2025 Southeastern Residency Conference

Title: Implementation and Impact Assessment of a Pharmacy Led Geriatrics Clinic


Authors: Emily Corbett, Krishna Rana, Kelly Krieger


Background: A geriatrics pharmacy clinic will be implemented as an expansion of pharmacy services to address geriatric related concerns such as dementia related medication titrations, polypharmacy, and deprescribing potentially inappropriate medications as identified by the American Geriatrics Society (AGS). The purpose of this project is to describe the interventions made and evaluate the impact of a pharmacist- led geriatrics clinic on reducing the drug burden index and increasing access to care among Veterans   ≥ 65 years old with dementia related treatment and/or polypharmacy within a Veterans Affairs (VA) Health Care System.


Methods: A pharmacist-led geriatrics telephone clinic will be implemented to assist with the medication management of dementia related medications, reduce polypharmacy, and increase access to care among Veterans enrolled in the geriatrics psychiatric clinic. Patients will be referred to the clinic by geriatric psychologists for the titration and/or monitoring of acetylcholinesterase inhibitors, N-methyl-D-aspartate receptor inhibitor, selective serotonin reuptake inhibitors, and anti-amyloid therapy. Patients will also referred by the Acute Care for the Elders inpatient pharmacist for outpatient follow up after deprescribing is initiated at hospital discharge. Additionally, patients will be referred internally for polypharmacy assessment, prior authorization drug request consults and cost saving drug conversions.


A retrospective chart review will be conducted to include all patients referred to the pharmacy geriatrics clinic  with at least one visit within a 6-month period. The primary objective is to describe the pharmacist interventions associated with implementation of the service expansion clinic. The secondary objective is to evaluate the change in a patients drug burden index score from the initial to last pharmacist visit for patients referred for polypharmacy. Lastly, the number of interim pharmacist-led visits will be used to estimate the geriatric psychologist time saved. Descriptive statistics will be utilized to describe the primary objective. Student t-test will be utilized for parametric data, while chi-square will be utilized for non-parametric data.


Results: There were a total of 31 patients enrolled in the pharmacist-led geriatrics clinic from August 12, 2024 to March 2, 2025. A total of 107 interventions were made among 80 unique visits. Patients that were referred for polypharmacy had an average of 1.85 visits per patient. Those referred from Geri-psych required an average of 2.43 visits per patient. A total of 57 medications were deprescribed. The most commonly prescribed medications were proton pump inhibitors and benzodiazepines. The average index DBI score was 2.28 and average post DBI 2.00 (-0.28, P = 0.02). The average time to first pharmacist visit from time of Geri-psych referral was 2.9 weeks with an average of 1.58 pharmacist visits between Geri-psych follow ups. 


Conclusion: The majority of referrals came from Geri-psych providers for assistance with monitoring and titrating dementia related medications. Patients referred from Geri-psych often required more visits than those referred for polypharmacy likely due to the complexity and frequently changing needs of both patients and caregivers. This project showed that pharmacists can effectively assist with deprescribing to decrease a patients drug burden index.