The Role of The by 2m3MTq1b

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									  Preventing Falls Among Older
Adults: The Role of the Community
            Pharmacist



         David A. Mott, PhD
         Barb Michaels, RN
          Jeff Kirchner, RPh
                 Funding & Team
• ICTR Pilot Grant
   – 1UL1RR025011 (Mott) 07/01/11–06/30/12 CTSA program
     of NCRR/NIH

• Team
   – Brown County ADRC
   – Streu’s Pharmacy, Green Bay
   – University of Wisconsin- Madison School of Pharmacy
      • Sonderegger Research Center
   – University of Wisconsin-Madison School of Medicine
   – Community Academic Aging Research Network (CAARN)
       Motivation for the Study
• Falls and Drugs
  – Fall risk-increasing drugs (FRIDs)
  – Common use of FRIDs
• Stepping On
  – Medication management workshop
                  Study Goals
• Focus on improving management of medications
by Stepping On participants.
• The purpose of the study is to test the feasibility of
two different methods to modify medication use by
Stepping On participants.
• The main hypothesis to be tested is whether an
individualized, pharmacist-provided MTM session is
feasible and will result in more medication
modification compared to not providing the
pharmacist-led MTM.
• Identify barriers and facilitators.
                Study Specifics
• Study Groups
     - Random assignment (SO class level) to one of
      two groups.
            - Group A (n =40) receives a pamphlet describing
            strategies to change medication use.
            - Group B (n = 40) receives the pamphlet as well
            as meets with a pharmacist to review their
            medication.
• Subjects are followed for six months
• Subjects are paid $50.
                 Study Specifics
• All study subjects participate in:
   – A 60 minute pre- and post-intervention telephone
     interview to collect health, medication use, and falls
     history information.
   – A 30 minute follow-up telephone call every 30 days (a
     total of five follow-up telephone calls) after the
     intervention to collect information about medication
     use and any falls events. Tools provided to subjects to
     aid recall.
   – All phone call interviews occur between a student
     pharmacist and a study subject. Attention is focused
     on building a relationship, appointment setting, and
     quality of conversation and data collection.
   – All conversations with students are audio-recorded.
               Study Specifics
• Treatment Group
  – Meet with a pharmacist for 1 hour at a pharmacy
    located in downtown Green Bay to review their
    medications. Pharmacist uses patient data collected in
    interviews and clinical algorithm for FRIDs developed
    by study personnel and pharmacist.
  – Pharmacist discusses medication modifications with
    patient and communicates with prescriber. Pharmacist
    tracks all modifications.
  – A telephone follow-up session with the pharmacist
    occurs about 3 months after the first session.
  – All conversations with pharmacist are audio-recorded.
               Recruitment
• Last class session of 7-week Stepping On
  workshop.
• Study is discussed as first topic of session.
• Discussion led by IRB-trained study personnel.
• Subjects can consent at the session or
  afterwards following phone call.
• Role of ADRC
                Recruitment
• Results
  – Recruitment rate to date
  – Recruitment patterns
  – Reasons for “yes” and “no”
     MTM Session with Pharmacist
•   Initial patient response
•   Pharmacist recommendations
•   Physician follow-up
•   Patient follow-up
           Preliminary Results
• Study Enrollment
• FRID Use
• MTM Impact
  – Physician response
Questions

								
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