A Team Approach To Reducing Polypharmacy

polypharmacyAcute-care units have been improving hospital care for older patients, but apparently even health care personnel in these areas need to be on the alert for patients taking multiple medications. A study at Barnes-Jewish Hospital in St. Louis found that polypharmacy was common and, in fact, increased during hospitalization. More than half of the 47 patients (mean age, 74 years) were prescribed a so-called Beers medication (one of those usually considered inappropriate for elderly people).

The unit’s interdisciplinary team included a geriatrician, a gerontological clinical nurse-specialist, a clinical pharmacist, a registered dietitian, and the patient’s primary nurse. The study was conducted to determine the effect of the team on drug prescribing.

The researchers found that most of the team’s recommendations that were communicated to physicians were implemented, even when the primary physicians were not members of the team. Regimens were changed for more than 50% of the patients because of a recommendation. In addition, Beers or other high-risk drugs were discontinued, medication errors were corrected, patients’ persistent symptoms were addressed, and the optimal timing of drug administration was clarified.

Overall, 82% of the teams’s recommendations were accepted.

Source: Am J Geriatr Pharmacother 2009;7:151-154