Preventing Falls Among Older Adults: The Role of the Community Pharmacist

1. Preventing Falls Among Older Adults: The Role of the Community Pharmacist David A. Mott, PhD Barb Michaels, RN Jeff Kirchner, RPh

2. Funding & Team • ICTR Pilot Grant • 1UL1RR025011 (Mott) 07/01/11–06/30/12 CTSA program of NCRR/NIH • Team • Brown County ADRC • Streu’sPharmacy, Green Bay • University of Wisconsin- Madison School of Pharmacy • Sonderegger Research Center • University of Wisconsin-Madison School of Medicine • Community Academic Aging Research Network (CAARN)

3. Motivation for the Study • Falls and Drugs • Fall risk-increasing drugs (FRIDs) • Common use of FRIDs • Stepping On • Medication management workshop

4. Study Goals • Focus on improving management of medications by Stepping On participants. • The purpose of the study is to test the feasibility of two different methods to modify medication use by Stepping On participants. • The main hypothesis to be tested is whether an individualized, pharmacist-provided MTM session is feasible and will result in more medication modification compared to not providing the pharmacist-led MTM. • Identify barriers and facilitators.

5. Study Specifics • Study Groups - Random assignment (SO class level) to one of two groups. - Group A (n =40) receives a pamphlet describing strategies to change medication use. - Group B (n = 40) receives the pamphlet as well as meets with a pharmacist to review their medication. • Subjects are followed for six months • Subjects are paid $50.

6. Study Specifics • All study subjects participate in: • A 60 minute pre- and post-intervention telephone interview to collect health, medication use, and falls history information. • A 30 minute follow-up telephone call every 30 days (a total of five follow-up telephone calls) after the intervention to collect information about medication use and any falls events. Tools provided to subjects to aid recall. • All phone call interviews occur between a student pharmacist and a study subject. Attention is focused on building a relationship, appointment setting, and quality of conversation and data collection. • All conversations with students are audio-recorded.

7. Study Specifics • Treatment Group • Meet with a pharmacist for 1 hour at a pharmacy located in downtown Green Bay to review their medications. Pharmacist uses patient data collected in interviews and clinical algorithm for FRIDs developed by study personnel and pharmacist. • Pharmacist discusses medication modifications with patient and communicates with prescriber. Pharmacist tracks all modifications. • A telephone follow-up session with the pharmacist occurs about 3 months after the first session. • All conversations with pharmacist are audio-recorded.

8. Recruitment • Last class session of 7-week Stepping On workshop. • Study is discussed as first topic of session. • Discussion led by IRB-trained study personnel. • Subjects can consent at the session or afterwards following phone call. • Role of ADRC

9. Recruitment • Results • Recruitment rate to date • Recruitment patterns • Reasons for “yes” and “no”

10. MTM Session with Pharmacist • Initial patient response • Pharmacist recommendations • Physician follow-up • Patient follow-up

11. Preliminary Results • Study Enrollment • FRID Use • MTM Impact • Physician response

12. Questions