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Impact of Pharmacy Medication Reviews on the Prescribing of Potentially Inappropriate Medications for Older Veterans in Primary Care

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OBJECTIVE: The primary objective was to evaluate prescribing of potentially inappropriate medications (PIMs) as defined by the Beers criteria in outpatient clinics with and without mandatory pharmacy medication reviews. DESIGN: Retrospective electronic medical chart review at a single academic Veterans Affairs (VA) medical center. SETTING: Home-based primary care (HBPC) and geriatric primary care. PATIENTS: Patients were included if they were 65 years of age or older at the time of enrollment and newly enrolled with an initial visit to HBPC or geriatric primary care between January 2015 and September 2015. Charts were included if patients received at least one follow-up visit with their primary care provider within 13 months of the initial visit. An additional inclusion criterion for HBPC patients was the documentation of at least one follow-up medication review by a clinical pharmacist within 13 months of the initial mandatory chart review. A total of 30 patients were included in both groups. INTERVENTIONS: Mandatory pharmacy medication reviews compared with usual care (no formal pharmacy review). MAIN OUTCOME MEASURE: Mean change in PIMs prescribed in both groups. RESULTS: The mean number of PIMs at initial and final visits was 0.4 unit per patient in HBPC. In geriatric primary care, the mean number of PIMs at the initial visit was 0.4 unit per patient, which increased at the final visit to 0.6 unit per patient. CONCLUSION: No change in PIMs was observed in the HBPC group, while an increase was observed in geriatric primary care.
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Keywords: BEERS CRITERIA; HOME CARE; HOME-BASED PRIMARY CARE; OLDER ADULTS; PIM; POTENTIALLY INAPPROPRIATE MEDICATION; VETERANS

Document Type: Research Article

Publication date: July 1, 2019

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