Bell, Lindsay
(2020)
Evaluation of a Medication Management Program for Older Adults.
Master's Thesis, University of Pittsburgh.
(Unpublished)
Abstract
Background: As the prevalence of chronic disease increases among older adults in the United States, the need for medical interventions to adequately manage disease is also growing. Increased prescription drug use and care by multiple health providers among older adults are associated with potentially inappropriate prescribing, which may lead to adverse drug events. The HomeMeds Medication Assurance Program (HomeMeds program) is an in-home medication risk assessment for older adults to identify and prevent potentially inappropriate prescribing.
Objective: To determine the effectiveness of the HomeMeds program by describing the attitudes about the program among the target population, identifying barriers and facilitators to the program, and evaluating the results of medication risk assessments.
Methods: Qualitative data were collected through focus group sessions with members of the target population and key informant interviews with HomeMeds program staff and experts in geriatric clinical pharmacy. Quantitative data were collected using the HomeMeds program database.
Results: Barriers to participation in the program were a lack of awareness about the susceptibility and severity of potentially inappropriate prescribing among older adults, trust in the health care system to accurately track medications, and fear of breach in confidentiality. Clients who took five or more medications were more likely to have an alert generated in the HomeMeds system than clients who took fewer medications. Despite this, less than 35% of alerts resulted in follow-up consultations between the partnering pharmacist and client. HomeMeds staff experienced challenges with recruiting individuals and providing clinically relevant recommendations about medications.
Conclusion: The public health significance of this study is that community programs that implement medication risk assessments may not be effective in preventing potentially inappropriate prescribing in older adults. Improvements to the HomeMeds program should include pharmacist-led educational sessions to provide the information necessary to motivate participation in the program. Program champions at AgeWell residential sites should be leveraged to identify vulnerable older adults and facilitate participation. Finally, partnerships with local primary care practices should be formed to recruit clients to the program, provide comprehensive information about clients’ health history, and evaluate outcomes that result from participation.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
30 July 2020 |
| Date Type: |
Publication |
| Defense Date: |
21 April 2020 |
| Approval Date: |
30 July 2020 |
| Submission Date: |
30 March 2020 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
70 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Behavioral and Community Health Sciences |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Polypharmacy, Older Adults, Medication Management, Adverse Medication Events |
| Date Deposited: |
30 Jul 2020 17:08 |
| Last Modified: |
30 Jul 2020 17:08 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/38427 |
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