Reducing cost by reducing polypharmacy: the polypharmacy outcomes project.

Area of Science:

• Geriatric Medicine
• Pharmacoeconomics
• Long Term Care

Background:

• Polypharmacy is prevalent in long term care residents, increasing medication costs and potential adverse events.
• Interventions targeting medication review and deprescribing are crucial for optimizing care in this population.

Purpose of the Study:

• To evaluate the impact of a geriatric medicine fellow and geriatrician intervention on medication costs among long term care residents with polypharmacy.
• To assess the effectiveness of using Beers Criteria and drug-drug interaction programs in reducing medication expenses.

Main Methods:

• An interventional study was conducted in a hospital-affiliated long term care facility.
• Medication lists of residents on 9 or more medications were reviewed using the 2003 Beers Criteria and Epocrates.
• Recommendations were made to primary physicians, who determined medication changes.

Main Results:

• The intervention group included 70 residents with polypharmacy.
• Mean monthly medication costs per resident significantly decreased post-intervention (overall: $874.27 to $843.56; scheduled: $814.05 to $801.14; PRN: $60.22 to $42.43).
• Highest cost savings were observed in gastrointestinal, central nervous system-active, analgesic, and diabetes medications.

Conclusions:

• Physician-led polypharmacy reduction interventions can significantly decrease medication costs in long term care.
• This intervention provided valuable training for geriatric medicine fellows in practice-based learning and systems-based practice.
• Utilizing readily available tools like Beers Criteria and drug interaction programs is effective for cost-saving medication management.