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Am J Geriatr Psychiatry. 2014 Sep;22(9):884-8. doi: 10.1016/j.jagp.2013.01.075. Epub 2013 Sep 8.

Enhancing Quality in Psychiatry with Psychiatrists (EQUIPP)--results from a pilot study.

Author information

  • 1Department of Psychiatry, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: lea_watson@med.unc.edu.
  • 2Division of General Medicine and Clinical Epidemiology, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Biostatistics, UNC Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • 3Division of Pharmacy Practice and Experiential Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • 4Division of General Medicine and Clinical Epidemiology, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • 5Department of Pharmacy Care Systems, Harrison School of Pharmacy, Auburn University, Auburn, AL.
  • 6Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill School, Chapel Hill, NC; Center for Health Services Research, Durham Veterans Affairs Medical Center, Durham, NC.
  • 7Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Abstract

OBJECTIVES:

To pilot a pharmacist-led, patient centered medication management program.

DESIGN:

Prospective, single arm trial.

SETTING:

Academic geriatric psychiatry outpatient clinic.

PARTICIPANTS:

Outpatients at least 65 years old, proxy available if demented, and on two or more psychiatric medications.

INTERVENTION:

A clinical pharmacist completed a baseline medication review and made evidence-based recommendations that were implemented by the pharmacist after discussion with the physician. The pharmacist made a minimum of monthly contact for 6 months to review medications and related issues.

MEASUREMENTS:

The primary outcome was the change in number of medication related problems over time (3 and 6 months) as defined by a predetermined classification system.

RESULTS:

The mean age of the 27 patients was 75 years, 10 of whom required a proxy to participate. On average, patients had nine chronic conditions and were taking 14 medications. The mean number (SD; range) of medication related problems at baseline was 4.1 (2.2; 0-8) and at 3 and 6 months were 3.6 (2.4, 0-9) and 3.4 (2.1; 0-8), respectively. Most follow-up problems were new (80% and 89% at 3 and 6 months, respectively).

CONCLUSION:

Using a pharmacist to deliver a medication management program was feasible and addressed existing problems. New problems, however, developed over a short interval (3-6 months), suggesting that ongoing intervention is required.

Copyright © 2014 American Association for Geriatric Psychiatry. All rights reserved.

KEYWORDS:

Medications; pharmacist; quality

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