title: Medication management interventions in patients enrolled in GRACE Team Care.
abstract: GRACE targets home-based, geriatrics team management, primary care collaboration, and protocols for common conditions. GRACE can improve outcomes and reduce acute-care utilization. We aimed to characterize medication-related GRACE recommendations. Medical record review of Indiana University Health Physicians GRACE patients (June 2012 to September 2013), with six months' follow-up was conducted. Demographics, clinical characteristics, and recommendations were summarized. Mean age (N = 156) was 82 years; 71% were women, 24% black, and 34% living alone, with a mean of 12 medications. Medication management was activated in 99%. Implementation occurred in 96% of 924 recommendations, including reviewing medication lists (N = 153) and purposes (N = 109) with patients, and providing medication lists to providers (N = 119). GRACE recommended and implemented medication-related interventions, facilitating medication reconciliation, education, communication, and coordination of care. Medication management, a key GRACE component, may contribute to reducing hospitalization rates.
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Health, Indianapolis, IN, USA. Electronic address: kquist@iu.edu.
authors.forename: Kofi K
authors.initials: KK
authors.lastname: Quist
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Health, Indianapolis, IN, USA; Indiana University Center for Aging Research, Indianapolis, IN, USA; Regenstrief Institute, Inc., Indianapolis, IN, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Counsell
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA.
authors.forename: Cathy C
authors.initials: CC
authors.lastname: Schubert
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Aging Research, Indianapolis, IN, USA; Regenstrief Institute, Inc., Indianapolis, IN, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA; Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Indianapolis, IN, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Weiner
mesh_terms: D000369:Aged, 80 and over; D019468:Disease Management; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006699:Home Care Services; D006801:Humans; D007196:Indiana; D008297:Male; D059065:Medication Reconciliation / Q000379:methods*; D010348:Patient Care Team / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration; D012189:Retrospective Studies
keywords: Care management; Geriatric assessment; House calls; Interdisciplinary team; Medication reconciliation