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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 8 of 8 Research Studies DisplayedCampbell NL, Pitts C, Corvari C
Deprescribing anticholinergics in primary care older adults: experience from two models and impact on a continuous measure of exposure.
The purpose of this study was to assess two pilot pharmacist-based advanced practice deprescribing intervention models and their impact on patients’ exposure to high-risk anticholinergics. The researchers conducted pilot studies of a collaborative clinic-based pharmacist deprescribing intervention and a telephone-based pharmacist deprescribing intervention. Deprescribing was defined as a discontinuation or dose reduction. Patients participating in the clinic-based pharmacy model were aged 55 years and older and were referred for deprescribing at a specialty clinic. Patients participating in the telephone-based pharmacy model were aged 65 years and older and called by a clinical pharmacist for deprescribing without referral. The study found that among the 24 medications deemed eligible for deprescribing for the18 patients in the clinic-based model, 23 were deprescribed. The clinic-based deprescribing model resulted in a 93% reduction in median annualized total standardized dose (TSD), 56% lowered their annualized exposure below a cognitive risk threshold, and 17% of medications were represcribed within 6 months. Among the 24 medications deemed eligible for deprescribing for the 24 patients in the telephone-based pharmacy model, 50% were deprescribed. There was no change in the median annualized TSD, the annualized TSD was lowered below a cognitive risk threshold in 46%, and no medications were represcribed within 6 months. The researchers concluded that pharmacist-based deprescribing successfully reduced exposure to high-risk anticholinergics in the study population.
AHRQ-funded; HS24384.
Citation: Campbell NL, Pitts C, Corvari C .
Deprescribing anticholinergics in primary care older adults: experience from two models and impact on a continuous measure of exposure.
Journal of the American College of Pharmacy 2022 Oct;5(10):1039-47. doi: 10.1002/jac5.1682..
Keywords: Elderly, Primary Care, Medication, Provider: Pharmacist, Medication: Safety, Patient Safety
Gilson AM, Stone JA, Morris AO
Impact of a pilot community pharmacy system redesign on reducing over-the-counter medication misuse in older adults.
This pilot study’s goal was to decrease misuse of over-the-counter (OTC) medications by older adults aged 65 years or older by creating a pharmacy “Senior Section”. The Senior Section contains a curated selection of OTC medications and it located close to the prescription department to facilitate pharmacy staff-patient engagement to reduce misuse. The study recruited 87 older adults from 3 pharmacies. Misuse outcomes measured were drug-drug, drug-disease, drug-age, and drug-label, with 5 subtypes. The Senior Section reduced drug-label misuse for different models. Misuse was found to decrease after implementation for 7 of 11 comparisons.
AHRQ-funded; HS024490.
Citation: Gilson AM, Stone JA, Morris AO .
Impact of a pilot community pharmacy system redesign on reducing over-the-counter medication misuse in older adults.
J Am Pharm Assoc (2003) 2021 Sep-Oct;61(5):555-64. doi: 10.1016/j.japh.2021.04.007..
Keywords: Elderly, Provider: Pharmacist, Medication, Medication: Safety
Gurwitz JH, Kapoor A, Garber L
Effect of a multifaceted clinical pharmacist intervention on medication safety after hospitalization in persons prescribed high-risk medications: a randomized clinical trial.
The purpose of this study was to determine whether a multifaceted clinical pharmacist intervention improves medication safety for patients who are discharged from the hospital and prescribed medications within 1 or more of these high-risk drug classes: anticoagulants, diabetes agents, and opioids. The randomized clinical trial was conducted at a large multidisciplinary group practice in Massachusetts and included patients 50 years or older. Findings showed that there was not an observed lower rate of adverse drug-related incidents or clinically important medication errors during the posthospitalization period that was associated with a clinical pharmacist intervention.
AHRQ-funded; HS023774.
Citation: Gurwitz JH, Kapoor A, Garber L .
Effect of a multifaceted clinical pharmacist intervention on medication safety after hospitalization in persons prescribed high-risk medications: a randomized clinical trial.
JAMA Intern Med 2021 May;181(5):610-18. doi: 10.1001/jamainternmed.2020.9285..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Provider: Pharmacist, Provider
Gilson AM, Xiong KZ, Stone JA
A pharmacy-based intervention to improve safe over-the-counter medication use in older adults.
This study assessed whether the development of a physical redesign that located a curated inventory of lower-risk over-the-counter (OTC) medications proximal to the pharmacy prescription area was helpful to discourage inappropriate use from OTC medications. An area called the Senior Section™ was developed and placed in 4 pharmacies within a single chain. Eight pharmacists and 5 technicians participated in semi-structured interviews which were transcribed. The staff viewed the Senior Section as contributing to notable improvements in proximity, medication safety, convenience, and patient selection behaviors. It also streamlined the coordination of services between pharmacists and technicians and did not interfere with existing pharmacy workflows.
AHRQ-funded; HS024490.
Citation: Gilson AM, Xiong KZ, Stone JA .
A pharmacy-based intervention to improve safe over-the-counter medication use in older adults.
Res Social Adm Pharm 2021 Mar;17(3):578-87. doi: 10.1016/j.sapharm.2020.05.008..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Provider: Pharmacist
Ailabouni NJ, Marcum ZA, Schmader KE
Medication use quality and safety in older adults: 2018 update.
This study identified four key articles from 2018 that address medication use quality and safety for older adults. The first study highlighted a cluster-randomized trial that utilized a pharmacist-led education-based intervention delivered to both patients and doctors to deprescribe four types of inappropriate medications. The second study from the UK examined the association between anticholinergic exposure, overall and by medication class, and dementia risk in 40,770 older adults. The third study was a Swedish longitudinal cohort study examining the association between antihypertensive medications and incident dementia. The fourth and last study was a randomized, double-blind, placebo-controlled trial and examined the effect of daily low-dose aspirin for primary prevention of cardiac events and hemorrhage in 19,144 community-dwelling older adults.
AHRQ-funded; HS022982.
Citation: Ailabouni NJ, Marcum ZA, Schmader KE .
Medication use quality and safety in older adults: 2018 update.
J Am Geriatr Soc 2019 Dec;67(12):2458-62. doi: 10.1111/jgs.16243..
Keywords: Elderly, Medication, Medication: Safety, Patient Safety, Quality of Care, Provider: Pharmacist, Provider
Chui MA, Stone JA, Holden RJ
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
This study proposes to evaluate the effectiveness of the intervention for preventing misuse of high-risk OTC medications by older adults; and to evaluate the implementation of the intervention in community pharmacies. The primary outcome will be a comparison of proportion of older adults who misuse OTC medication from baseline to post-intervention.
AHRQ-funded; HS024490.
Citation: Chui MA, Stone JA, Holden RJ .
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
Res Social Adm Pharm 2017 Sep - Oct;13(5):930-37. doi: 10.1016/j.sapharm.2016.11.006.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Provider: Pharmacist
Kane-Gill SL, Niznik JD, Kellum JA
Use of telemedicine to enhance pharmacist services in the nursing facility.
The researchers conducted a systematic literature review to determine what telemedicine services are provided by pharmacists and the impact of these services in the nursing facility setting. Since only three manuscripts met inclusion criteria, the researchers concluded that there is a general paucity of practice-related research to demonstrate potential benefits of pharmacists' services incorporating telemedicine.
AHRQ-funded; HS024208.
Citation: Kane-Gill SL, Niznik JD, Kellum JA .
Use of telemedicine to enhance pharmacist services in the nursing facility.
Consult Pharm 2017 Feb;32(2):93-98. doi: 10.4140/TCP.n.2017.93.
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Keywords: Telehealth, Nursing Homes, Medication, Elderly, Provider: Pharmacist
Doucette WR, Pendergast JF, Zhang Y
Stimulating comprehensive medication reviews among Medicare Part D beneficiaries.
The authors assessed the impact of a patient engagement intervention utilizing the Medication User Self-Evaluation (MUSE) tool on the completion percentage of comprehensive medication reviews (CMRs) among Medicare Part D beneficiaries. They found that the estimated odds of having a CMR among those who received the MUSE intervention were 2 times that of their counterparts. They concluded that Part D plans could use the MUSE to engage targeted beneficiaries in using pharmacist-provided MTM services.
AHRQ-funded; HS018353.
Citation: Doucette WR, Pendergast JF, Zhang Y .
Stimulating comprehensive medication reviews among Medicare Part D beneficiaries.
Am J Manag Care 2015 Jun;21(6):e372-8.
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Keywords: Elderly, Medicare, Medication, Patient and Family Engagement, Provider: Pharmacist