Impact of Pharmacist Interventions in an Ambulatory Geriatric Care Clinic: The IMPACC Study

To compare the impact of a pharmacist's presence for the detection of drug-related problems (DRP) in an interdisciplinary geriatric-ambulatory clinic with a control group without a pharmacist.
DESIGN: Retrospective quasi-experimental study.
SETTING: A geriatric ambulatory-care clinic of a 772-bed tertiary-care teaching hospital in Montreal, Canada.
PARTICIPANTS: A total of 227 ambulatory patients 65 years of age and older presenting to their appointment at the geriatric ambulatory clinic between May 1, 2018, and April 30, 2019.
MAIN OUTCOME MEASURE(S): DRP detected by the interdisciplinary team during the patient evaluation process. Data were collected from clinical notes written by the health care professionals in the electronic medical chart.
RESULTS: The mean age was 80.8 years, and 60.8% of the population were female. Patients were prescribed a mean of 11.3 medications at home. Overall, 636 DRP were detected in the study population. In the adjusted analysis, the difference between the two groups was 2.7 (95% confidence interval 2.0-3.3) DRP detected favoring the group with a pharmacist.
CONCLUSION: The inclusion of a pharmacist in an interdisciplinary team in an ambulatory geriatric-care clinic was associated to a positive impact on care by substantially increasing the number of DRP detected in older patients.