Transcript The Role of The

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
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Initial patient response
Pharmacist recommendations
Physician follow-up
Patient follow-up
Preliminary Results
• Study Enrollment
• FRID Use
• MTM Impact
– Physician response
Questions