The Mother Cabrini Health Foundation (MCHF) has renewed its support this year for three innovative United Hospital Fund programs aimed at helping young children and older adults.
MCHF awarded $500,000 to support a second year of our Addressing Polypharmacy in Nursing Homes initiative and $500,000 to continue the Pediatrics for an Equitable Developmental Start Learning Network (PEDS Network). It also continued its support of a UHF program started last year as part of the Learning Network to help New York City-based pediatric primary care practices integrate literacy intervention strategies into well child-visit schedule.
Polypharmacy refers to prescribing an inappropriately high number of medications that may increase the likelihood of drug-drug interactions and other adverse events, such as falls, cognitive impairment, and hospitalization. The polypharmacy project has created a learning collaborative with six skilled nursing facilities to design and implement ways to better monitor and assess the appropriateness of medication regimens and implement deprescribing practices.
In its first year, the project held four learning sessions for clinical leaders from the participating institutions. The sessions focused on reducing four classes of medication: protein pump inhibitors, used to treat acid reflux and one of the world’s most widely prescribed drugs; benzodiazepines, which are sedatives often used to treat anxiety; dementia medications; and antihypertensives for the treatment of high blood pressure. All six nursing homes were able to reduce the percentage of residents on the targeted medications.
“While it has been estimated that two-thirds of nursing home residents receive 10 or more medications daily, the key issue is ensuring that all medications are appropriate and the benefits of each medication outweigh the risks,” said Joan Guzik, director, Quality and Efficiency, for UHF’s Quality Institute.
In 2023, our learning collaborative plans to continue working with the six nursing homes, while recruiting additional facilities, and to expand the list of high-risk medications targeted for deprescribing and dose reduction. It will also measure longer-term outcomes, such as falls and visits to emergency rooms.
The PEDS Network is working to improve early childhood development and reduce disparities throughout New York State though primary care-based interventions that promote healthy development, address unmet social and developmental needs, and strengthen families.
The Network supports a 15-month fellowship for eight to ten early career pediatric clinicians, helping them to develop equity-focused practices. It also offers participants an online resource center with tools and strategies to improve child health equity and sponsors a series of webinars with expert speakers that showcase successful strategies for improving early childhood development.
In 2023 the program will continue to promote opportunities for collaboration, build upon existing interventions, develop new approaches, and partner with community-based organizations.
Our literacy project was launched last year to raise awareness and promote pediatric literacy, one of the frequently overlooked social determinants of health. UHF is partnering with four pediatric primary care practices serving neighborhoods with high rates of families experiencing homelessness, medically underserved immigrant families, and low or inadequate literacy rates.
It will continue to seek out pediatric practices for participation that serve neighborhoods with poor literacy rates and children and families struggling with the toxic stress associated with living in under-resourced communities with high levels of unmet social need.
“There is a lot of work to do to enhance early literacy in under-resourced communities,” said Denise Arzola, director of Clinical-Community Partnerships at UHF. “This cannot be achieved unless we increase awareness and access among pediatricians.”
Oxiris Barbot, MD, UHF president and CEO, said that UHF is extremely grateful to The Mother Cabrini Health Foundation “for its ongoing support of our efforts to address the some of the critical health issues facing children and the elderly. These grants are critical to our mission to help build an effective and equitable health system for all New Yorkers.”