In this way, DRR is truly patient centered. Adverse drug reactions such as confusion, anorexia, and movement disorders are often subtle, and the long-term care pharmacist must visit with the patient to determine the presence and cause of these conditions. Timely visits also alert the long-term care pharmacists to emerging problems that can then be addressed before they become fully manifest. This constant vigilance improves the patient's quality of life and ensures cost-effective care. Once comprehensive DRR uncovers a potential or actual problem with a resident's therapy, one or more of several interventions by the long-term care pharmacist may be indicated.
Therapeutic interchange can follow readily from careful formulary development.
Once the therapeutic value of certain medications for the treatment of specific conditions is well established, cost-effective therapeutic interchange, which should still be approved by the prescriber, can occur. Generic substitution, when appropriate, decreases drug product costs when the long-term care pharmacist recommends replacement of a more costly brand name medication with a less costly but therapeutically equivalent generic medication. Disease management draws on long-term care pharmacists' expertise in drug and nondrug interventions. By working with other health professionals, long-term care pharmacists can help assure conformity to published therapeutic guidelines for the treatment of chronic diseases. This attention to the patient's overall health, not just the effect of drug therapy in isolation, makes the long-term care pharmacist especially valuable in improving the quality of care and preventing costly acute interventions for nursing home residents.