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geriatric pharmacy

Pierre Renaudin, Karine Baumstarck, Aurélie Daumas, Marie-Anne Esteve, Stéphane Gayet, Pascal Auquier, Michel Tsimaratos, Patrick Villani, Stéphane Honore
BACKGROUND: Early hospital readmission of patients after discharge is a public health problem. One major cause of hospital readmission is dysfunctions in integrated pathways between community and hospital care that can cause adverse drug events. Furthermore, the French ENEIS 2 study showed that 1.3% of hospital stays originated from serious adverse drug events in 2009. Pharmacy-led medication reviews at hospital transitions are an effective means of decreasing medication discrepancies when conducted at admission or discharge...
February 9, 2017: Trials
Anaïs Berthe, Clémentine Fronteau, Éloïse Le Fur, Caroline Morin, Jean-François Huon, Isabelle Rouiller-Furic, Marielle Berlioz-Thibal, Gilles Berrut, Aline Lepelletier
Iatrogenic effects represent a large part of emergency admissions among elderly people. Throughout the care pathway of a patient, whether he is at home or hospitalized, many different health professionals are involved regarding the patient's medication. Medication reconciliation is one way to prevent adverse drug events at all care transitions for every patient by eliminating undocumented intentional discrepancies and unintentional discrepancies in the patient's medication. The aim of this article is to present the different activities of clinical pharmacy developed since 2011 in a follow up and rehabilitation geriatric care service, including medication reconciliation activity...
January 23, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Mohammed Shurrab, Eugene Crystal, Denis O'Donnell, Hrishikesh Navare, Paula Neves, Rasha Khatib, Ilan Lashevsky, David Newman
PURPOSE: The use of oral anticoagulation (OAC) in the elderly population with atrial fibrillation (AF) treated in long-term care (LTC) facilities is inconsistent. We examined the magnitude and sources of the gap between indicated and prescribed OAC in the elderly population with AF. METHODS: We retrospectively scanned the electronic medical record (EMR) and pharmacy data of 25 LTC facilities in Ontario, Canada. The diagnosis of AF was drawn from EMR. Different attributable risk factors for possible failure to prescribe OAC were examined...
January 16, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Krista L Donohoe, Aulbrey G Drisaldi, Fawaz M Alotaibi, Tabatha N Bonas, Edward M Shibley, Patricia W Slattum
Objective. To assess changes in pharmacy students' knowledge, skills, and self-efficacy after completing an advanced pharmacy practice experience (APPE) in geriatrics. Design. During the 2013-2014 academic year, 30 Virginia Commonwealth University (VCU) School of Pharmacy students were required to complete a 5-week Geriatrics APPE at Plaza Professional Pharmacy in Richmond, Virginia. All students completed a 25-point knowledge-based pre- and post-assessment to measure students' self-efficacy. The average time required to accurately fill one unit dose prescription card before and after completing the APPE was also evaluated...
November 25, 2016: American Journal of Pharmaceutical Education
Grace Farris, Mousumi Sircar, Jonathan Bortinger, Amber Moore, J Elyse Krupp, John Marshall, Alan Abrams, Lewis Lipsitz, Melissa Mattison
OBJECTIVES: To examine whether a novel videoconference that connects an interdisciplinary hospital-based team with clinicians at postacute care sites improves interprofessional communication and reduces medication errors. DESIGN: Prospective cohort. SETTING: One tertiary care medical center and eight postacute care sites. PARTICIPANTS: Hospital-based providers (hospitalists, geriatricians, pharmacists, social workers, medical trainees, and subspecialists) and postacute care clinicians...
December 29, 2016: Journal of the American Geriatrics Society
Isabelle Récoché, Cécile Lebaudy, Charlène Cool, Sandrine Sourdet, Antoine Piau, Maryse Lapeyre-Mestre, Bruno Vellas, Philippe Cestac
Background Frailty is a clinical syndrome highly predictive of functional decline after a stress or a medical event, such as adverse drug events. Objective To describe the prevalence of potentially inappropriate prescribing in a population of frail elderly patients. Setting Geriatric day hospital for assessment of frailty and prevention of disability, Toulouse, France. Method A cross-sectional study performed from January to April 2014. Two pharmacists retrospectively analyzed the prescriptions of elderly patients who were sent to the day hospital to assess their frailty and to be given a personalized plan of care and prevention...
February 2017: International Journal of Clinical Pharmacy
Kristina M Hash, Marla Berg-Weger, Daniel B Stewart, David P Elliott
This study was conducted to determine the level and types of participation of social workers in the activities of the Geriatric Education Centers (GECs). Through an online survey of GECs, the level of participation of social work professionals was compared with those in dentistry, nursing, medicine, and pharmacy, during the years 2010 to 2014. Thirty-one percent (14) of the 45 GECs completed the survey. The results found increases in participation for both social workers and nurses for both GEC activities and involvement in leadership positions within the centers...
November 29, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Katelyn M Steele, Janelle F Ruisinger, Jessica Bates, Emily S Prohaska, Brittany L Melton, Stephanie Hipp
OBJECTIVE: To evaluate the effects of pharmacist-conducted, home-based comprehensive medication reviews (CMRs) on drug therapy problems (DTPs) in geriatric patients. DESIGN: Pre-/postintervention study. SETTING: Grocery store chain affiliated with three independent living facilities. PARTICIPANTS: Twenty-five older adults using pharmacy delivery services for at least three chronic medications. INTERVENTION: A pharmacist conducted a home-based CMR for each participant...
2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Derek Jorgenson, Jonathan Penm, Neil MacKinnon, Jennifer Smith
OBJECTIVES: Pharmacists are increasingly providing specialized services. However, no process exists for specialist certification in Canada. The aim of this study was to determine the extent to which Canadian community pharmacists support the development of a certification system for specialization. METHODS: This study utilized a cross-sectional online survey of licensed Canadian pharmacists identified through the member databases of national and regional pharmacy associations...
August 4, 2016: International Journal of Pharmacy Practice
Elizabeth Eckstrom, Margaret B Neal, Vicki Cotrell, Colleen M Casey, Glenise McKenzie, Megan W Morgove, Gary E DeLander, William Simonson, Kathie Lasater
Falls are the leading cause of accidental deaths in older adults and are a growing public health concern. The American Geriatrics Society (AGS) and British Geriatrics Society (BGS) published guidelines for falls screening and risk reduction, yet few primary care providers report following any guidelines for falls prevention. This article describes a project that engaged an interprofessional teaching team to support interprofessional clinical teams to reduce fall risk in older adults by implementing the AGS/BGS guidelines...
August 2016: Journal of the American Geriatrics Society
Katharine Cimmino, Michele Pisano
INTRODUCTION: Patients who have transitioned to end-of-life (EOL) care are at an increased risk for polypharmacy as they face new symptoms requiring palliative-care medications. CASE: The patient was a 96-year-old, 6' 2", 125-pound male patient who was brought into the outpatient geriatric practice by his daughter, with whom he had been living all his life. The patient had no pain, but severe dysphagia. Both daughter and patient were fully aware that death was imminent, as the patient had lost 60 pounds in the past three to four months because of gastrointestinal cancer...
July 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Marta Moro Agud, Rocío Menéndez Colino, María Del Coro Mauleón Ladrero, Margarita Ruano Encinar, Jesús Díez Sebastián, Elena Villamañán Bueno, Alicia Herrero Ambrosio, Juan Ignacio González Montalvo
Background During care transitions, discrepancies and medication errors often occur, putting patients at risk, especially older patients with polypharmacy. Objective To assess the results of a medication reconciliation and information programme for discharge of geriatric patients conducted through hospital information systems. Setting A 1300-bed university hospital in Madrid, Spain. Method A prospective observational study. Geriatricians selected candidates for medication reconciliation at discharge, and sent an electronic inter-consultation request to the pharmacy department...
August 2016: International Journal of Clinical Pharmacy
Sandra L DiScala, Nhi N Tran, Michael A Silverman
This case describes the use of valproic acid suppositories for secondary seizure prophylaxis in a geriatric veteran with a feeding and swallowing disorder. The effectiveness of valproic acid suppositories is outlined to reinforce the need for compounding pharmacies to have this formulation available to meet the needs of geriatric patients.
2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Nathan J Pauly, Jeffery C Talbert, Joshua Brown
BACKGROUND: Administrative claims data are used for a wide variety of research and quality assurance purposes; however, they are prone to medication exposure misclassification if medications are purchased without using an insurance benefit. Low-cost generic drug programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted, and the exposure may go unobserved in claims data...
June 2016: Journal of Managed Care & Specialty Pharmacy
Peter A Engel, Jacqueline Spencer, Todd Paul, Judith B Boardman
Three thousand nine hundred thirty-one veterans aged 75 and older receive primary care (PC) in two large practices of the Department of Veterans Affairs (VA) Boston Healthcare System. Cognitive and functional disabilities are endemic in this group, creating needs that predictably exceed available or appropriate resources. To address this problem, Geriatrics in Primary Care (GPC) embeds geriatric services directly into primary care. An on-site consulting geriatrician and geriatric nurse care manager work directly with PC colleagues in medicine, nursing, social work, pharmacy, and mental health within the VA medical home...
April 2016: Journal of the American Geriatrics Society
Kanizeh Visram, Laura S Carr, Joanne Doyle Petrongolo
PURPOSE: The implementation of a required residency rotation in transitions of care (TOCs) and the resulting resident-led clinical interventions and learning experiences are described. SUMMARY: A newly required four-week TOC rotation was implemented for postgraduate year 1 (PGY1) pharmacy residents at Massachusetts General Hospital (MGH). Unlike acute care rotations, this learning experience encouraged residents to focus on providing direct patient care in a holistic manner and use pharmacologic and nonpharmacologic strategies to improve patient outcomes...
May 1, 2016: American Journal of Health-system Pharmacy: AJHP
Saeed Al Shemeili, Susan Klein, Alison Strath, Saleh Fares, Derek Stewart
RATIONALE AND AIM: The structures and processes around the management of medicines for elderly, hospitalized patients are ill defined. This study aimed to determine consensus related to strategic and operational approaches in the United Arab Emirates. METHODS: A modified Delphi technique, consensus study with first round statements developed from systematic reviews related to medicines management. Normalization process theory and the theoretical domains framework were applied in the construction of statements, organized into key elements of medicines management: guidelines for medicines management, medicines reconciliation, medicines selection, prescribing and review, medicines adherence, medicines counselling, health professional training and evaluation research...
October 2016: Journal of Evaluation in Clinical Practice
Brandon T Suehs, Cralen Davis, Billy Franks, Thomas E Yuran, Daniel Ng, Jason Bradt, John Knispel, Maria Vassilakis, Todd Berner
OBJECTIVES: To examine potentially inappropriate medication (PIM) use in older adults initiating an antimuscarinic medication for the treatment of overactive bladder (OAB). DESIGN: Retrospective database analysis. SETTING: Medical and pharmacy claims data. PARTICIPANTS: Medicare Advantage Prescription Drug Plan members aged 65 and older newly initiated on an antimuscarinic OAB treatment were identified and assigned to PIM and non-PIM comparison groups based on 2012 American Geriatrics Society Beers Criteria and/or the presence of an anticholinergic medication interaction at the time of initiation of treatment (N = 66,275)...
April 2016: Journal of the American Geriatrics Society
Francesca Guerriero, Valentina Orlando, Daniele Ugo Tari, Annalisa Di Giorgio, Antonio Cittadini, Gianluca Trifirò, Enrica Menditto
PURPOSE: To explore the frequency of polypharmacy, functional and cognitive capacity among the elderly in Southern Italy. METHODS: Population-based retrospective cross-sectional study. Information were retrieved from electronic-geriatric-forms matched by record-linkage to outpatient pharmacy-records. The following domains were collected from geriatric forms: BMI, cognitive capacity (SPMSQ), functional status (Barthel-index), mobility, living condition. Polypharmacy status was categorized as non-polypharmacy (0-4), polypharmacy (5-9) and excessive-polypharmacy (≥10)...
December 2015: Translational Medicine @ UniSa
Jason M Moss, William E Bryan, Loren M Wilkerson, George L Jackson, Ryan K Owenby, Courtney Van Houtven, Melissa B Stevens, James S Powers, Camille P Vaughan, William W Hung, Ula Hwang, Alayne D Markland, Gerald McGwin, Susan Nicole Hastings
BACKGROUND: As the proportion of older adult patients who interface with the health care system grows, clinical pharmacy specialists (CPS) have a pivotal role in reducing potentially inappropriate medication (PIM) use in this population. OBJECTIVES: To (a) describe CPS involvement in the design and implementation of a quality improvement (QI) initiative to decrease PIM prescribing in a Veterans Affairs (VA) emergency department (ED) and (b) report on changes in PIM prescribing before and after the initiative...
January 2016: Journal of Managed Care & Specialty Pharmacy
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