Pharmacists and their effectiveness in ensuring the appropriateness of the chronic medication regimens of geriatric inpatients.

Objective: Geriatric patients are prescribed multiple medications by multiple physicians, leaving them at an increased risk for adverse events. The Beers criteria for determining inappropriately prescribed medications have been applied to elderly patients in various geriatric settings. Using the 1997 Beers criteria, we planned to determine if the Acute Care for Elders (ACE) team pharmacist improved the medication regimens of geriatric inpatients.

Design: This study was a retrospective, case series design.

Setting: The setting for this study was a large teaching hospital.

Patients: There were 99 patients who met the inclusion criteria.

Main Outcome Measures: Age, gender, race, and medication data were collected for all eligible patients. The prevalence of inappropriately prescribed medications and the number of medications were determined both upon admission and at discharge. Statistical analyses were conducted where appropriate.

Results: Upon admission to the hospital, 10.1% of the patients were prescribed inappropriate medications. At discharge, 2.02% of patients consulted by the ACE team were prescribed an inappropriate medication. This was a statistically significant difference (P < 0.02). The number of medications at admission compared with discharge showed no statistical difference (P = 0.15).

Conclusion: Based on the Beers criteria, the ACE team pharmacist was able to make a statistically significant difference in the number of elderly patients being prescribed inappropriate medications upon discharge when compared with admission medication regimens. The number of medications a patient was prescribed did not decrease.