(117) Characteristics of seniors undergoing cognitive assessment or with a recent diagnosis of neurocognitive disorders in Quebec Family Medicine Groups in the GPS study
Background: Pharmacists are now interprofessional team members in Family medicine groups (FMG). Among the patients they should prioritize in their practice focusing on medication optimization, are older adults with neurocognitive disorders (NCD) who are more vulnerable to adverse drug reactions. An ongoing living laboratory-type intervention and pragmatic controlled study, called GPS, is evaluating the impact of their activities on the well-being and medication use of these older adults.
Objectives: The objective of this analysis is to report the baseline characteristics of GPS patients.
Methods: Older adults undergoing neurocognitive assessment, recently diagnosed with NCD or receiving care for this at home, are being recruited in FMGs in two Quebec regions. In intervention FMGs (n=9), pharmacists are systematically involved in the care trajectories of these patients, doing recommendations and interventions about medications. ln control FMGs (n=2), no FMG pharmacist is involved. Pharmacists report medication use at baseline and after six months of follow-up. They also report medical conditions and clinical information, such as Mini Mental State Evaluation (MMSE) scores (26-30: no neurocognitive impairment; 20-25: mild; 10-19: moderate; 3-9: severe; < 3: very severe). Medication appropriateness (using Beers’ criteria), treatment burden, patient satisfaction with care and quality of life are assessed at these same time-points by the researchers. Descriptive statistics at baseline were computed. Medications were classified using the Anatomical, Therapeutical, Chemical classification.
Results: From September 2021 to February 2023, 156 patients have been identified and approached for GPS and 136 agreed to participate. At baseline, GPS patients had the following characteristics: their median age was 80 years, 58% were women and 68% had completed 12 years or less of schooling. Their median MMSE score was 26/30 [IQR: 22-28]. At baseline, on average, patients used 10.4 (95%CI: 9.6-11.2) different medications, some of which are potentially inappropriate. Therapeutic classes most often used were statins (71% of users), vitamin D and analogues (55%), proton pump inhibitors (54%) and acetaminophen (44%). Anxiolytics were used by 19.5% of GPS patients while 12.5% used hypnotics and 10% anti-dementia drugs.
Conclusions: Baseline GPS patients use of medication indicates that their pharmacotherapy could be optimized and confirms the relevance of involving pharmacists in their care trajectories. The GPS study will inform processes in which pharmacists can be involved in primary care teams to improve older adults with NCD care.
