Problem Statement: The availability of new medications in long-term care (LTC) facilities is a critical issue in the field of geriatric healthcare. While advancements in pharmaceutical research and therapeutic alternatives offer significant benefits to the aging population, the practical implementation of these innovations within LTC environments often faces systemic obstacles. As the population of older adults expands, the need for effective and safe pharmacological treatments becomes increasingly urgent. There are significant disparities in access to medications, with factors such as age and ethnicity affecting the probability of receiving newer treatments (Medlinskiene et al., 2021). The distinct challenges encountered by LTC residents, including multimorbidity and polypharmacy, may complicate medication use and management. This initiative seeks to examine access to medications, including new medications, in LTC contexts and suggest implications for patient outcomes and healthcare systems.
Value Proposition: The Access to New Medications Research Initiative by PointClickCare Life Sciences aims to investigate the availability and use of medications within long-term care (LTC) environments. This initiative is part of a broader research effort to understand and address challenges associated with medication access in LTC settings.
KEY OBJECTIVES
Describe variation in treatment rates for ten common chronic conditions.
Begin to identify potential relationships between treatment, demographic, and clinical characteristics.
RESEARCH OVERVIEW
POPULATION DATA OVERVIEW
The population data for this research initiative is derived from PointClickCare Life Sciences' deidentified electronic health records (EHRs) of nursing home residents collected between January 1, 2015, and January 30, 2025. This data set includes over 19 million nursing home residents, providing a comprehensive overview of the population.
ONGOING RESEARCH INITIATIVE
Table 1: Historical Data on Medicare Beneficiaries with Dementia in Long-Term Care Facilities (2002)
Note. The data above is adapted from the US Agency for Healthcare Research and Quality, 2002, Treatment of dementia among community-dwelling and institutionalized Medicare beneficiaries | Effective Health Care (EHC) Program. (n.d.). Retrieved February 19, 2025, from https://effectivehealthcare.ahrq.gov/products/dementia-databases-methods/research#T3
This table presents historical data on Medicare beneficiaries with dementia in various long-term care settings, based on the 2002 Medicare Current Beneficiary Survey (MCBS). The data has been reworked to provide a comprehensive overview of the characteristics of these beneficiaries.
Table 2: Commonly Prescribed Medications for Diabetes Management in Nursing Homes
Note. The data above is reproduced from Pandya, N., Jung, M., Norfolk, A., Goldblatt, C., Trenery, A., & Sieradzan, R. (2023). Medication prescribing for type 2 diabetes in the US long-term care setting: Observational study. Journal of the American Medical Directors Association, 24(6), 790-797.e4. https://doi.org/10.1016/j.jamda.2023.03.020 This table presents the percentage of nursing home residents prescribed various medications for diabetes management, highlighting the most commonly used treatments.
Understanding treatment patterns in long-term care (LTC) settings is crucial for improving patient outcomes and ensuring effective medication management. Our study aims to address this by analyzing deidentified EHR data from over 13 million LTC residents collected between January 1, 2017, and January 30, 2025, to describe treatment frequency for ten chronic conditions. By integrating these historical and contemporary data sources, we aim to contribute to the development of evidence-based guidelines and strategies that enhance the quality of care for LTC residents.
POPULATION
Figure 1. Demographic and Clinical Characteristics from Clinical Data Set.
Table 3. Preliminary report on medications for 10,998,450 long-term care residents of which 4,493,067 are receiving treatments.
Preliminary data indicate treatment rates for chronic conditions were unexpectedly low at 41% (Wagner & Arora, 2025). The lowest rates of treatment were for chronic kidney disease at 15% and ischemic heart disease at 21%. Highest rates were for diabetes at 69% and hypertension at 64% (Wagner & Arora, 2025).
We will research the ten most common chronic conditions in the Life Sciences database to update literature and check for trend changes. Our goal is to understand recent medication use patterns and identify barriers and facilitators to accessing new medications in LTC.
METHODOLOGY
We referenced medication binders of commonly used medications indicated for the studied conditions. We are reviewing these binders with regard to prescribing guidelines for the conditions to map the treatment landscape accurately, ensuring precise data for our research.
FUTURE/ONGOING RESEARCH INITIATIVES
We are actively reviewing medication binders to align with current treatment guidelines, starting with the ADRD (Alzheimer's Disease and Related Dementias) project. This revision is crucial as it ensures that our research remains up to date with the latest medical standards and practices. The ADRD project is particularly significant as it focuses on updating treatment approaches for Alzheimer's Disease and related dementias based on contemporary data and guidelines. Preliminary data indicate that treatment rates for chronic conditions like ADRD were unexpectedly low highlighting potential need for ongoing research to identify barriers to treatment and develop strategies to improve medication access and adherence among long-term care residents.
A series of retrospective cohort studies will continue to build on this foundation, with a focus on updating the medication binders used to estimate treatment rates in Table 1 to reflect the latest treatment guidelines for each condition. By doing so, we aim to describe contemporary quality of care for long-term care residents and help ensure that residents are able to receive the most effective and appropriate treatments for their conditions.
ADRD Retrospective Cohort Study:
The study will concentrate on Alzheimer's Disease and Related Dementias (ADRD). Its primary goal is to assess whether the contemporary treatment approaches for ADRD (as of 2025) are consistent with baseline data and expectations derived from a 2002 observational study. This investigation will replicate the 2002 cohort by utilizing data from the Medicare Current Beneficiary Survey (MCBS) and information extracted from PCC Electronic Health Records (EHR) for all long-term care residents diagnosed with ADRD. Critical inquiries will include whether there has been an increase in treatment rates for ADRD, how medication usage and prevalence have evolved, and whether disparities in care continue to exist. The study will review current ADRD treatment methodologies, identify changes in prescribing patterns, and recognize areas necessitating policy intervention.
Diabetes Retrospective Cohort Study:
The second retrospective cohort study will examine diabetes management in long-term care settings. The aim is to determine whether the adoption of new diabetes medications (GLP-1s and SGLT-2s) is in accordance with the 2022 guidelines established by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Additionally, it will evaluate the uptake of these medications among U.S. adults with type 2 diabetes by 2025, utilizing PCC EHR data. This study will juxtapose baseline data from 2017-2020 with current treatment practices as of 2025.
Key questions will address:
The anticipated findings will include an update on current diabetes medication practices and insight into evolving prescribing trends.
Multichronicity:
Polypharmacy :
The presence of multiple chronic conditions complicates the management and administration of new medications. More complexity may possibly lead to greater uncertainty surrounding prescribing and may ultimately contribute to lower treatment rates. The lack of evidence-based guidelines tailored to individuals with multiple chronic conditions exacerbates these challenges and further motivates our research into this area.
Polypharmacy, defined as the simultaneous administration of several medications, is a common occurrence for older adults residing in long-term care (LTC) facilities. This situation may complicate the integration of new therapeutic interventions and is understood to heighten the likelihood of adverse drug reactions (Hagiwara et al., 2024; Wang et al., 2018).
Many residents in LTC facilities are historically excluded from clinical trials, which results in a lack of evidence-based guidelines tailored to their specific requirements, thereby exacerbating challenges in medication management (Sluggett et al., 2024). The presence of multiple chronic conditions complicates the management and administration of new medications. More complexity may possibly lead to greater uncertainty surrounding prescribing and may ultimately contribute to lower treatment rates. The lack of evidence-based guidelines tailored to individuals with multiple chronic conditions exacerbates these challenges and further motivates our research into this area.
Lack of Information on Barriers:
The lack of information on barriers for prescribing for LTC residents LTC, and associated population features like age-related barriers, multiple chronic conditions, polypharmacy, and newness of medications motivates our research initiative. By integrating historical and contemporary data sources, we aim to contribute to the development of evidence-based guidelines and strategies that enhance the quality of care for long-term care residents.
DISCUSSION:
Effective communication and collaboration among healthcare providers are essential for adopting new therapeutic options, with prescriber networks playing a key role (Lublóy, 2014). As only population-level information is presented here, the scope remains limited. Resident-level data and analysis will be conducted in a series of research studies. New and existing medications are crucial for geriatric healthcare, but systemic barriers include factors related to perceptions of age and aging, residents' multiple health conditions (multimorbidity) and polypharmacy.
Any treatment must be linked to the therapeutic area being studied. For each disease, we have provided a list of medications or medication classes queried. This ensures that the treatments are relevant and specific to the conditions being addressed. If you need detailed information on the medications or medication classes used for each disease, please refer to the medication binder provided in the appendix.
The numbers may seem quite low if this includes any treatment. Preliminary data indicate that treatment rates for chronic conditions were unexpectedly low at 41% (Wagner & Arora, 2025). The lowest rates of treatment were observed for chronic kidney disease at 15% and ischemic heart disease at 21%. In contrast, the highest treatment rates were for diabetes at 69% and hypertension at 64% (Wagner & Arora, 2025). These findings highlight the need for ongoing research to identify barriers to treatment and develop strategies to improve medication access and adherence among long-term care residents.
Yes, the percentage of residents not on treatment in the chart indicates that they are not being treated at all for the indicated condition. This is a significant concern as it suggests gaps in care and potential areas for improvement in treatment practices. Understanding the reasons behind these gaps is crucial for developing effective interventions and policies to ensure that all residents receive appropriate care.
The influence of funding, formularies, and coverage on treatment rates was not intentionally omitted but would require a separate study to fully understand. These factors can significantly impact the availability and accessibility of medications for long-term care residents. Funding constraints, formulary restrictions, and coverage limitations can all contribute to disparities in treatment rates and access to new medications. Further research is needed to explore these influences and develop strategies to mitigate their impact on patient care.
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Acknowledgements: All aspects of this research initiative are supported by PointClickCare Life Sciences.
Data & Resources: Wagner, B., Arora, T. (2025). Medication Use for Chronic Conditions in Long-Term Care. Poster abstract submitted (under review) to the AMIA Annual Symposium, Atlanta, GA. Submitted at: AMIA 2025 Annual Symposium
References:
Hagiwara, S., Komiyama, J., Iwagami, M., Hamada, S., Komuro, M., Kobayashi, H., & Tamiya, N. (2024). Polypharmacy and potentially inappropriate medications in older adults who use long-term care services: A cross-sectional study. BMC Geriatrics, 24(1), 696. https://doi.org/10.1186/s12877-024-05296-4
Lublóy, Á. (2014). Factors affecting the uptake of new medicines: A systematic literature review. BMC Health Services Research, 14(1), 469. https://doi.org/10.1186/1472-6963-14-469
Medlinskiene, K., Tomlinson, J., Marques, I., Richardson, S., Stirling, K., & Petty, D. (2021). Barriers and facilitators to the uptake of new medicines into clinical practice: A systematic review. BMC Health Services Research, 21(1), 1198. https://doi.org/10.1186/s12913-021-07196-4
Pandya, N., Jung, M., Norfolk, A., Goldblatt, C., Trenery, A., & Sieradzan, R. (2023). Medication prescribing for type 2 diabetes in the US long-term care setting: Observational study. Journal of the American Medical Directors Association, 24(6), 790-797.e4. https://doi.org/10.1016/j.jamda.2023.03.020
Sluggett, J. K., Inacio, M. C., & Caughey, G. E. (2024). Medication management in long-term care: Using evidence generated from real-world data to effect policy change in the Australian setting. American Journal of Epidemiology, 193(12), 1645–1649. https://doi.org/10.1093/aje/kwae136
Treatment of dementia among community-dwelling and institutionalized Medicare beneficiaries | Effective Health Care (EHC) Program. (n.d.). Retrieved February 19, 2025, from https://effectivehealthcare.ahrq.gov/products/dementia-databases-methods/research#T3
Wagner, B., Arora, T. (2025). Medication Use for Chronic Conditions in Long-Term Care. Poster abstract submitted (under review) to the AMIA Annual Symposium, Atlanta, GA. Submitted at: AMIA 2025 Annual Symposium
Wang, K. N., Bell, J. S., Chen, E. Y. H., Gilmartin-Thomas, J. F. M., & Ilomäki, J. (2018). Medications and Prescribing Patterns as Factors Associated with Hospitalizations from Long-Term Care Facilities: A Systematic Review. Drugs & Aging, 35(5), 423–457. https://doi.org/10.1007/s40266-018-0537-3
