CAN WE IMPROVE MEDICATION USE IN OLDER ADULTS? AN INTERDISCIPLINARY MEDICATION THERAPY INTERVENTION

Older adults are at higher risk for experiencing medication side effects due to an altered metabolic profile and higher comorbidity rates. Many of the clinical guidelines for optimizing pharmacotherapy in this population include anticholinergic drugs on the list of potentially inappropriate medications. Although several drugs exhibit anticholinergic effects, prescribers may be unaware of such properties, thus a team effort (pharmacist-physician) might be the key for successfully implementing interventions to reduce inappropriate prescribing in this population. We conducted an interdisciplinary medication therapy management (MTM) intervention for older patients who were prescribed one or more anticholinergic medications. We recruited 50 subjects ≥65 years with normal cognition (n=33), mild cognitive impairment (n=12), or mild dementia (n=5) enrolled in the University of Kentucky Alzheimer’s Disease Center cohort. Participants were randomized to either MTM (direct physician-pharmacist review and modification of medications) or control intervention (FDA materials on inappropriate medication use). After 8 weeks, primary outcomes included change from baseline in the number of anticholinergic drugs and Medication Appropriateness Index (MAI). The intervention reduced anticholinergic use in 56% of the participants (intervention arm) vs 8% (control), p