title: Impact of Pharmacists in Optimizing Geriatric Pharmacotherapy in Primary Care Within a Veterans Affairs Medical Center.
abstract: OBJECTIVE
  To assess pharmacists' impact on optimizing pharmacotherapy among geriatric patients.
  
  
  METHODS
  Single-site, prospective, quality-improvement project.
  
  
  METHODS
  Primary care at a Veterans Affairs medical center.
  
  
  METHODS
  Thirteen males 75 years of age and older were included.
  
  
  METHODS
  Recommendations were made by pharmacists to optimize prescribing.
  
  
  METHODS
  Differences between specific instances of suboptimal prescribing before and after pharmacists' recommendations, the percentage of pharmacists' recommendations accepted, and the top most commonly prescribed psychotropic medications and their most common indications.
  
  
  RESULTS
  Sixty-three recommendations were made by pharmacists, and 48% of these recommendations were accepted by providers. There was a 27% reduction of the use of high-risk medications, a 44% reduction of omissions of care, and a 74% reduction of incomplete medication monitoring after pharmacists' recommendations. The most commonly prescribed psychotropic medications were zolpidem (31%), lorazepam (23%), and clonazepam and temazepam (each 15%). The most common indications for these medications were anxiety and insomnia (each 46%), with 8% of patients having an indication for both.
  
  
  CONCLUSIONS
  Pharmacists' recommendations improved geriatric pharmacotherapy by decreasing the overall instances of suboptimal prescribing.
authors.forename: Taryn B
authors.initials: TB
authors.lastname: Mondiello
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Stutzman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D016903:Drug Monitoring / Q000379:methods; D017723:Drug Utilization Review / Q000458:organization & administration*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D010595:Pharmacists / Q000458:organization & administration*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D011446:Prospective Studies; D058996:Quality Improvement / Q000458:organization & administration*; D012307:Risk Factors; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines