A pharmacist-physician intervention model using a computerized alert system to reduce high-risk medication use in...

Area of Science:

• Geriatric Pharmacology
• Medication Safety
• Knowledge Translation

Background:

• Potentially inappropriate medications (PIMs) increase adverse drug events and hospitalizations in older adults.
• Reducing PIMs is crucial for improving health outcomes in the elderly population.
• Family health teams (FHTs) are key settings for implementing medication management strategies.

Purpose of the Study:

• To evaluate a knowledge translation (KT) strategy aimed at reducing PIMs in community-dwelling older adults.
• To assess the effectiveness of a pharmacist-physician intervention model utilizing a computerized alert system (CAS).
• To determine the impact of CAS-generated alerts on PIM cessation, dose reduction, or medication replacement.

Main Methods:

• A pragmatic, single-site pilot study conducted in a Quebec FHT clinic.
• Inclusion criteria: community-dwelling adults aged 65 years or older with at least one PIM alert (Beers and STOPP criteria) and a scheduled medical appointment.
• Primary outcome: PIM cessation, dose decrease, or replacement. Secondary outcome: clinical relevance of CAS alerts assessed by pharmacists.

Main Results:

• The CAS screened 369 individuals over 134 days, identifying 65 patients (18%) with at least one new PIM alert.
• Of the 65 patients, 27 (42%) had clinically relevant alerts, with 17 (63%) undergoing at least one medication change as recommended by the pharmacist.
• The average age of included patients was 77 years, with 29% males and 55% on 10 or more medications.

Conclusions:

• An interdisciplinary pharmacist-physician intervention model effectively reduced PIM use in community-dwelling older adults.
• Computerized alert systems (CAS) integrated into FHTs can facilitate successful medication management strategies.
• This approach demonstrates potential for improving medication safety and reducing PIM-related risks in geriatric populations.