1	Reducing Polypharmacy With a Focus on Older Adults Sandra Dorr, RN, BSN
2	Polypharmacy is an undesirable state caused by the use of duplicative medications, drug interactions, and disregard for pharmacokinetic and pharmacodynamic principles (Rocchiccioli et al, 2007)
3	Background Older adults: consume 40% of all prescription medication. 50% use five or more prescription and over-the counter medications per week 12% used ten or more Each year thousands are admitted to hospitals with illness directly related to medications.
4	Background It is essential that the healthcare practitioner understand how pharmacokinetics and pharmacodynamics are affected by the aging process.
5	Statement of Problem These factors result in an increase in the incidence of polypharmacy in older adults
6	Recommended Solution That a pharmacist review of a patient’s medication list and medical record would decrease polypharmacy.
7	Action Plan Team would be formed to oversee the process Process- trialed first on a single medical/surgical unit for 3 months Education of staff Pharmacist would be assigned to the nursing unit On admission if a patient had five or more medication, a Pharmacist Consult would be initiated. The Pharmacist would review the patient’s medication list laboratory results Height weight diagnosis. The Pharmacist make recommendations to the Physician/s for changes in the medication regiment or dosage if any are required. Data will be collected
8	Data Collected The number of Pharmacist Consults requested. The name, frequency, and dose of all the medications Prior to hospital admission. Ordered by the physician on admission. At discharge from the hospital How often the pharmacist recommends a change. Does the physician follow the recommendation?
9	Data Analysis Is there… A change in the number of medications from admission to discharge? A significant number of recommendations made by the Pharmacist on consult? The recommendations will be placed in the following categories: Eliminating a duplicate medication. Increasing a dose that is not therapeutic. Decreasing a dose that is too large for the older adult. Substituting of a medication that is less likely to cause an adverse drug reactions in an older adult.