Geriatric Patient Care Improvement, Health Literacy, Medication Adherence, Pharmacy Economic Improvement
Conditions
Keywords
Geriatric, Pharmacoeconomics, Health Literacy, Adherence
Brief summary
It has been shown that patients can improve their safety through informed choice, safe medication use, and complication reporting. This includes not only the potential problems that occur from prescription medication use but also issues that may arise through the improper use of over-the-counter medications. The willingness of a patient to take on safety action is known to be complicated by an unwillingness to behave in a manner that might challenge a physician's judgment or actions. Community pharmacists are in the unique position to provide perspective on the physician's recommendation and act as an advocate to facilitate necessary change. Through supportive and repeated interaction with their community pharmacist patients will develop assertiveness toward their own health care, an increased frequency and quality of interaction with their physician, and thus a minimized risk of harm and maximized opportunity to optimize clinical outcomes.
Detailed description
This is a single center, observational study to determine if geriatric patients who are on five or more chronic medications will have a difference in clinical, humanistic, and/or economic outcome through an integrated clinical pharmacy service intervention. The primary efficacy objective will be assessed through a single cohort, paired research design measuring the change from baseline in the adherence rate, number of medication related problems, and Beers criteria medications. The primary economic objective will be assessed through prescription revenue to validate the employment of a 0.5-1.0 Full-time equivalent (FTE). Secondary efficacy objectives will be assessed through a single cohort, paired research design measuring the change from baseline in the health literacy, optimization in the anthropometrics, and health related quality of life (HRQOL).
Interventions
BEHAVIORALMedication adherence consultation
Patients will be counseled in person on day 0 then telephonically every month after until day 365.
OTHERMedication problems assessment
Patients will be asked if they are having any issues that may be attributable to their current drug therapy on a monthly basis. Any issue that is identified will be addressed by the pharmacist.
OTHERBeer's Criteria Assessment
The patient's drug therapy will be reviewed for Beer's criteria medications and possible alternatives will be addressed by the pharmacist if deemed appropriate.
BEHAVIORALHealth Literacy Assessment
Patients will be given a Health Literacy Assessment on day 0 and day 365 using the Realm-SF.
Sponsors
Community Pharmacy Foundation
VascuScript Pharmacy
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients who are at least 65 years of age * Have at least 5 medications that they take on a chronic basis * Willing to have their prescriptions filled by VascuScript Pharmacy * Understand the terms of the informed consent
Exclusion criteria
* Any patient who does not meet the requirements of the Inclusion Criteria
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Medication adherence | Every 30 days for 12 months | To determine if an integrated clinical pharmacy service program in geriatric patients can maintain a medication adherence rate ≥80%. |
| Medication related problems | Every 30 days for 12 months | To determine if an integrated clinical pharmacy service program in geriatric patients can reduce the number of medication related problems by ≥10%. |
| Beers criteria medications | Every month for 12 months | To determine if an integrated clinical pharmacy service program in geriatric patients can reduce the number of Beers criteria medications by ≥10%. |
| Economic impact | 12 months | To determine the number of patients required to validate a part-time or full-time pharmacist to perform the required clinical functions of the clinical pharmacy service geriatric program. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Optimizing Anthropometrics | 12 months | To determine if an integrated clinical pharmacy service program in geriatric patients can demonstrate ≥10% improvement and/or greater optimization of patient weight, blood pressure, cholesterol, and blood glucose (if applicable). |
| Quality of Life | 12 months | To determine if an integrated clinical pharmacy service program in geriatric patients can improve quality of life as evidenced by the CDC HRQOL Healthy Days Core Module. |
| Health literacy | 12 months | To determine if an integrated clinical pharmacy service program in geriatric patients can improve health literacy as evidenced by the REALM-SF. |
Countries
United States
Outcome results
None listed