Date of Conferral

2022

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Gardner

Abstract

AbstractPolypharmacy is the concomitant use of five or more medicines and is associated with a higher risk of being prescribed potentially inappropriate or interactive medications. Polypharmacy in adults over 60 years of age may correlate with adverse outcomes of multimorbidity such as functional impairment, low quality of life, high healthcare use, and increased costs. Health practitioners need to be aware of tools and methods to manage polypharmacy-related issues to optimize patient safety. The gap in practice is that a primary care practice did not have a comprehensive clinical guideline for a systematic and ongoing assessment of appropriateness of medication use as well as reduction of inappropriate medicines in older adults. The purpose of this scholarly project was to involve an interprofessional team in the development of polypharmacy clinical practice guidelines for the primary care of older adults. The practice-focused question involved whether an interprofessional team can develop a clinical guideline (CG) for regular medication management protocols. Guidelines involved developing suitable treatment goals to meet patients’ most pressing issues while focusing on the rationale for individual prescriptions and recognizing improper prescribing using Beers criteria and START (Screening Tool to Alert to Right Treatment) STOP (Screening Tool of Older Persons' Prescriptions)criteria. The AGREE (Appraisal of Guidelines, Research and Evaluation II) test was used to assess the proposed CG’s methodological quality, and 100% of team members (N = 4) from medicine, nursing, nutrition, and pharmacy strongly agreed that the CGs were acceptable. The use of clinical practice guidelines in primary care settings may leadto social change by ensuring patient safety, reducing adverse effects, encouraging more efficacious drug use, and potentially reducing hospitalizations. Abstract Polypharmacy is the concomitant use of five or more medicines and is associated with a higher risk of being prescribed potentially inappropriate or interactive medications. Polypharmacy in adults over 60 years of age may correlate with adverse outcomes of multimorbidity such as functional impairment, low quality of life, high healthcare use, and increased costs. Health practitioners need to be aware oftools and methods to manage polypharmacy-related issues to optimize patient safety. The gap in practice is that a primary care practice did not have a comprehensive clinical guideline for a systematic and ongoing assessment of appropriateness of medication use as well as reduction of inappropriate medicines in older adults. The purpose ofthis scholarly project was to involve an interprofessional team in the development of polypharmacy clinical practice guidelines for the primary care of older adults. The practice-focused question involved whether an interprofessional team can develop a clinical guideline (CG) for treatment goals to meet patients’ most pressing issues while focusing on the rationale for individual prescriptions and recognizing improper prescribing using Beers criteria and START (Screening Tool to Alert to Right Treatment) STOP (Screening Tool of Older Persons' Prescriptions)criteria. The AGREE (Appraisal of Guidelines, Research and Evaluation 11) test was used to assess the proposed CG’s methodological quality, and 100% ofteam members (N = 4) from medicine, nursing, nutrition, and pharmacy strongly agreed that the CGs were acceptable. The use of clinical practice guidelines in primary care settings may leadto social change by ensuring patient safety, reducing adverse effects, encouraging more efficacious drug use, and potentially reducing hospitalizations. regular medication management protoGuidelines_involved developing suitable

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