Implementing a pharmacist-led, individualized medication assessment and planning (iMAP) intervention to reduce medication related problems among older adults with cancer.

Abstract

OBJECTIVES:

Medication-related problems (MRP) affecting older adults are a significant healthcare concern and account for billions in medication-related morbidity. Cancer therapies can increase the prevalence of MRP. The objective of this study was to test the feasibility and effectiveness of implementing a pharmacist-led individualized medication assessment and planning (iMAP) intervention on the number and prevalence of MRP.

MATERIALS AND METHODS:

This prospective pilot study enrolled oncology outpatients aged ≥65years. Intervention feasibility encompassed recommendation acceptance rate and intervention delivery time. The intervention was facilitated by pharmacists where patients received comprehensive medication management at baseline and at the 30- and 60-day follow-up.

RESULTS:

Forty-eight eligible patients enrolled and 41 patients (85.4%) were included in the analysis. Mean age was 79.1years [range 65-101]; 66% women, 83% Caucasian, mean comorbidity count was 7.76. Forty-six percent of the pharmacist recommendations were accepted and the prevalence of MRP at baseline versus 60-day follow-up decreased by 20.5%. The average time to conduct the initial session was 22min versus 15min for the follow-up sessions. Resources needed included a tracking system for scheduling follow-up calls and a database for tracking acceptance of recommendations. A total of 123 MRP were identified in 95% of patients (N=39) with a mean of 3 MRP per patient. The mean reduction in number of MRP (3 at baseline versus 1.6 at 60-day follow-up) was 45.5%.

CONCLUSIONS:

The pharmacist-led iMAP intervention was feasible and effective at reducing MRP. Additional inter-professional medication safety based interventions measuring patient-reported outcomes are still needed.

• Authors: Ginah Nightingale, Emily Hajjar, Laura T Pizzi, Margaret Wang, Elizabeth Pigott, Shannon Doherty, Katherine M Prioli, Kristine Swartz, Andrew E Chapman
• Journal: Journal of geriatric oncology (J Geriatr Oncol) Vol. 8 Issue 4 Pg. 296-302 (Jul 2017) ISSN: 1879-4076 [Electronic] Netherlands
• PMID: 28506543 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 Elsevier Ltd. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Female
• Geriatric Assessment (methods)
• Humans
• Linear Models
• Male
• Medication Therapy Management
• Neoplasms (drug therapy)
• Pharmacists
• Pilot Projects
• Prospective Studies