Older adults are demanding increased healthcare attention with regards to prescription use\ndue in large part to highly complex medication regimens. As patients age, medications often have a\nmore pronounced effect on older adults, negatively impacting patient safety and increasing healthcare\ncosts. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and\nhelp to avoid inappropriate medication use. Previous literature has shown that such CMRs can\nsuccessfully identify and reduce the number of medication-related problems and improve acute\nhealthcare utilization. The purpose of this pharmacy resident research study is to examine the impact\nof pharmacist-conducted geriatric medication reviews to reduce medication-related problems within\na leading community health system in southwest Michigan. Furthermore, the study examines type of\npharmacist interventions made during medication reviews, acute healthcare utilization, and physician\nassessment of the pharmacist�s value. The study was conducted as a retrospective post-hoc analysis\non ambulatory patients who received a CMR by a pharmacist at a primary care practice. Inclusion\ncriteria included patients over 65 years of age with concurrent use of at least five medications who\nwere a recent recipient of a CMR. Exclusion criteria included patients with renal failure, or those\nwith multiple providers involved in primary care. The primary outcome was the difference in\nnumber of medication-related problems, as defined by the START and STOPP Criteria (Screening\nTool to Alert doctors to Right Treatment/Screening Tool of Older Persons� Prescriptions). Secondary\noutcomes included hospitalizations, emergency department visits, number and type of pharmacist\ninterventions, acceptance rate of pharmacist recommendations, and assessment of the pharmacist�s\nvalue by clinic providers. There were a total of 26 patients that received a comprehensive medication\nreview from the pharmacist and were compared to a control group, patients that did not receive\na CMR. The average patient age for both groups was 76 years old. A total of 11 medication-related\nproblems in the intervention group patients were identified compared with 24 medication-related\nproblems in the control group (p-value 0.002). Pharmacist-led comprehensive medication reviews\nwere associated with a statistically significant different in the number of medication-related problems\nas defined by the START and STOPP criteria.
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