Impact of geriatric consultation on the number of medications in hospitalized older patients.
OBJECTIVE
This study aims to determine the impact of the geriatric consultation on the number of medications in hospitalized older adults and the corresponding financial impact.


METHODS
Retrospective chart review of patients seen by geriatric consultants.


METHODS
Tertiary-care teaching hospital.


METHODS
The number of medications prescribed before hospitalization, at time of consult, and at discharge, and the number and category of medications adjusted by the geriatrician. The monthly cost of the pharmaceutical interventions was computed based on the drugstore.com cost of acquisition of drugs.


RESULTS
A cohort of 62 patients was reviewed with a mean age of 84.6 (± 7.3) years; 79% were women. The patients presented with an average of 5.6 (± 2.1) comorbidities of which hypertension, dementia, and musculoskeletal disorders were the most common. The most common reasons for geriatric consultations were neuropsychiatric, nutritional, and gait-related issues. The geriatric consultant identified 2.96 (± 1.5) additional diagnoses, of which debility, delirium, and pain were the most prevalent. The average number of medications on admission was 7.7 (± 3.7) and at discharge was 9.5 (± 2.12). The average number of medications adjusted by the geriatric consultant was 2.96 (± 2.12). The most common classes of adjusted medications were pain medications (22%), nutrition (13%), bowel regimens (8.5%), antipsychotics (8%), and osteoporosis (8%). The cost impact of the pharmaceutical intervention ranged between -$343 and $2,607, with an average increase of $102 (± 368).


CONCLUSIONS
Geriatric consultations increased the total number of medications and the cost of medications used by elderly patients.
Clinical Pharmacy Department, St. John's University School of Pharmacy and Allied Health Professions, Queens, NY, USA. saadm@stjohns.edu
Maha
M
Saad
Ruchika
R
Harisingani
Lori
L
Katinas
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005853:Geriatrics; D006760:Hospitalization; D006801:Humans; D008297:Male; D019338:Polypharmacy; D011788:Quality of Life; D012017:Referral and Consultation; D012189:Retrospective Studies