Category: Federal Forum Posters
Purpose: The primary objective of this quality improvement project is to investigate the relationship between medication non-adherence and cognitive impairment as discovered through interprofessional collaboration in a nephrology clinic. First, a pharmacist will identify non-adherent patients through a comprehensive medication reconciliation. Then, patients will be referred to a geriatrician who will complete a Montreal Cognitive Assessment (MoCA) to identify cognitive impairment. The aim is to correlate medication non-adherence to cognitive impairment as assessed by the Montreal Cognitive Assessment. By doing so, pharmacist-led medication reconciliation may be used as a tool to recognize geriatric patients who may benefit from a cognitive evaluation.
Methods: Previously, pharmacists completed medication reconciliations during multidisciplinary nephrology clinic visits which identified patients with medication non-adherence. Several of these patients were referred to outside clinics for a cognitive assessment using the Montreal Cognitive Assessment (MoCA) and were found to have cognitive impairment. For the purposes of this project, previously identified non-adherent patients will undergo a MoCA with the embedded geriatrician to assess for cognitive impairment. Pharmacists will continue to conduct medication reconciliation to identify non-adherent patients for assessment, targeting patients for medication reconciliation based on the following: advanced age, number of medications, recent hospitalization or history of non-adherence. Non-adherent patients will be excluded from this project if they receive assistance from a caregiver for medication management or have completed a MoCA within the past year. Pharmacists will note the number and type of medication discrepancies, drug therapy problems and non-adherence. Non-adherence will be classified as missed or extra dose, incorrect frequency or route or the inability to recall name or dose of medication. Patients will be given a cumulative non-adherence score which will be compared to the results of their MoCA. The primary outcome will be the relationship between the patient’s non-adherence and cognition as identified by their MoCA score.
Results: Not applicable
Conclusion: Not applicable
Nicole Genovese– PGY1 Pharmacy Resident, Veterans Affairs Boston Healthcare System, Roslindale, MA