Health Care Professionals

MedsCheck

Frequently Asked Questions: MedsCheck Long-Term Care (LTC)

Patient Eligibility

Conducting the MedsCheck LTC


Patient Eligibility

Who is eligible to receive a MedsCheck LTC?

Residents of licensed Long-Term Care Homes (LTCs) are eligible for the MedsCheck LTC. This includes a long-term care home under the Long-Term Care Homes Act and any other residential facility funded by the Government of Ontario that is designated by the Executive Officer and published on the Ministry website (for example, a resident of a Home for Special Care governed under the Homes for Special Care Act) .

Patients, who are not otherwise living in a licensed home, as described, are not eligible for this program; pharmacists should consider an alternative MedsCheck service to suit patient specific needs.

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Are patients who live in a Retirement Home or a Group Home eligible for the MedsCheck LTC?

No. Residents of Retirement Homes are not eligible for the MedsCheck for LTC or MedsCheck at Home. The resident of a Retirement Home, provided s/he meets the respective program criteria, may be eligible to receive a MedsCheck Annual, MedsCheck Follow-up or a MedsCheck for Diabetes Annual.

If the Retirement Home or Group Home is governed by Provincial legislation designated by the Executive Officer as noted in the previous response then pharmacies may include these patients in the MedsCheck LTC program. Otherwise, pharmacists should seek an alternative MedsCheck service for these patients.   

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Are residents of Elderly Capital Assistance Program (ELDCAP) beds eligible for the MedsCheck LTC

Patients that occupy an ELDCAP designated bed are eligible to receive benefits (including the MedsCheck LTC) under the Ontario Drug Benefit program as they would if living in a LTC home provided the hospital / home is named in the Long Term Care Homes Act in s. 187 (18) as having ELDCAP beds.

Pharmacists should ensure that the designated hospital / home has a valid license to operate as a long-term care home; licenses will have an expiry date.

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How often can I conduct a MedsCheck LTC medication review for a patient?

During the year, pharmacists will conduct the MedsCheck LTC medication review every three months for eligible patients. The review is either a quarterly review or a more in-depth annual review which takes the place of one of the quarterly reviews. The annual in-depth review is a more comprehensive inter-professional analysis which is done once per year from the date of the last annual review.

All MedsCheck reviews are subject to audit by the ministry. If more than four LTC medication reviews (i.e., annual and/or quarterly) have been claimed over the one-year period, the pharmacist must document the rationale for conducting those extra reviews surpassing the annual limit.

The MedsCheck LTC aligns with the regulations under the Long-Term Care Homes Act whereby the pharmacy service provider is part of the interdisciplinary team that conducts patient Quarterly and Annual Evaluations of the medication management system. The regulations to the Long-Term Care Homes Act came into effect July 1, 2010. 

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Conducting the MedsCheck LTC

As a pharmacist, do I require specific training and education to conduct a MedsCheck LTC?

Pharmacists are required to be registered to practice direct patient care with the Ontario College of Pharmacists (OCP) (Part A of the Register, OCP). It is encouraged that pharmacists either have experience working with LTC patients or have training or certification in geriatrics and/or specific disease states related to residents of LTC Homes.

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Where does the pharmacist conduct the MedsCheck service for residents of long-term care homes?

The reviews may be initiated at the community pharmacy. However, the results of the review and concerns identified during the review must be communicated in person to the resident’s care team in order to be eligible for payment.

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Is the patient required to sign the MedsCheck LTC quarterly and annual medication reviews along with the pharmacist?

No. The MedsCheck LTC is signed and dated by the pharmacist who conducted the review. The name of the care team delegate at the LTC Home must be noted along with the date that the assessment was reviewed with the LTC Home care team.

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What is included in the MedsCheck LTC quarterly medication review?

The MedsCheck LTC quarterly review includes medication, dosage, hours and route of administration, duration of therapy, treatments, allergies, drug interactions as well as any potential drug therapy issues that may require a more in-depth review. The pharmacist is also reviewing drug utilization trends and patterns in the home, including the use of specific drugs and combination of drugs.

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Is there a standardized form that pharmacists must use for the MedsCheck LTC?

No. Pharmacist are encouraged to adapt the various form templates as outlined in the program details document when conducting both the MedsCheck LTC quarterly and annual medication reviews. As the annual is a more in-depth review, it is expected that pharmacist will use a more in-depth form. Pharmacist should also incorporate professional notes to support the final review that is shared with the LTC home health team.

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Are there specific drugs that require monitoring by pharmacists when conducting the MedsCheck LTC?

While the MedsCheck program is not considered a “monitoring” service as in “monitoring INR (international normalized ratio) levels”, when conducting any medication review, pharmacists are reviewing all drugs and combinations of drugs towards optimizing a patient’s drug therapy and improving quality of life. However, specific to the MedsCheck LTC, pharmacists are evaluating / monitoring the effectiveness and safety of medications that may cause or aggravate common geriatric problem areas if appropriate including drugs listed on the Beers criteria.

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When will the pharmacist conduct the MedsCheck LTC annual medication review?

LTC residents are eligible for the MedsCheck LTC annual once per year from the date of the previous year’s annual review. The MedsCheck LTC Annual is an in-depth medication review that is ideally conducted when the pharmacist identify drug therapy issues as a result of conducting a quarterly medication review.

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How long should a MedsCheck LTC quarterly and annual review take?

Time required to conduct the MedsCheck LTC will vary from patient to patient depending on the degree of their chronic condition; it is estimated that the quarterly review will take approximately 20 minutes and the annual review will take approximately 30-45 minutes.

Pharmacy support staff including registered pharmacy technicians can assist in the administrative work required to prepare for any MedsCheck program including identifying patients and organizing appointments.

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For More Information

To learn more about MedsCheck talk to your Pharmacist or contact ServiceOntario, INFOline 1-866-255-6701 or TTY 1-800-387-5559