Impact of Pharmacists in Optimizing Geriatric Pharmacotherapy in Primary Care Within a Veterans Affairs Medical Center.

OBJECTIVE

To assess pharmacists' impact on optimizing pharmacotherapy among geriatric patients.

DESIGN

Single-site, prospective, quality-improvement project.

SETTING

Primary care at a Veterans Affairs medical center.

PARTICIPANTS

Thirteen males 75 years of age and older were included.

INTERVENTIONS

Recommendations were made by pharmacists to optimize prescribing.

MAIN OUTCOME MEASURES

Differences between specific instances of suboptimal prescribing before and after pharmacists' recommendations, the percentage of pharmacists' recommendations accepted, and the top most commonly prescribed psychotropic medications and their most common indications.

RESULTS

Sixty-three recommendations were made by pharmacists, and 48% of these recommendations were accepted by providers. There was a 27% reduction of the use of high-risk medications, a 44% reduction of omissions of care, and a 74% reduction of incomplete medication monitoring after pharmacists' recommendations. The most commonly prescribed psychotropic medications were zolpidem (31%), lorazepam (23%), and clonazepam and temazepam (each 15%). The most common indications for these medications were anxiety and insomnia (each 46%), with 8% of patients having an indication for both.

CONCLUSION

Pharmacists' recommendations improved geriatric pharmacotherapy by decreasing the overall instances of suboptimal prescribing.