| Geriatric Polypharmacy: A Potentially Lethal Dilemma was a four-week Direct Practice Improvement Project using a small convenience sample of 32 subjects divided into two groups of 16 each. A quantitative comparison design using nominal data collection for prescription, over-the-counter, homeopathic, herbal, nutritional supplements, and home remedies were collected and evaluated for significance of the aggregate total at an approved medically underserved site with a geriatric population twice that of the national average. The polypharmacy algorithm was built upon the question: In geriatric patients with polypharmacy, how does using a polypharmacy algorithm reduce medication usage compared to not using a polypharmacy algorithm as an intervention affecting the quantity of patient medications over the project period of two weeks? This question was an imperative concern for each active medication's side effects, interactions, age, weight, renal function, hepatic function, and comorbidities such as renal, hepatic, and cardiac concerns. Pre and post application evaluation of the polypharmacy algorithm was accomplished by importing recorded data using an excel worksheet for comparison by Pearson's Correlations and a paired t-test with 95% confidence and p<0.05 significance to assess implications and translation of the results into clinical practice. Nola Pender's health promotion model was used as the theoretical platform. A positive correlation was found between reduction in prescription medications and application of the polypharmacy algorithm with the two-tail test p = 0.018 and the one-tail test p = 0.009. Keywords: geriatric, provider tools for medication prescribing, Medicare D pharmaceutical costs, polypharmacy, adverse effects, prescriptions, over-the-counter, herbal, homeopathic, nutritional supplements, home remedies, and algorithms. |
