The Implementation of an Evidence-Based Guideline for the Management of Polypharmacy in the Geriatric Population: A Quality Improvement Project
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Aim: The primary goal of this study was to evaluate the impact of evidence-based polypharmacy guidelines in managing polypharmacy and deprescribing. Geriatric patients are at high risk for polypharmacy and increasing their knowledge will increase awareness. Methods: A quality improvement (QI) project, which included a cross-sectional study, was performed on patients 65 and older during wellness medical visits over four weeks. The Patient Attitudes Towards Deprescribing (PATD) survey was given to each patient to evaluate pre- and post-intervention knowledge. The Beers criteria, polypharmacy clinical flow chart, and polypharmacy deprescribing flow chart were additional interventions utilized during the study. The exclusion criteria were patients aged less than 65 years, those who were not taking five or more medications, and those who were cognitively impaired. Results: A total of 161 elderly patients were identified at risk for polypharmacy and overprescribing. Of the 161 patients with the prevalence of polypharmacy, 68 (42%) were deprescribed by utilizing the 2019 American Geriatrics Society Beers criteria. The average number of medications taken pre-intervention were 8.12 and 7.65 post-intervention. Patients’ knowledge, across all questions, increased by 0.04% based on a paired samples t test. There was a slight growth despite the small effect size of 0.27, which was statistically significant P < 0.001. Clinically significant aspects of the project were the reduction of pill burden, the reduction in chances of adverse events, and the decrease in financial hardships due to unnecessary prescribing of medications. Conclusion: The findings show a decrease in polypharmacy and an increase in deprescribing and patient knowledge.