Medication management for elderly patients in an academic primary care setting: a quality improvement project.

Abstract

Medication reconciliation is a National Patient Safety Goal. Completing medication reconciliation minimizes the risk for preventable adverse drug events (ADEs). The elderly are at greatest risk for ADEs because of their high number of comorbidities and medications usage. The purpose of this quality improvement project was to improve medication management in a geriatric primary care practice. Interventions focused on improving medication reconciliation documentation, improving accuracy of medication lists, reducing inappropriate medication use, and minimizing duplicate medication therapy. A pre/post design was used over a 9-month period. Interventions focused on educating providers, staff, and patients on medication management. Analysis of 1580 manual chart audits and 903 patient questionnaires were completed. Outcomes improved in all four performance outcomes: medication reconciliation-χ(2) (1, N = 576) = 32.00, p < .0001, V = 0.4; patients bringing medications to clinic-χ(2) (1, N = 277) = 90.46, p < .0001, V = 0.7; reduction in use of specific medications-χ(2) (1, N = 267) = 19.49, p < .0001, V = 0.3; and duplicate therapy was reduced-χ(2) (1, N = 267) = 45.13, p < .0001, V = 0.5. Improved medication management had a significant impact in patient safety and quality of care in this clinic.