title: Role of the pharmacist on a general medicine acute care for the elderly unit.
abstract: BACKGROUND
  The prevalence of prescription medication use increases with age, and older adults are at increased risk of harm from medication use.
  
  
  OBJECTIVE
  To describe the role of a pharmacist on a General Medicine Acute Care of the Elderly (GM-ACE) Unit.
  
  
  METHODS
  A job description was prepared, and a clinical pharmacist specializing in internal medicine was re-assigned to participate in multidisciplinary rounds on the ACE unit twice weekly and to work with a unit-based pharmacist assigned to multiple units. The clinical pharmacist also provided formal education on geriatric pharmacotherapy for other health care providers. Interventions were defined as changes in the medical record and provision of drug information. Interventions were tracked with an existing form and sorted by category. Data on interventions were presented to the pharmacy and therapeutics committee routinely.
  
  
  RESULTS
  After 3 months, the clinical pharmacist accomplished 76 interventions in the areas of agent selection, dose optimization, addition of therapy, deletion of therapy, medication reconciliation, intravenous to oral conversion, technology improvements, and drug information/patient education.
  
  
  CONCLUSIONS
  Expanding the role of the pharmacist in a GM-ACE unit has improved the medication use process in a high-risk population through improvements in medication overuse, medication underuse, dosing, medication reconciliation, patient education, and health care provider education.
authors.affiliation: Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Reilly
authors.forename: David
authors.initials: D
authors.lastname: Barile
authors.forename: Stanley
authors.initials: S
authors.lastname: Reuben
mesh_terms: D000368:Aged; D005853:Geriatrics / Q000458:organization & administration; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration; D059065:Medication Reconciliation / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000379:methods; D010595:Pharmacists / Q000458:organization & administration*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D024382:Professional Role
chemical_list: D055553:Prescription Drugs