The purpose of the study is to implement a pharmacist-led deprescribing intervention for adults 65 and older taking 10 or more medications at University of Texas (UT) Physicians clinics and to assess the effect of the pharmacist intervention on the incidence of adverse drug reactions, emergency room visits, and hospitalizations as well as costs to the patient and to the healthcare system in adults 65 and older taking 10 or more medications treated at UT Physicians.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
419
An individualized deprescribing intervention will be created by a pharmacist working with a patient to identify harmful, costly, and unnecessary medications to be reduced. The intervention will include a plan and monitoring for up to 3 months to reduce medication use.
The usual care arm will receive the current standard of care, which includes medication reconciliation by a clinic nurse at the time of their appointment. Nurses review all medications and answer medication-related questions, and refer medication questions to the healthcare provider for further discussion when necessary.
The University of Texas Health Science Center at Houston
Houston, Texas, United States
Adverse Drug Reactions (ADR)
Patient-reported side effects and adverse events potentially attributable to medication, rated for the likelihood of ADR by an independent reviewer based on the Naranjo algorithm.
Time frame: 3 months post enrollment
Adverse Drug Reactions
Patient-reported side effects and adverse events potentially attributable to medication, rated for the likelihood of ADR by an independent reviewer based on the Naranjo algorithm.
Time frame: 6 months post enrollment
Adverse Drug Reactions
Patient-reported side effects and adverse events potentially attributable to medication, rated for the likelihood of ADR by an independent reviewer based on the Naranjo algorithm.
Time frame: 12 months post enrollment
Healthcare Cost
Healthcare cost based on utilization of clinic visits, emergency room visits, and hospitalizations, based on patient report with specific costs obtained when possible from the Health Information Exchange.
Time frame: 3 months post enrollment
Healthcare Cost
Healthcare cost based on utilization of clinic visits, emergency room visits, and hospitalizations, based on patient report with specific costs obtained when possible from the Health Information Exchange.
Time frame: 6 months post enrollment
Healthcare Cost
Healthcare cost based on utilization of clinic visits, emergency room visits, and hospitalizations, based on patient report with specific costs obtained when possible from the Health Information Exchange.
Time frame: 12 months post enrollment
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Medication use
Number and name of each medication a participant is taking.
Time frame: At enrollment
Medication cost
Average wholesale price of each medication taken by a participant, determined using reference software.
Time frame: 3 months post enrollment
Medication cost
Average wholesale price of each medication taken by a participant, determined using reference software.
Time frame: 6 months post enrollment
Medication cost
Average wholesale price of each medication taken by a participant, determined using reference software.
Time frame: 12 months post enrollment
QOL
Quality of life as measured by the EQ5D scale.This scale is numbered from 0 to 100. 100 means the best health you can imagine. 0 means the worst health you can imagine.
Time frame: Baseline
QOL
Quality of life as measured by the EQ5D scale.This scale is numbered from 0 to 100. 100 means the best health you can imagine. 0 means the worst health you can imagine.
Time frame: 12 months post enrollment