July 19, 2017
New findings from University of Kentucky faculty published in Alzheimer’s Research and Therapy demonstrate the value of physician-pharmacist teams in providing elderly care.
As people age, the number of prescribed medications tends to increase, raising the level of complexity for both patient care and medication therapy. In the United States, patients over 60 take an average of five different medications, many of which are prescribed by different physicians. This complexity often results in a higher probability of inappropriate drug prescriptions and side effects, including cognitive impairment.
This is especially relevant for patients living with Alzheimer’s disease and other dementias. Anticholinergics drugs – used extensively to treat nausea, peptic ulcers, lung disease, dizziness, and other conditions common in elderly patients – are often the culprits of inappropriate prescriptions. While they sometimes prove helpful, they’ve also been known to result in cognitive decline in certain patients. Therefore, it is essential to find the right balance between risks and benefits for individuals patients.
In order to examine this further, Dr. Daniela Moga from UK College of Pharmacy and Dr. Greg Jicha from the UK Sanders-Brown Center on Aging partnered together to conduct an 8-week randomized trial with patients from the UK's Sanders-Brown Center on Aging.
Their aim was to investigate whether a targeted patient-centered pharmacist-physician Medication Therapy Management team intervention could reduce the incidents of inappropriate prescribing of anticholinergics. Their research was the first step in evaluating whether intervention can improve cognitive function in patients.
Their findings showed promise. Compared to the control group, patients receiving the intervention showed a reduction in the number of anticholinergic drugs. In addition, patients appreciated the opportunity to participate in the study and recognized the importance of optimizing their medical treatment.
Now with funding from the National Institutes of Health, Moga and Jicha will follow a larger cohort of patients for one year, and further evaluate the long-term effects of intervention by a Medication Therapy Management team.
Physicians are constantly managing risks and benefits of medications with patients, and sometimes the potential for adverse effects is not fully recognized.
“When physicians and pharmacists work together, everyone wins," Moga said. "It’s clear that including a pharmacist on the patient-care team means better outcomes and better healthcare for patients.”
“This study highlights the benefits of patient-centered medical teams that improve drug choices and the health of elderly patients, many of whom have highly complex medical conditions and needs,” said Greg Graf, assistant dean for translational research and UK College of Pharmacy faculty member. “The project is a collaborative effort between the UK Colleges of Medicine and Pharmacy, and we’re proud of the work we’re able to do together.”
This research was funded in part by the UK Center for Clinical and Translational Sciences, Sanders-Brown Center on Aging, the National Institutes of Health, the Office of Women’s Health Research and the National Institute on Drug Abuse.