Pharmacist intervention for a frail elderly population in primary care
Canadian Pharmacists Conference ePoster Library. Patel T. Jun 25, 2016; 132134
Dr. Tejal Patel
Dr. Tejal Patel
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Abstract
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OBJECTIVES: In 2013, the Centre for Family Medicine Family Health Team initiated a new program called the “Case-Finding for Complex Chronic Conditions in seniors 75+ (C5-75)” to systematically screen for frailty amongst all persons aged 75 years and older to address medical conditions appropriately and to avert crises. As a component of this program, a pharmacist intervention was developed to address medication related problems (MRPs). The objectives of this study are to describe the medication use in the population referred and activities performed by pharmacists in this program.,METHODS: This was a retrospective medical records review of frail elderly patients seen by pharmacists in the C5-75 program from April 2013 to August 2015. Data pertaining to patient demographics, medical conditions, and medication history as well as activities performed and recommendations made by pharmacists were abstracted.,RESULTS: Of 142 patients (54 males and 88 females, mean age 85 years (range: 75 - 98)) identified as frail, 54 patients accepted the offer of a medication review with a pharmacist in the C5-75 program. At initial visit with the pharmacist, the means for number of total medications was 11.60 (range: 5 - 23), for prescribed medications, 7.67 (range: 3 - 20), and for over-the-counter medications, 3.93 (0 - 15). Polypharmacy and high-risk medication use was highly prevalent (83% and 93%, respectively). A total of 218 MRPs were identified among the 41 patients with at least one follow-up visit with the pharmacist. Pharmacists made a total of 222 recommendations. Of the 138 that were measurable, physicians had accepted 70% and 50% were implemented at most recent follow-up.,CONCLUSIONS: Polypharmacy, high-risk medication use and MRPs are highly prevalent in the frail elderly in primary care. Pharmacists were able to address these problems with recommendations, many of which were accepted and implemented.
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