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Addressing polypharmacy: deprescribing in geriatric acute care

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TitleInfo
Title
Addressing polypharmacy: deprescribing in geriatric acute care
Name (type = personal)
NamePart (type = family)
Dussard Wright
NamePart (type = given)
Nadia
NamePart (type = date)
1981-
DisplayForm
Nadia Dussard Wright
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Chao
NamePart (type = given)
Ying-Yu
DisplayForm
Ying-Yu Chao
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Nursing - RBHS
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school
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Text
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theses
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DateCreated (encoding = w3cdtf); (qualifier = exact)
2019
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2019-05
Language
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English
Abstract (type = abstract)
Background: As the American population ages with those over 65 years old accounting for about 15% of the population, more focus is needed in the area of polypharmacy. With multiple chronic conditions, the number of medications needed to treat these illnesses increases. This places the elderly at risk for adverse outcomes. Addressing polypharmacy will not only decrease economic cost but will also improve the quality of life of this population. In-patient acute hospitalization is an opportune time for providers to identify potentially inappropriate medications (PIMs). Interventions such as the screening tool of older persons' prescriptions (STOPP), screening tool to alert doctors to right treatment (START), and a pharmacist-led review of medications are useful ways of reducing these PIMs.
Purpose: The overall goal of this project is to reduce polypharmacy in the geriatric population through the development of a pharmacist-led medication review protocol. The development of a pharmacy recommendation tool will facilitate a seamless communication between the pharmacist and licensed healthcare provider.
Methodology: A retrospective review of patients' chart was conducted at an urban hospital in Northeast New Jersey. A total of 128 charts were reviewed to identify the number of PIMs ordered before and after the interventions were implemented. Patients ? 65 years old admitted to the geriatric program were randomly selected.
Results: A paired t-test was used to analyze data. 49% of study participants were prescribed between 5-9 medications while 30% were prescribed 10-14 medications. Between November 1st to November 30th the pharmacy recommendation tool was utilized to modify 22 medications. The continued use of this tool will result in a significant decrease in the use of PIMs during the inpatient visit.
Implications for Practice: Polypharmacy is costly to the economy due to adverse events. This project proved that a pharmacist-led review of medications is valuable in helping to reduce polypharmacy in the inpatient setting. The implication for policy is that a pharmacist-led protocol should be put in place to address this issue in the impatient setting. Further research is needed in this area of study.
Subject (authority = RUETD)
Topic
Family Nurse Practitioner
Subject (authority = LCSH)
Topic
Polypharmacy
Subject (authority = LCSH)
Topic
Geriatric pharmacology
RelatedItem (type = host)
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Title
Rutgers University Electronic Theses and Dissertations
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ETD
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ETD_9917
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application/pdf
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text/xml
Extent
1 online resource (64 pages) : illustrations
Note (type = degree)
DNP
Note (type = bibliography)
Includes bibliographical references
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TitleInfo
Title
School of Nursing (RBHS) DNP Projects
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rucore10004500001
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NjNbRU
Identifier (type = doi)
doi:10.7282/t3-tm5w-zw37
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

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The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Dussard Wright
GivenName
Nadia
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2019-04-28 12:30:19
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Name
Nadia Dussard Wright
Role
Copyright holder
Affiliation
Rutgers University. School of Nursing - RBHS
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Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Type
Embargo
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2019-05-31
DateTime (encoding = w3cdtf); (qualifier = exact); (point = end)
2099-12-31
Detail
Access to this PDF has been restricted at the author's request.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2019-04-28T12:15:41
DateCreated (point = end); (encoding = w3cdtf); (qualifier = exact)
2019-04-28T12:15:41
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