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| Name | Class |
|---|---|
| Blue Cross Blue Shield | OTHER |
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The purpose of the study is to implement a pharmacist-led deprescribing intervention for adults 65 and older taking 10 or more medications at University of Texas (UT) Physicians clinics and to assess the effect of the pharmacist intervention on the incidence of adverse drug reactions, emergency room visits, and hospitalizations as well as costs to the patient and to the healthcare system in adults 65 and older taking 10 or more medications treated at UT Physicians.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Deprescribing Intervention | Experimental |
| |
| Usual Care | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Deprescribing Intervention | Behavioral | An individualized deprescribing intervention will be created by a pharmacist working with a patient to identify harmful, costly, and unnecessary medications to be reduced. The intervention will include a plan and monitoring for up to 3 months to reduce medication use. |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Drug Reactions (ADR) | Patient-reported side effects and adverse events potentially attributable to medication, rated for the likelihood of ADR by an independent reviewer based on the Naranjo algorithm. | 3 months post enrollment |
| Adverse Drug Reactions | Patient-reported side effects and adverse events potentially attributable to medication, rated for the likelihood of ADR by an independent reviewer based on the Naranjo algorithm. | 6 months post enrollment |
| Adverse Drug Reactions | Patient-reported side effects and adverse events potentially attributable to medication, rated for the likelihood of ADR by an independent reviewer based on the Naranjo algorithm. | 12 months post enrollment |
| Healthcare Cost | Healthcare cost based on utilization of clinic visits, emergency room visits, and hospitalizations, based on patient report with specific costs obtained when possible from the Health Information Exchange. | 3 months post enrollment |
| Healthcare Cost | Healthcare cost based on utilization of clinic visits, emergency room visits, and hospitalizations, based on patient report with specific costs obtained when possible from the Health Information Exchange. | 6 months post enrollment |
| Healthcare Cost | Healthcare cost based on utilization of clinic visits, emergency room visits, and hospitalizations, based on patient report with specific costs obtained when possible from the Health Information Exchange. |
| Measure | Description | Time Frame |
|---|---|---|
| Medication use | Number and name of each medication a participant is taking. | At enrollment |
| Medication cost | Average wholesale price of each medication taken by a participant, determined using reference software. |
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Inclusion Criteria:
- taking 10 or more regular medications
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Holly M Holmes, MD,MS | The University of Texas Health Science Center, Houston | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Texas Health Science Center at Houston | Houston | Texas | 77030 | United States |
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| ID | Term |
|---|---|
| D064420 | Drug-Related Side Effects and Adverse Reactions |
| ID | Term |
|---|---|
| D064419 | Chemically-Induced Disorders |
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|
| Usual Care | Behavioral | The usual care arm will receive the current standard of care, which includes medication reconciliation by a clinic nurse at the time of their appointment. Nurses review all medications and answer medication-related questions, and refer medication questions to the healthcare provider for further discussion when necessary. |
|
| 12 months post enrollment |
| 3 months post enrollment |
| Medication cost | Average wholesale price of each medication taken by a participant, determined using reference software. | 6 months post enrollment |
| Medication cost | Average wholesale price of each medication taken by a participant, determined using reference software. | 12 months post enrollment |
| QOL | Quality of life as measured by the EQ5D scale.This scale is numbered from 0 to 100. 100 means the best health you can imagine. 0 means the worst health you can imagine. | Baseline |
| QOL | Quality of life as measured by the EQ5D scale.This scale is numbered from 0 to 100. 100 means the best health you can imagine. 0 means the worst health you can imagine. | 12 months post enrollment |