Improving Medication Safety for Older Adults
Michelle Chui, Pharm.D., Ph.D.
Professor, and Director of Sonderegger Research Center for Improved Medication Use
University of Wisconsin – Madison
“With funding from AHRQ, I have been able to look at medication safety from a systems perspective and develop tools that community pharmacists can use to reduce patient harm.”
“Older adults, who take many prescription and over-the-counter medications, are required to self-manage their complex medication regimen. As a result, adverse drug events (ADEs) are frequent, costly, and potentially life-threatening,” according to Michelle Chui, Pharm.D., Ph.D., a professor at the University of Wisconsin (UW) – Madison, School of Pharmacy and director of UW-Madison’s Sonderegger Research Center for Improved Medication Use.
Dr. Chui aims to prevent ADEs in seniors by providing community pharmacists with interventions to improve medication safety in the outpatient setting. With funding from AHRQ, she designed and implemented a medication information resource for pharmacists, called a “Senior Section™,” to use specifically with older adults. Dr. Chui also has evaluated health information technology applications for their ability to promote effective communication and help coordinate care. These efforts are helping pharmacists reduce harm from both prescription and over-the-counter (OTC) medication use in older adults.
Dr. Chui was awarded her first AHRQ grant in 2016 to study whether her Senior Section™ for OTC medications in pharmacies could improve communication between pharmacy staff and patients aged 65 and over, who are particularly vulnerable to ADEs. The Section features a curated supply of safer OTC medications, cautionary signage, and tools to support OTC selection. Dr. Chui hypothesized that making older adults aware of high-risk OTC medications would facilitate their communication with a pharmacist who could help them make informed decisions, leading to safer over-the-counter use. Dr. Chui and her team tested the Senior Section™ in three pharmacies and found that it prompted more frequent, effective, and efficient engagements between pharmacy staff and patients.
In 2018, Dr. Chui received a second AHRQ grant to measure the impact of CancelRx, an e-prescribing tool developed by the National Council for Prescription Drug Programs that can reduce medication discrepancies between the electronic health record (EHR) and pharmacy dispensing software. The tool automatically sends a message from the clinic's EHR to the outpatient pharmacy's software when a patient’s physician stops a medication, reducing ADEs caused by continuing to refill a discontinued medication. Dr. Chui and her team tested the tool’s reliability for 12 months prior and 12 months after CancelRx implementation at an academic health system. They found that CancelRx had a marked benefit in reconciling old and new medication lists and illustrated how health IT can be used to improve medication safety.
Dr. Chui’s current AHRQ project, which ends in 2023, builds on her previous Senior Section™ study. The transdisciplinary team is collaborating with Advocate Aurora Health (AAH), a not-for-profit health system, to adapt, implement, and evaluate this intervention in 63 AAH pharmacies to enhance patients’ awareness of and attention to risks inherent in OTC medications.
As co-director of UW-Madison’s Institute for Clinical and Translational Research T1 Program, Dr. Chui mentors junior faculty, pre-doctorate graduate students, and post-doctoral fellows, helping them to develop federal grant proposals. She also is a member of the AcademyHealth Science of Dissemination and Implementation group, the American Pharmacists Association, and the Human Factors and Ergonomics Society.
Related AHRQ Resources
Principal Investigator: Michelle Chui, Pharm.D., Ph.D.
Institution: University of Wisconsin – Madison
Grantee Since: 2016
Type of Grant: Various
Consistent with its mission, AHRQ provides a broad range of extramural research grants and contracts, research training, conference grants, and intramural research activities. AHRQ is committed to fostering the next generation of health services researchers who can focus on some of the most important challenges facing our Nation's health care system.
To learn more about AHRQ's Research Education and Training Programs, please visit https://www.ahrq.gov/training.