Student Pharmacist Led Fish Oil Deprescribing Initiative at a Veterans Affairs Hospital and Rural Clinics

Maria Wopat, Federick Dunkerson, Alissa Moss, Chelsea Moyer, Alyssa Pitterle, Edward Portillo
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Abstract

Background: Polypharmacy impacts one-third of older adults and has been shown to lead to adverse health effects. One contributor to polypharmacy includes omega-3 fatty acid (fish oil) due to the lack of evidence supporting clinical benefit. Pharmacists can identify and reduce polypharmacy, inspiring this student led deprescribing initiative to introduce a standard of care process for deprescribing fish oil. Purpose/Objectives: The overall objectives of this evaluation are to assess the need for a fish oil deprescribing process, to analyze the role of student pharmacists in deprescribing, and to evaluate the effectiveness of a fish oil deprescribing service. Methods: This project integrated three doctor of pharmacy students in their third year of pharmacy school who were enrolled in a yearlong class about improving healthcare for rural populations and the quality improvement research process. Four primary care clinic patient panels who were prescribed fish oil were assessed. Chart reviews were conducted, and patients were contacted to deprescribe their fish oil by the student and offer statin or lipid therapy modifications, if applicable. Results: A generated report identified 106 patients who had active prescriptions for fish oil. After application of exclusion criteria, 68 patients were included in the evaluation. A total of 76.2% of patients accepted at least one therapy modification offered by the pharmacy student. Conclusion: This evaluation demonstrates the positive impact of the integration of student pharmacists for deprescribing in a primary care setting. Opportunities exist to further explore student pharmacist roles within ambulatory care clinic models.
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退伍军人事务医院和农村诊所的学生药剂师领导的鱼油去处方化行动
背景:多重药物治疗影响着三分之一的老年人,并已被证明会对健康造成不良影响。由于缺乏支持临床益处的证据,导致多药滥用的一个因素包括欧米伽-3 脂肪酸(鱼油)。药剂师可以识别并减少多重用药,这激发了由学生主导的取消处方倡议,以引入取消鱼油处方的标准护理流程。目的/目标:本评估的总体目标是评估对鱼油处方程序的需求,分析学生药剂师在处方中的作用,并评估鱼油处方服务的有效性。方法:该项目结合了药学院三年级的三名药学博士生,他们参加了为期一年的关于改善农村人口医疗保健和质量改进研究过程的课程。我们对四个初级保健诊所的鱼油处方患者小组进行了评估。学生对病历进行了审查,并联系患者开出鱼油处方,同时提供他汀类药物或血脂治疗调整(如适用)。结果:生成的报告显示,106 名患者拥有鱼油的有效处方。在应用排除标准后,68 名患者被纳入评估。共有 76.2% 的患者接受了药剂学学生提供的至少一项治疗调整。结论这项评估表明,学生药剂师在基层医疗机构的处方开具中发挥了积极作用。我们有机会进一步探索学生药剂师在非住院医疗诊所模式中的作用。
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