Older adults with cancer have comorbidities that require medical management and confounders of chemotherapy and supportive medications exacerbate polypharmacy. A multidisciplinary team model was created to address these needs within the Cancer Aging and Resiliency (CARE) clinic. To reconcile medications for accuracy, compliance, side effects, and effectiveness, a pharmacist-led audit includes identification of potential therapeutic duplications, drug-drug interactions, or potential medication inappropriateness identified using Beers criteria. A pharmacist led review of patient’s prescriptions can identify drug therapy problems (DTP) and result in safer medication management. METHODS: A retrospective review of pharmacy specific interventions was conducted using CARE Clinic patient data from February 2016 to October 2019 evaluating data from n=259 patients. RESULTS: A preliminary analysis of n=137 patients who had received medication reconciliation were included. The mean number of medications per patient was 13.1 ± 5.7 and 457 DTP were identified leading to 523 medication related interventions. There was an average of 3.3 DTP per patient. The most common types of DTP included medication reconciliation (n=137, 30.0%), potentially inappropriate medication (PIM) (n=74, 16.2%), administration/technique (n=35, 7.7%), and drug-drug interaction (n=28, 6.1%). The most frequent types of interventions involved education to the patient (n=166, 31.7%), medication reconciliation (n=137, 26.2%), medication discontinuation (n=84, 16.1%), patient to discuss further with physician (n=39, 7.5%), and medication initiated (n=35, 6.7%). Updated results involving approximately 259 patients will be presented. CONCLUSION: Comprehensive medication review within a multidisciplinary setting for the management of older adults with cancer can reduce polypharmacy and inappropriate medication use.
The objective of this study was to compare the rate of pneumonia resolution in obese (BMI ≥ 30 kg/m 2 ) and non-obese (BMI < 30 kg/m 2 ) patients treated with ertapenem one gram daily. This was a retrospective cohort study evaluating patients treated at The Ohio State University Wexner Medical Center between January 1, 2015 and August 31, 2020. Patients were included if they were between 18 and 89 years old and received ertapenem for at least 48 hours for pneumonia. Patients were excluded if pregnant, incarcerated, had renal impairment, received antibiotics with gram-negative activity for a significant period prior to or in addition to ertapenem, and patients with other concomitant deep-seated infections. The primary outcome of clinical resolution was defined as meeting any of three criteria in order of evaluation: discontinuation of antibiotics by day 8 of therapy, afebrile while on ertapenem in addition to a decrease in white blood cell count, or improvement on chest radiograph at day 7 of therapy. A multivariable logistic regression analysis was performed to examine the association between obesity and clinical resolution, while adjusting for proven confounders. There were 76 non-obese and 65 obese patients included. The median patient BMI was 23.7 kg/m 2 (21.0-26.9) and 35.0 kg/m 2 (32.8-39.8) for the non-obese and obese cohorts, respectively. Clinical resolution was achieved in 78% (59/76) of non-obese and 75% (49/65) of obese patients (p=0.75) without an observed difference in the regression model. Outcomes were similar in obese and non-obese patients treated with ertapenem one gram daily for pneumonia.
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