Once patients are noncompliant for the following measures, they cannot be made compliant for the rest of the year:

  1. Concurrent Use of Opioids and Benzodiazepines (COB)
  2. Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)

Consider these best practices to reduce risk and improve compliance:

  • Prescribe covered alternatives if clinically appropriate.
  • Limit refills and auto-refills to allow for interventions to assess the appropriateness of continued therapy.
  • Limit dosages and durations to the minimum possible while achieving the desired clinical effect.
  • For COB: Check the Louisiana Prescription Monitoring Program to verify that patients are not being prescribed controlled substances by other providers.
  • For Poly-ACH:
    • Identify patients prescribed two or more ACH medications.
    • Regularly re-evaluate the efficacy and risks of ACH medications, especially for treatment periods longer than three months because of the potential for irreversible cognitive effects.
    • When prescribing to older adults, prioritize medications with fewer ACH effects and high effectiveness at the target site.