title: Screening for adverse drug events in older adults: the impact of interventions.
abstract: OBJECTIVE
  Primary, to evaluate the usefulness of a comprehensive medication review (CMR) process in screening for adverse drug event (ADE) risk and to measure the impact of pharmacist recommendations; secondary, to evaluate whether screening tools assist in detecting ADEs.
  
  
  METHODS
  Nonrandomized, prospective pre/post pilot study.
  
  
  METHODS
  Wisconsin-based community pharmacy affiliated with a two-campus retirement facility serving independently living older adults.
  
  
  METHODS
  Sixty-nine older adults responded to the initial call for participation in the ADE screening (mean age 84 years, mean daily medications: 13.7). Thirty-nine older adults (mean age 86 years, mean daily medications: 13.8) participated in both pre/post pilot study phases.
  
  
  METHODS
  Each participant received a CMR, including self-identified geriatric syndromes and St. Louis University Memory Screen (SLUMS) assessment. Recommendation letters included lifestyle changes to reduce medication use. A three-month follow-up call gathered current medication lists and recommendation acceptance rates. Repeat screenings were also conducted.
  
  
  METHODS
  Number of ADEs identified, recommendation acceptance rates, medication-related changes. Secondary measures: self-reported geriatric syndromes, SLUMS scores associated with ADE identification, screening tools associated with ADE identification.
  
  
  RESULTS
  Pharmacist-initiated CMRs resulted in a high rate of discontinued nonsteroidal anti-inflammatory drugs (NSAIDs) and overall reduction in the number of scheduled medications. Participants with a positive ADE history were significantly more likely to report a suspected current ADE. Pharmacists incorporated nonpharmacologic interventions for reported geriatric syndromes, with high participant acceptance rates. In isolated cases, cognition was measurably improved with discontinuation of a targeted medication.
  
  
  CONCLUSIONS
  Pharmacist-provided CMR services should be comprehensive, including patient's self-report of ADEs and history of ADEs. Pharmacist intervention can minimize prescription medication use, reducing the risk of ADEs.
authors.affiliation: Pharmacy Services, Oakwood Village Retirement Communities, Madison, Wisconsin. USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Lukazewski
authors.forename: Beth
authors.initials: B
authors.lastname: Martin
authors.forename: Dimmy
authors.initials: D
authors.lastname: Sokhal
authors.forename: Kathy
authors.initials: K
authors.lastname: Hornemann
authors.forename: Ann
authors.initials: A
authors.lastname: Schwartzwald