Measuring the Impact of an Interdisciplinary Polypharmacy Clinic Within a Patient-centered Medical Home

Title: Measuring the impact of an interdisciplinary polypharmacy clinic within a
patient-centered medical home

Objectives:

The primary objective of this project will be to track the types of interventions made in an
interdisciplinary polypharmacy clinic to improve medication regimens and medication burden.
Polypharmacy has been well documented in the literature as a risk for medication errors,
adverse drug events, and morbidity. Team visits, including complete medication reviews, by
pharmacists and physicians within a National Committee for Quality Assurance (NCQA) tier 3
patient-centered medical home (PCMH) at an academic medical center, can improve medication
regimens. Secondary objectives include (1) measuring each patient's quality of life at
baseline and one month post-intervention and (2) tracking the cost of medication additions
and discontinuations.

Methods:

Patients taking ten or more chronic medications will be identified for referral to the
polypharmacy clinic from a report generated from the electronic medical record. The
polypharmacy clinic will be staffed by a pharmacist and medical resident with oversight from
an attending physician who specializes in geriatrics. Drug-related problems identified
during the visit will be resolved and categorized based upon indication, efficacy, cost,
safety, and compliance. The numbers and types of interventions made, both during the primary
visit and anticipated in the future, will be tracked. The 12-item short form (SF-12) survey
will also be administered at baseline and one month post intervention. The increase or
decrease in cost for medications added and removed during these visits will be captured
using the average wholesale prices.

Preliminary Results Using descriptive statistics, the types of drug-related problems
identified and interventions made will be reported. Changes in quality of life and monthly
medication costs will also be described.