-presenting during the Nursing Symposium with LIFE U Penn nurse practitioners. We spoke about improved hospitalization outcomes from our first year of partnership, as well as sessions on PACE Clinical Pharmacy and Pharmacogenomics. We also co-presented an Adherence poster. During exhibit times, we saw many familiar faces and raffled off two mini i-pads. We had a huge turnout at our booth during the Ice Cream social, where we served CareKinesis cookies and other chocolate covered goodies.


We were delighted so many people could attend our PACE appreciation dinner on Sunday, and we thank the National PACE Association for another year of camaraderie, sharing, and learning.
We are passionate about improving lives for PACE participants through medication risk mitigation. For more information, visit or call 888-974-2763.
Happy Autumn!