Polypharmacy and High-risk Medications in Older Veterans Presenting for Emergency Care

Authors

Paige Morizio, Durham Veterans Affairs Health Care SystemFollow
Vinita MistryFollow
Ashley McKnightFollow
Marc PepinFollow
William BryanFollow
Ryan OwenbyFollow
Laura PrevillFollow
Luna RagsdaleFollow

Abstract

Background: Guidelines suggest screening for polypharmacy and documentation of high-risk medications in the geriatric Emergency Department (ED) setting. The purpose of this quality improvement initiative was to describe high-risk medications and polypharmacy in older Veterans presenting to the ED in order to inform the workflow of a Geriatric ED pharmacist.

Methods: This was a retrospective, quality improvement project that included patients age 65 years or older who presented to the ED between 10/1/2017 and 9/30/2019. The endpoints included the number of patients with at least one high-risk medication and the mean number of medications on the outpatient medication list. The number of patients age greater than 75 and one at least 10 medications or one high-risk medication was also evaluated.

Results: A total of 27,018 patients were included in the analysis. Approximately 83% of patients had at least one high-risk medication, with a mean of 13 ± 7 active outpatient medications per patient. Thirty-one percent of patients were at least 75 years of age, on 10 medication, or a high-risk medication. The three most common high-risk drug classes were antihypertensives, antidepressants, and opioids.

Discussion: A high prevalence of high-risk medications and polypharmacy was found in this population. Screening criteria was developed for comprehensive medication reviews to be completed by a clinical pharmacist in a geriatric ED setting.

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Recommended Citation

Morizio, Paige; Mistry, Vinita; McKnight, Ashley; Pepin, Marc; Bryan, William; Owenby, Ryan; Previll, Laura; and Ragsdale, Luna (2021) "Polypharmacy and High-risk Medications in Older Veterans Presenting for Emergency Care," Journal of Geriatric Emergency Medicine: Vol. 2: Iss. 4, Article 4.
DOI: https://doi.org/10.17294/2694-4715.1007
Available at: https://institutionalrepository.aah.org/jgem/vol2/iss4/4