Implementation of a Pilot VIONE PharmD Telephone Clinic within an Older Adult Patient-Aligned Care Team at the West Palm Beach VA Healthcare System

Abstract

Background: Patients receiving palliative-focused care have complex medication regimens and multi-morbidity. Risk of adverse drug reactions (ADR), fall risk, and drug-drug interactions are increased with polypharmacy. Within the Department of Veteran’s Affairs a commonly used deprescribing model is the VIONE methodology. VIONE catego-rizes medications into vital/life-saving medications, important for quality of life, optional, not indicated/treatment complete, and every medication has a diagnosis. The VIONE dashboards aids providers identify potentially inappropriate medications and prioritizes patients. This study aimed to pilot implementation of board-certified clinical pharmacist practitioners utilizing the VIONE model of deprescribing within an older adult patient-aligned care team at the West Palm Beach VAHCS. Methods: The PGY2 Pain Management and Palliative Care resident reached out via telephone to the patients for an initial medication regimen review to identify medication optimization opportunities and a 14 day follow up call. Primary outcomes were quantity of medications depre-scribed per patient, classes of medications that were deprescribed,