Adverse drug events (ADEs) are a very real problem in older adults leading to 16 to 30% of hospital admissions and negatively affecting function and quality of life. With ADEs being the 4th or 5th leading cause of death by disease, albeit a man-made disease, now that we have all the pharmacologic tools to manage chronic disease we now need to work the other end of the spectrum, that being reducing harm from these medications. The Agency for Healthcare Quality and Research has resources, including a toolkit, for providing MTM in older adults who are at high-risk for experiencing ADEs which may be useful for pharmacists performing MTM in this population. However, the study that used this toolkit did not necessarily show a difference in ADE rates as compared to the control group, this is definitely a step in the right direction in improving medication safety in older adults.
In addition to this toolkit, prospective monitoring, in addition to the comprehensive medication review (CMR), is more likely to detect negative trends and help mitigate serious ADEs, along with using a more robust knowledge base that can increase the sensitivity in detecting ADEs and ADE risk in this vulnerable population. Lastly, applying medication minimization practices shown to improve function and quality of life in older adults will most likely reduce ADEs incidence and lower medication costs substantially. The link to the AHRQ resources is as follows: http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=1186