Category: Federal Forum Posters
Purpose: Polypharmacy is the utilization of more medications than are clinically indicated and is associated with an increased risk for adverse drug events, drug-drug and drug-disease interactions, and increased mortality. The objective of this quality improvement study is to evaluate the current polypharmacy and deprescribing review processes of the SFVAHCS CLC and implement a standardized process, that includes tracking of pharmacist recommendations, to help address polypharmacy.
Methods: This study was approved by the San Francisco VA medical center quality improvement determination board. The polypharmacy dashboard captures patients at the CLC with nine or more medications. This dashboard will be used to obtain pre-intervention polypharmacy reports once a week for four weeks. Each medication will be classified using the drug information function in the Veterans Integrated Systems Technology Architecture (VISTA). For each patient captured in the polypharmacy dashboard reports, the number of active disease states will be identified through the most recent annual medical problem provider note in the electronic medical record (EMR). A standardized deprescribing tool will be developed for the SFVAHCS CLC, and the CLC pharmacists will use the deprescribing tool. The following data will be collected per chart review: patient age, gender, number of medications, medication classifications, number of active disease states, type of recommendation made by CLC pharmacist, total number of CLC pharmacist recommendations, reasons medications were deprescribed, and total number of recommendations accepted. Using the polypharmacy dashboard, post-intervention polypharmacy reports will be obtained once a week for four weeks. Polypharmacy data from pre- and post-deprescribing tool implementation at the CLC will be compared.
Jamie Russell– Pharmacy Resident, VA San Francisco, Daly City, CA