title: Pharmacist-managed telephone clinic review of antidementia medication effectiveness.
abstract: OBJECTIVE
  To describe the development and implementation of a telephone clinic for evaluating continued effectiveness of antidementia medication therapy in patients with dementia.
  
  
  METHODS
  Ambulatory care at the Veterans Affairs Salt Lake City Health Care System.
  
  
  METHODS
  A pharmacist-directed, telephone dementia clinic review of patients taking dual antidementia therapy to determine whether a medication-discontinuation trial is appropriate based on caregiver global impressions.
  
  
  METHODS
  Pharmacists review eligible patients' electronic medical records for adherence history and caregiver impressions of response to antidementia medications to determine if a discontinuation trial of antidementia medication is warranted. Pharmacists coordinate any discontinuation discussion with caregivers and medical providers and monitor patients' response to the resultant interventions via telephone.
  
  
  RESULTS
  Pharmacist involvement allows for a structured method of monitoring adherence with antidementia medications and for determining whether they continue to provide benefit.
  
  
  RESULTS
  Expected results include percentage of patients who underwent a medication-discontinuation trial, percentage of patients who did not demonstrate clinical decline after a discontinuation trial, and percentage of patients who subsequently restarted medication because of noticeable decline after the discontinuation trial.
  
  
  CONCLUSIONS
  This telephone clinic capitalizes on the expertise of clinical pharmacists and helps establish a functional collaboration between health care providers, patients, and the electronic medical record to obtain a multiperspective evaluation of the effectiveness of antidementia therapy from a patient-centric view. This systematic approach improves patient-centered care and may have favorable impacts on antidementia medication cost utilization.
authors.affiliation: Pharmacotherapy Department, University of Utah College of Pharmacy, and a clinical pharmacist, Pharmacy Department, Veterans Affairs Salt Lake City Health Care System (VASLCHCS), Salt Lake City, Utah.
authors.forename: Lynda
authors.initials: L
authors.lastname: Oderda
authors.forename: Christine
authors.initials: C
authors.lastname: Holman
authors.forename: Ben
authors.initials: B
authors.lastname: Nichols
authors.forename: Randall
authors.initials: R
authors.lastname: Rupper
authors.forename: Byron
authors.initials: B
authors.lastname: Bair
authors.forename: Matthew
authors.initials: M
authors.lastname: Hoffman
authors.forename: Bret
authors.initials: B
authors.lastname: Hicken
mesh_terms: D000553:Ambulatory Care; D003704:Dementia / Q000188:drug therapy*; D006801:Humans; D055118:Medication Adherence; D054539:Medication Therapy Management; D010593:Pharmaceutical Services; D010595:Pharmacists; D013689:Telephone; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs