Geriatric Pharmacy Specialty Review Course for Recertification + RECERT EXAM (Cert # L239128)

The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education with Commendation.

The American College of Clinical Pharmacy is accredited by the Accreditation Council for Pharmacy Education as providers of continuing pharmacy education.

These recertification activities are intended for board certified pharmacists seeking to update their knowledge and skills in geriatric pharmacy.

Board certified pharmacists are eligible to receive up to 22.5 contact hours of recertification credit for completing this course. To earn recertification credit, learners must review the course content and successfully complete the online assessments by the deadline. Only completed assessments will be eligible for credit; no partial or incomplete assessments will be processed.  You are allowed only one attempt to successfully complete this assessment.

This course is not intended for those preparing to take the BPS Geriatric Pharmacy Specialty Examination for Certification. To prepare for the examination, please see courses here: http://elearning.ashp.org/catalog/geriatric-pharmacy-review

These activities are part of the ASHP and ACCP professional development program for BCGP recertification approved by the BPS.

Complex Case: Inpatient to Family Medicine Clinic
ACPE Number: 0204-9999-23-941-H01-P

• Interpret results of screening and assessments in the management of the geriatric patient.
• Select the appropriate treatment and monitoring for a complex patient-case with multiple conditions, including:
  • Atrial fibrillation
  • Post-myocardial infarction
  • Heart failure
  • Hypertension
  • Hyperlipidemia
  • Peripheral vascular disease
  • Insomnia
  • Drug induced urinary retention
  • Dry eyes
  • C. difficile infection
• Identify potentially inappropriate medications (PIM) for older adults, as well as medications that contribute to geriatric syndromes or conditions (e.g., falls, cognitive impairment). 

Complex Case: Ambulatory - Family Medicine Clinic
ACPE Number: 0204-9999-23-942-H01-P

• Interpret results of screening and assessments in the management of the geriatric patient.
• Select the appropriate treatment and monitoring for a complex patient-case with multiple conditions, including:
  • Atrial fibrillation, post-MI
  • Heart failure
  • Coronary artery disease
  • Hypothyroidism
  • Diabetes mellitus, new onset
  • Benign prostatic hyperplasia
  • Hypotension
  • Gastroesophageal reflux disease
• Evaluate financial/reimbursement issues (e.g., formularies, insurance coverage) when making therapeutic recommendations.
• Explain steps to assist a patient with payment issues for medications, medication therapy management services, and medical equipment.
• Describe strategies to assess caregiver knowledge and expectations regarding advanced age and disease on health risks, needs, and treatment of health conditions.
• Evaluate the appropriateness of care plans and services based on older adults and caregivers’ changes in age, health status, and function; assist caregivers in altering plans and actions as needed.
• Apply strategies for improvement of adherence in older adults, their caregivers and the interprofessional care team.
• Give examples of how to collaborate with older adults, their caregivers, and the healthcare team during care planning and implementation.
• Explain the need for continuity of treatment and communication across the spectrum of services and during transitions between care settings.
• Apply outcomes of investigations to optimize care of older adults. 

Complex Case: Ambulatory - Geriatric Clinic
ACPE Number: 0204-9999-23-943-H01-P

• Interpret the results of screening and assessments in the management of the geriatric patient.
• Select the appropriate treatment and monitoring for a complex patient-case with multiple conditions, including:
  • Chronic obstructive pulmonary disease
  • Osteoarthritis
  • Depression
  • Urinary tract infection
  • Glaucoma
  • Herpes Zoster
• Evaluate strategies to promote evidence-based approaches for screening, immunizations, health promotion, and disease prevention for older adults.
• Assess a patient medication list, including prescription and over-the-counter medications, and complementary and alternative therapies.
• Identify the components of an interprofessional, comprehensive geriatric assessment and the roles individual disciplines play in conducting and interpreting a comprehensive geriatric assessment.
• Assess specific risks to older adult safety, including falls, abuse, physical/chemical restraints, and other environmental hazards.
• Explain the role of advanced directives and living wills, do not resuscitate, power of attorney, and other substitute decision-makers documents in medication use decisions. 

Complex Case: Inpatient-Surgery to Skilled Nursing Facility
ACPE Number: 0204-9999-23-944-H01-P

• Interpret results of screening and assessments in the management of the geriatric patient.
• Select the appropriate treatment and monitoring for a complex patient-case with multiple conditions, including:
  • Delirium
  • Deep vein thrombosis prophylaxis
  • Pneumonia
  • Anxiety
  • Pain management (acute)
  • Fluid & electrolyte disorder
  • Falls
• Define Describe the continuum of care available to geriatric patients, such as community resources, home care, assisted living facilities, nursing facilities, sub-acute care facilities, hospice care, and hospitals.
• Explain the need for continuity of treatment and communication across the spectrum of services and during transitions between care settings.
• Identify potential hazards of hospitalization for older adults, including immobility, delirium, medication side effects, malnutrition, pressure ulcers, procedures, and hospital acquired infections.
• Assess specific risks to older adult safety, including falls, abuse, physical/chemical restraints, and other environmental hazards.
• Identify iatrogenic conditions (e.g., healthcare associated infections, falls, pressure ulcers, medication-induced). 

Complex Case: Skilled Nursing Care
ACPE Number: 0204-9999-23-945-H01-P

• Interpret results of screening and assessments in the management of the geriatric patient.
• Select the appropriate treatment and monitoring for a complex patient-case with multiple conditions, including:
  • Anemia
  • Anxiety
  • Deep vein thrombosis prophylaxis
  • Osteoporosis
  • Pain management
  • SIADH
  • Falls
  • Constipation
• Explain the need for continuity of treatment and communication across the spectrum of services and during transitions between care settings.
• Identify potential medication-related causes of declining physical and cognitive function.
• Select methods to facilitate medication reconciliation during transitions of care.
• Summarize limitations of biomedical information for the care of older adults.
• Apply outcomes of investigations to optimize care of older adults.
• Develop strategies to prevent or resolve iatrogenic conditions.
• Identify elder abuse/neglect (e.g., physical, psychological, and financial).
• Identify resources to assist in prevention, reporting, and treatment of elder abuse/neglect. 

Statistics, Evidence-based Medicine, and Research Design
ACPE Number: 0204-9999-23-940-H04-P

Given an excerpt from a study:

• Evaluate quality and appropriateness of the excerpt, with specific attention to:
  • study design,
  • statistical analysis,
  • internal/external validity
  • source of bias/confounders
  • quality of conclusions,
  • interpretation of graphs.
• Explain why a statistical test is appropriate or not appropriate, based on the sample distribution, data type, and study design.
• Interpret clinical and statistical significance for results from commonly used statistical tests.
• Explain the strengths and limitations of different types of measures of central tendency (mean, median, and mode) and data spread (standard deviation, standard error of the mean, range, and interquartile range).
• Evaluate odds ratio, risk/incidence rate, relative risk, number needed to treat, number needed to harm, and other risk estimates.
• Assess whether the study applies to a specified patient population. 

Complex Case: Long-term Care
ACPE Number: 0204-9999-23-946-H01-P

• Interpret results of screening and assessments in the management of the geriatric patient.
• Select the appropriate treatment and monitoring for a complex patient-case with multiple conditions, including:
  • Alzheimer’s with behaviors
  • Hypertension
  • T2DM
  • Geriatric syndromes – malnutrition/failure to thrive/weight loss
  • Renal dysfunction/CKD
• Summarize ethical issues that arise during therapy with individuals who have diminished decision-making capacity.
• Identify potential medication-related causes of declining physical and cognitive function.
• Identify clinical situations where life expectancy, functional status, patient preference or goals of care should override standard recommendations for screening/ treatment.
• Summarize care need priorities considering severity of illness, patient preference, quality of life, and time to benefit.
• Select interventions and behaviors that promote physical and mental health, nutrition, function, safety, social interactions, independence, and quality of life to older adults and their caregivers.
• Assess specific risks to older adult safety, including falls, abuse, physical/chemical restraints, and other environmental hazards.
• Apply the findings of research to the care of older adults.
• Evaluate the relevancy of clinical practice guidelines and standards of care for older adults.
• Describe the medication utilization process in the long-term care setting as it relates to the consultant pharmacist. 

Geriatric Practice Administration
ACPE Number: 0204-9999-23-947-H04-P

• Describe integration of evidence-based geriatric literature into institutional guidelines and processes.
• Develop a plan to monitor and evaluate compliance with, and impact of, policies and guidelines (e.g., institutional, evidence based).
• Select quality assurance methods, metrics, and improvement activities, including needs assessment techniques, aimed at enhancing the safety and effectiveness of medication-use processes in the geriatric settings.
• Explain regulatory/IRB requirements relative to conducting geriatric research.
• Describe regulatory requirements and organizational structure of long-term care facilities as it relates to the consultant pharmacist.
• Design education programs/materials/tools for geriatric patient populations.
• Assess formulary management protocols in geriatric practice settings.
• Develop systems to identify risk factors and prevention for adverse drug events/medication incidents/errors in the geriatric patient population.
• Apply protocols for managing high-risk medications in the older adults.
• Identify factors that enhance the education and training of geriatric pharmacists available in published documents from relevant professional societies (e.g., ASHP, ACCP, SCP, AGS etc.). 

Complex Case: Assisted Living
ACPE Number: 0204-9999-23-948-H01-P

• Interpret results of screening and assessments in the management of the geriatric patient.
• Select the appropriate treatment and monitoring for a complex patient-case with multiple conditions, including:
  • Urinary incontinence
  • Dysphagia
  • Stroke
  • Neuropathic pain
  • Gout
  • Seizure disorder
  • Substance abuse
• Evaluate self-care capacity, including medication self-administration.
• Identify signs of substance and medication misuse/abuse in older adults.
• Assess the impact of social behaviors, including use of tobacco, caffeine, alcohol, and illicit drugs.
• Identify need for referral of patients to other healthcare professionals.
• Apply verbal and nonverbal communication strategies to overcome potential sensory, language, and cognitive limitations in older adults.
• Evaluate improvement strategies for adherence in older adults, their caregivers and the interprofessional team. 

Principles of Aging
ACPE Number: 0204-9999-23-949-H04-P

• Summarize the spectrum of aging and physiological heterogeneity of older adults.
•  Apply the knowledge of physiologic changes associated with aging to the clinical use of medications (e.g., pharmacokinetics and pharmacodynamics).
• Describe social and financial issues that impact therapeutic recommendations for geriatric patients.
• Select the appropriate treatment and monitoring for a patient with frailty. 

Complex Case: Hospice/Palliative Care
ACPE Number: 0204-9999-23-950-H01-P

• Interpret results of screening and assessments in the management of the geriatric patient.
• Select the appropriate treatment and monitoring for a complex patient-case with multiple conditions, including:
  • Parkinson’s disease
  • Pressure ulcers
  • Dry mouth
  • Pain management
• Summarize care need priorities considering severity of illness, patient preference, quality of life, and time to benefit.
• Identify iatrogenic conditions (e.g., healthcare associated infections, falls, pressure ulcers, medication-induced conditions).
• Apply cultural competency concepts (e.g., ethnic/racial, religion, spiritual, age-related, language) and guidelines to healthcare decisions.
• Identify clinical situations where life expectancy, functional status, patient preference or goals of care should override standard recommendations for screening/ treatment.
• Identify need for referral of patients to other healthcare professionals.
• Explain the altered benefit-risk ratio of medications at the end of life.
• Discuss end of life issues as they relate to medication appropriateness. 

Infectious Disease Considerations and Antimicrobial Stewardship Principles in Geriatric Patients and Care Settings
ACPE Number: 0204-9999-23-951-H04-P

• Describe regulations and government guidance statements calling for use of antimicrobial stewardship in geriatric care settings.
• Summarize the implications of infectious disease guidelines for use of antimicrobial agents in the geriatric patient population.
• Select appropriate antimicrobial therapy for a geriatric patient, taking into consideration infectious-diseases management principles and patient-specific variables.
• Recommend appropriate antimicrobial monitoring recommendations for a geriatric patient based on patient-specific variables and antimicrobial stewardship principles.
• Develop methods for monitoring trends and identifying opportunities for improvement in antimicrobial use within geriatric care settings.

Faculty Bios

Trista Askins-Bailey, PharmD, BCGP, BCPS, FASCP
Associate Professor
Texas Tech University Health Sciences Center School of Pharmacy
Abilene, Texas

Amie Taggart Blaszczyk, PharmD, BCGP, BCPS, FASCP*
Professor and Division Head – Geriatrics
Texas Tech University Health Sciences Center School of Pharmacy
Dallas, Texas

Dana Carroll, PharmD, BCGP, BCPS, CDES*
Clinical Professor
Auburn University Harrison School of Pharmacy
University of Alabama Family Medicine
Auburn, Alabama

Kalin Clifford, PharmD, BCGP, BCPS
Associate Professor, Geriatrics & Pediatrics Division, Department of Pharmacy Practice
Texas Tech University Health Sciences Center - School of Pharmacy
Dallas, Texas

Emily Ellsworth, PharmD, BCGP
Home-Based Primary Care Clinical Pharmacy Specialist
Edward Hines Jr. Veterans Affairs Hospital
Hines, Illinois

Carol B. Fox, PharmD, BCGP
Associate Professor and Chair
Department of Pharmacotherapeutics and Clinical Research
University of South Florida Taneja College of Pharmacy
Tampa, Florida

Emily Frederick, PharmD, BCPS
Associate Professor and Vice Chair
Department of Pharmacy Practice
Sullivan University College of Pharmacy and Health Sciences
Louisville, Kentucky

Lisa C. Hutchison, PharmD, MPH, BCGP, BCPS, FCCP
Professor and Vice Chair
University of Arkansas for Medical Sciences
Little Rock, Arkansas

Jill R. Johnson, PharmD, MHA, BCGP, BCPS
Clinical Pharmacy Specialist
Orlando VA Healthcare System
Orlando, Florida

Heather L. Ourth, PharmD, BCPS, BCGP, FASHP
Assistant Chief Consultant, Clinical Pharmacy Practice Program and Outcomes Assessment
Pharmacy Benefits Management (PBM) Service 12 PBM, Clinical Pharmacy Practice Office
Department of Veterans Affairs
Washington, DC

Maria Shin, PharmD, BCGP, BCPS*
Clinical Pharmacy Specialist in Internal Medicine
Robley Rex Louisville Veterans Affairs Medical Center
Louisville, Kentucky

*Content matter experts

Angie Knutson, PharmD, BCPS
Susan R. Dombrowski, M.S., R.Ph.

Olubusola Akinbote, PharmD, BCGP
Jennifer Armbrust, PharmD
Akua Asare-Addo, PharmD, MPH, BCGP, BCPS
Ramadas Balasubramanian, PharmD, PhD, BCGP, BCACP, FASCP
Laura Beste, PharmD
Emily Brandl, PharmD
Julie Caler, PharmD, BGCP
Tina Caliendo, PharmD, BCGP, BCACP
Rachel Campbell, PharmD
Rebecca Carle, PharmD, BCGP
David Cebula, PharmD, BCGP
Christine Chou, PharmD, BCPS, BCGP
Melissa Cloyd, PharmD, BCPS, BCGP, BCPP, DPLA
Gara Coffey, PharmD, BCGP
Kenneth Cohen, PharmD, PhD, MS, BS, BCGP
Susan Cole, PharmD, BCGP
Angela Considine, PharmD, BCGP, CSP
Brian Doss, PharmD, BCGP
Laura Dunston, PharmD, BCGP
Kira Durr, PharmD, BCGP
Arien Dwyer, BCGP
Cynthia Feucht, PharmD, BCPS, BCGP
Laura Finn, BCGP
Thomas Giovinazzo, PharmD, BCGP
Kathy Grams, BSPharm, PharmD, BCGP
Mark Haddad, PharmD, BCGP
Nathan Hedin, PharmD, BCGP
Katherine Hitchens, PharmD, BCGP
Sandra Hrometz, BSPharm, PhD, BCGP
Ernest Imatdinov, PharmD, BCGP, BCMTMS
Megan Kaiser, PharmD, BCPS, BCGP
Susan King, PharmD, BCGP, CNSC
Travis LaCore, PharmD, BCGP
Nancy Laux, PharmD, BCPS, BCGP
Kevin Lazaruk, RPh, BCGP, CDP
Kristine Lopez, PharmD, BCGP
Shalini Lynch, PharmD, BCGP
Matthew Maddox, PharmD, BCACP, BCGP, CPH
Sheila Mason, PharmD, BCGP
Tracey Meade, PharmD, BCGP
Rebecca Meli Curtin, PharmD, BCACP, BCGP
Carol Morreale, PharmD, MPH, MS, BCGP
Matthew Morrissey, PharmD, BCGP
Aaron Mosteller, PharmD, BCGP
Malcolm Nasirah, PharmD, BCGP
Andreea Nemes, PharmD, BCGP
Loann Nguy, PharmD, BCPS, BCGP
Tiffany O'Keefe, PharmD, BCGP
Palak Patel, PharmD, BCPS, BCGP
Brianne Polito, PharmD, BCGP
Mary Kate Probst, PharmD, BCACP, BCGP
Carly Ranson, PharmD, BCGP
Mohammad Rattu, PharmD, BCOP, BCPS, BCGP
Jocelyn Reynoso, PharmD, BCPS, BCGP, BCSCP
Sossity Riordan, PharmD, BCPS, BCGP
Lindsay Sampson, PharmD, BCPS, BCGP
Michelle Schmidt, PharmD, BCGP
Megan Sculley, PharmD, BCGP, CDCES
Ben Selph, PharmD, BCGP
Eric Set, PharmD, BCGP, APh
Garcia Simon-Clarke, PharmD, BCPS, BCGP, BCNP
Xingwu Teng, PharmD, PhD, BCPS, BCGP
Gayle Tuckett, PharmD, BCGP
Erin Williams, PharmD, BCGP
Lillie Willis, PharmD, BCPS, BCACP, BCGP
Leah Wonderful, Pharm.D, BCGP
Christine Wu, PharmD, BCPS, BCGP
Katherine Yep, PharmD, BCGP
Lorin Yolch, PharmD, BCGP, BCACP, CSP
Susie Yoo, PharmD

In accordance with our accreditor’s Standards of Integrity and Independence in Accredited Continuing Education, ASHP requires that all individuals in control of content disclose all financial relationships with ineligible companies. An individual has a relevant financial relationship if they have had a financial relationship with an ineligible company in any dollar amount in the past 24 months and the educational content that the individual controls is related to the business lines or products of the ineligible company. 

An ineligible company is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The presence or absence of relevant financial relationships will be disclosed to the activity audience. 

No one in control of the content of this activity has a relevant financial relationship (RFR) with an ineligible company. 

As required by the Standards of Integrity and Independence in Accredited Continuing Education, all relevant financial relationships have been mitigated prior to the CPE activity.

Activities can be completed in any order. Each activity consists of audio, video, and/or PDFs and evaluations. Learners must review all content and complete the evaluations to receive continuing pharmacy education credit for each activity. 

Follow the prompts to claim, view, or print the statement of credit within 60 days after completing the activity. 

ASHP and ACCP collaborate on geriatric pharmacy activities.