Evaluating the Effects of a Medication Adherence Packaging Program on Outcomes in Older People.

To determine the impact of an adherence packaging and medication synchronization program on hospital visits for older people living independently in the community. A retrospective pre-post study that evaluated patient outcomes over a 24-month period was conducted. Patient-specific socio-demographic, medical, and hospital visit-related data were collected for 12 months before and after patient enrollment in the adherence packaging program.

Older People and Acute Kidney Injury: A Student Perspective on Medication Changes During Hospital Admission and Transitions of Care Follow-Up.

Older people are particularly susceptible to acute kidney injury (AKI) for a variety of reasons. Because of this, medication changes during admission and transitions of care follow-up are often necessary to ensure the safety of these patients. The American Geriatrics Society's Beers Criteria provide guidance for select medications that are potentially inappropriate in the older adult population.

Transitions of Care: A Student Perspective on the Value of Current Successes and Growth Opportunities in the PharmD Curriculum.

Transitions of care (TOC) is becoming an essential component of pharmacy practice, and requires problem solving that is difficult to learn in the classroom. My unique experience of interning in community and inpatient settings along with doing my own TOC research with geriatric patients has allowed me to see patients throughout the spectrum of health care, and how discrepancies arise as they move between settings. This manuscript will provide insight to pharmacy students about why TOC is a critical area for pharmacist involvement, and how we must be prepared to guide patients through these transitions as we become new practitioners.

A Geriatric Pharmacy Resident's Clinical and Educational Activities During Weekly interprofessional Team Meetings.

To describe and gather further details about the clinical and educational activities that were documented by the geriatric pharmacist resident during both weekly interprofessional Acute Care for the Elderly (ACE) rounds as well as bedside patient counseling. Retrospective chart review (quality improvement project). Inpatient geriatric service at University of Pittsburgh Medical Center (UPMC).

Evaluation of Direct Oral Anticoagulant Dosing and Monitoring in Two Geriatric Outpatient Clinics.

This study was conducted to evaluate direct oral anticoagulants (DOACs) prescribed to elderly patients in an outpatient setting, specifically evaluating if Food and Drug Administration (FDA) -approved dosing recommendations are followed.
This study was a retrospective quality improvement project.
This study was conducted at geriatric hospital-based primary care clinics at the University of Pittsburgh Medical Center (UPMC), UPMC Senior Care Institute and UPMC Benedum Geriatric Center.

2018 American Society of Consultant Pharmacists Annual Meeting & Exhibition.

Poster abstracts are evaluated based on the following criteria: significance of the problem to healthy aging or medication management; innovativeness of ideas, methods, and/or approach; methodological rigor of methods and approach; presentation of finding; implications identified for future research, practice, and/or policy; and clarity of writing. Submissions are not evaluated through the peer-reviewed process used by . Industry support is indicated, where applicable.

Clinical Research That Matters: Designing Outcome-Based Research for Older Adults to Qualify for Systematic Reviews and Meta-Analyses.

Though older adults are more sensitive to the effects of medications than their younger counterparts, they are often excluded from manufacturer-based clinical studies. Practice-based research is a practical method to identify medication-related effects in older patients. This research also highlights the role of a pharmacist in improving care in this population.

Perceptions of care among high-risk geriatric patients, families, and caregivers in a patient-centered medical home.

Objective: A survey was conducted by the pharmacy team to identify improvement areas in the delivery of care in high-risk patients at a patient-centered medical home (PCMH) at the University of Pittsburgh Medical Center (UPMC).

Design: This survey was a quality improvement project.

Setting: The survey was conducted at UPMC Senior Care, a level-three accredited PCMH.

Prevalence of and factors associated with therapeutic failure-related hospitalizations in the elderly.

Objective: A therapeutic failure (TF) is defined as a failure to accomplish the goals of treatment attributable to inadequate therapy, a drug-drug interaction that results in a subtherapeutic level for a drug, or medication nonadherence. The objective of this study was to evaluate the prevalence of and factors associated with TF-related hospitalizations in older adults.

Design: This investigation was a retrospective cohort study.

Antihypertensive drug class use and differential risk of urinary incontinence in community-dwelling older women.

Background: Medication use is a potentially reversible cause of urinary incontinence (UI). The objective of this longitudinal cohort study was to evaluate whether self-reported UI in community-dwelling older women is associated with the use of different classes of antihypertensive agents.

Methods: The sample consisted of 959 black and white women aged 72-81 years without baseline (Year 1) UI from the Health, Aging, and Body Composition Study.

Prevalence of potentially preventable unplanned hospitalizations caused by therapeutic failures and adverse drug withdrawal events among older veterans.

Background. Studies of drug-related hospitalizations have focused on adverse drug reactions, but few data are available on therapeutic failures (TFs) and adverse drug withdrawal events (ADWEs) leading to hospitalization among community-dwelling older adults. Thus, we sought to describe the prevalence of unplanned hospitalizations caused by TFs and ADWEs.

Comparing effectiveness of 3 learning strategies: simulation-based learning, problem-based learning, and standardized patients.

Introduction: Curricula must not only provide students with knowledge but also foster the development of critical thinking and reasoning skills. Several learning strategies, including problem-based learning (PBL), standardized patients, and high-fidelity human simulation, have been incorporated into courses; however, it is currently unknown which technique is the most effective.

Methods: This is a prospective, randomized, crossover study that was conducted during two 90-minute seizure disorder laboratory sessions for PharmD students in their third professional year.

Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans.

Objectives: To describe the prevalence of unplanned hospitalizations caused by adverse drug reactions (ADRs) in older veterans and to examine the association between this outcome and polypharmacy after controlling for comorbidities and other patient characteristics.

Design: Retrospective cohort.

Setting: Veterans Affairs Medical Centers.

Analgesic use for knee and hip osteoarthritis in community-dwelling elders.

Objective: To examine the prevalence and correlates of non-opioid and opioid analgesic use and descriptively evaluate potential undertreatment in a sample of community-dwelling elders with symptomatic knee and/or hip osteoarthritis (OA).

Design: Cross-sectional.

Setting: Health, Aging, and Body Composition Study.

The effect of medication use on urinary incontinence in community-dwelling elderly women.

Objectives: To evaluate whether use of certain medications with potential urological effects is associated with development of incident urinary incontinence in community-resident older women.

Design: Longitudinal cohort study.

Setting: Pittsburgh, PA, and Memphis, TN.

Central nervous system medication use and incident mobility limitation in community elders: the Health, Aging, and Body Composition study.

Purpose: To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation.

Methods: This 5-year longitudinal cohort study included 3055 participants from the health, aging and body composition (Health ABC) study who were well-functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, and antidepressants) was determined yearly (except year 4) during in-home or in-clinic interviews.

Impact of a geriatric nursing home palliative care service on unnecessary medication prescribing.

Background: There is a lack of studies concerning improvement of medication use in palliative care patients in nursing homes.

Objective: This study was conducted to evaluate whether a geriatric palliative care team reduced unnecessary medication prescribing for elderly veterans residing in a nursing home.

Methods: This was a retrospective, descriptive study of patients who died while residing in a geriatric palliative care unit between August 1, 2005, and July 31, 2007.

Effect of central nervous system medication use on decline in cognition in community-dwelling older adults: findings from the Health, Aging And Body Composition Study.

Objectives: To evaluate whether combined use of multiple central nervous system (CNS) medications over time is associated with cognitive change.

Design: Longitudinal cohort study.

Setting: Pittsburgh, Pennsylvania, and Memphis, Tennessee.

Number and dosage of central nervous system medications on recurrent falls in community elders: the Health, Aging and Body Composition study.

Background: Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (>or=2) falls.

Methods: This longitudinal cohort study included 3,055 participants from the Health, Aging and Body Composition study who were well functioning at baseline.

Epidemiology of medication-related adverse events in nursing homes.

Background: Nursing home residents are prescribed more medications than patients in any other clinical setting. Although pharmacotherapy for older nursing home residents is usually safe and effective, it can lead to medication-related adverse events such as adverse drug reactions (ADRs), adverse drug withdrawal events (ADWEs), and therapeutic failures (TFs).

Objective: This article reviews the descriptive (incidence) and analytic (risk factor) epidemiology of medication-related adverse events occurring in nursing home residents as reported in the literature during the last 2 decades.

Clinically important drug-disease interactions and their prevalence in older adults.

Background: Older adults may have decreased homeostatic reserve, have multiple chronic diseases, and take multiple medications. Therefore, they are at risk for adverse outcomes after receiving a drug that exacerbates a chronic disease.

Objectives: The aims of this study were to compile a list of clinically important drug-disease interactions in older adults, obtain the consensus of a multidisciplinary panel of geriatric health care professionals on these interactions, and determine the prevalence of these interactions in a sample of outpatients.

Therapeutic failure-related hospitalisations in the frail elderly.

Background And Objective: Although therapeutic failure may be a common cause of drug-related morbidity in older adults, few studies have focused on this problem. The study objective was to determine the frequency and types of, and the factors associated with, therapeutic failure leading to hospitalisation in frail, elderly patients, using a new instrument named the Therapeutic Failure Questionnaire (TFQ).

Methods: The sample included 106 frail, hospitalised elderly patients enrolled in a 1-year-long health service intervention trial at 11 Veterans Affairs Medical Centres.

Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay.

Background: Adverse drug reactions (ADR) negatively impact life quality and are sometimes fatal. This study examines the incidence and predictors of all and preventable ADRs in frail elderly persons after hospital discharge, a highly vulnerable but rarely studied population.

Methods: The design was a prospective cohort study involving 808 frail elderly persons who were discharged from 11 Veteran Affairs hospitals to outpatient care.

Medication use and control of urination among community-dwelling older adults.

Objective: The purpose of this study is to evaluate whether the use of medications with urological activity (UA) is associated with self-reported difficulty in control of urination.

Methods: This is a cross-sectional study using data from the Duke Established Populations for Epidemiologic Studies of the Elderly.

Results: Difficulty holding urine was reported by 49.

Unnecessary drug use in frail older people at hospital discharge.

Objectives: To determine the prevalence and predictors of unnecessary drug use at hospital discharge in frail elderly patients.

Design: Cross-sectional.

Setting: Eleven Veterans Affairs Medical Centers.