Drug-related morbidity and mortality is common, with an estimated 100,000 deaths annually anda quarter of drug-related injuries being preventable. Medication errors are estimated to causeone of every 131 deaths in the outpatient setting. Many of the harmful effects of medicationsare preventable, particularly in the senior population. Previous research indicates thatinappropriate medication use occurs in up to 40% of seniors living in the community and thatinappropriate use increases as the number of medications used increases. Pharmacists have avital role in educating patients about medications and reviewing prescription records to helpdetermine whether or not medications are appropriate. They are able to assist patients increating strategies to take their prescribed medications appropriately. Unfortunately, somepatients may have inadequate opportunities to discuss their medications with a pharmacist forvarious reasons including limited access to transportation. The Meals on Wheels programprovides nutritional support to seniors as well as those persons with disabilities under age 60which allows them to remain independent at home. Meals on Wheels is the bridge betweenthese patients and the community-they are a trusted gateway to other services. We thereforepropose an innovative collaboration with Meals on Wheels to reach a population at high-risk forpreventable harm from medications, specifically seniors and persons with disabilities under age60. The broad hypothesis of this proposal is that adding medication education and counselingby a pharmacist to a Meals on Wheels program will decrease preventable harm frommedications. We will determine the types of drug-related problems and assess root causes aswell as quantify the number of patients at high-risk for preventable harm. The primarycomparative analysis will involve a comparison of medication adherence before and afterprovision of medication education and counseling by a pharmacist utilizing a validatedmedication adherence scale and pill counts. We will also assess whether pharmacistinterventions improve patient satisfaction and health status. This project will provide essentialinsight into the feasibility and effectiveness of teaming pharmacy services with Meals on Wheelsto prevent harm from medications in those patients who are among the most vulnerable topreventable harm from medications.
The focus on patient safety and preventable harm from medications puts most emphasis on harm that occurs in health-systems and hospitals;however, estimates suggest a much higher risk of harm from medication use in the outpatient setting. Seniors and persons with disabilities frequently require a substantial number of medications, increasing their risk of preventable harm. The goal of this research is to determine whether interaction with a pharmacist who provides education and counseling about medications at a congregate dining location serviced by Meals on Wheels minimizes preventable harm in seniors and persons with disabilities.
| Ward, Kristina E; Cohen, Lisa B (2015) Promoting Safe Use of Medications: Providing Medication Education to Seniors Receiving Meals on Wheels. Consult Pharm 30:616-22 |
