Abstract

The purpose of this study is to determine whether interventions by a clinical pharmacist can improve drug use patterns in a elderly ambulatory population with polypharmacy. By enhancing patient compliance and reducing inappropriate prescribing, the health care of older patients could be improved. The two specific interventions to be evaluated are (1) the provision of medication counseling to patients and (2) the provision of educational feedback concerning drug regimens to primary care physicians. The research design is significant in that it will be the first randomized controlled trial to focus on a high risk population, that is, patients older than 70 years of age and on more than three medications. Outcome measures, such as medications taken, adverse drug reactions, compliance, health service utilization, medication costs, and health status, will be assessed before and after the implementation of the interventions. The ultimate objectives are to enhance the quality of health care of older patients and to assess the cost-effectiveness of a clinical pharmacist within an ambulatory setting.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG008380-03
Application #
3119990
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1990-03-01
Project End
1994-02-28
Budget Start
1992-03-01
Budget End
1994-02-28
Support Year
3
Fiscal Year
1992
Total Cost
Indirect Cost

  Institution

Name
Duke University
Department
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705

  Publications

Graves, T; Hanlon, J T; Schmader, K E et al. (1997) Adverse events after discontinuing medications in elderly outpatients. Arch Intern Med 157:2205-10
Shelton, P S; Hanlon, J T; Landsman, P B et al. (1997) Reliability of drug utilization evaluation as an assessment of medication appropriateness. Ann Pharmacother 31:533-42
Fitzgerald, L S; Hanlon, J T; Shelton, P S et al. (1997) Reliability of a modified medication appropriateness index in ambulatory older persons. Ann Pharmacother 31:543-8
Schmader, K E; Hanlon, J T; Landsman, P B et al. (1997) Inappropriate prescribing and health outcomes in elderly veteran outpatients. Ann Pharmacother 31:529-33
Hanlon, J T; Schmader, K E; Koronkowski, M J et al. (1997) Adverse drug events in high risk older outpatients. J Am Geriatr Soc 45:945-8
Hanlon, J T; Landsman, P B; Cowan, K et al. (1996) Physician agreement with pharmacist-suggested drug therapy changes for elderly outpatients. Am J Health Syst Pharm 53:2735-7
Hanlon, J T; Weinberger, M; Samsa, G P et al. (1996) A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with polypharmacy. Am J Med 100:428-37
Schmader, K; Hanlon, J T; Weinberger, M et al. (1994) Appropriateness of medication prescribing in ambulatory elderly patients. J Am Geriatr Soc 42:1241-7
Weinberger, M; Nagle, B; Hanlon, J T et al. (1994) Assessing health-related quality of life in elderly outpatients: telephone versus face-to-face administration. J Am Geriatr Soc 42:1295-9
Hanlon, J T; Schmader, K E; Samsa, G P et al. (1992) A method for assessing drug therapy appropriateness. J Clin Epidemiol 45:1045-51

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