Abstract P1003: Enhancing Medication Safety and Outcomes for Elderly Patients in Rural Outpatient Cardiology: Year Long Evaluation of a Pharmacist-Led Remote Medication Reconciliation Program

Abstract

Background: Challenges of ensuring medication safety and compliance are compounded by limited access to healthcare services. Elderly individuals are disproportionately affected, often having to navigate complex medication regimens prescribed by multiple providers. Moreover, rural patients face a similar challenge, constrained by the number of nearby healthcare facilities and providers. Our study investigates the efficacy of a pharmacist-led (PharmD) remote medication reconciliation program, as part of Medicare’s Chronic Care Management (CCM) program, at a rural cardiology clinic serving a predominantly elderly population in Georgia, USA. Methodology: Methodology was centered around evaluation of medication reconciliation encounters (N=2123) performed by the PharmD team at a rural cardiology clinic from February 2023 to February 2024. The team conducted these encounters with 1065 patients (Avg. of 1.99 calls/patient) facilitated by a structured questionnaire. Initial priority for scheduled medication reconciliations was given to patients: with two or more chronic conditions, older than 65 years old, and six or more active medications. Key topics of focus from the questionnaire are shown in Table 1. Data from the questionnaires was retrospectively analyzed to evaluate program outcomes and efficacy. Conclusion: Retrospective analysis strongly illustrated the program’s effectiveness and clinical impact in a rural cardiology setting. The program's success demonstrates the substantial benefits of comprehensive medication reconciliation as part of Medicare’s CCM program in enhancing medication safety and promoting preventive care, especially among older populations with complex health needs. The program’s identification of notable drug-drug interactions allows for better month to month monitoring of patients’ symptoms, particularly those anticipated by the interaction report. The program allows elderly patients, who frequently have extensive medication regimens from multiple providers, to have a thorough up to date review of their medications in their own home. Through careful analysis of the state’s vaccine registry and current guidelines, the PharmD team discovered an alarming shortfall in preventive vaccinations and boosters among this rural patient population. The PharmD team's interventions during the medication reconciliation encounters, aimed at educating and advocating for vaccination, help protect this at-risk population from severe illnesses and complications.