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Pharmaceutical Practices and Patient Outcomes
Research Guide
What is Pharmaceutical Practices and Patient Outcomes?
Pharmaceutical Practices and Patient Outcomes is the study of medication management challenges in older adults, including polypharmacy, inappropriate prescribing, adverse drug events, pharmacist interventions, medication reconciliation, deprescribing, and anticholinergic burden, with the goal of improving patient outcomes.
This field encompasses 132,765 papers focused on polypharmacy and adverse drug events in the elderly. Key areas include potentially inappropriate prescribing and clinical pharmacy services. Research addresses medication management complexities to enhance outcomes in geriatrics.
Topic Hierarchy
Research Sub-Topics
Polypharmacy Elderly Outcomes
This sub-topic examines associations between multiple medication use and risks like falls, hospitalizations, and mortality in older adults. Cohort studies quantify dose-response relationships.
Potentially Inappropriate Prescribing Elderly
Researchers apply tools like Beers Criteria to identify high-risk medications and prescribing patterns in geriatrics. Validation studies assess criteria sensitivity and clinical utility.
Adverse Drug Events Elderly
Epidemiological research quantifies incidence, preventability, and causality of drug-related injuries in seniors using frameworks like Naranjo algorithm. Pharmacovigilance tracks hospital admissions.
Deprescribing Older Adults
This area develops and trials protocols to safely discontinue unnecessary medications, evaluating feasibility and sustainability. Frameworks address patient-provider shared decision-making.
Pharmacist Interventions Polypharmacy
Studies test pharmacist-led services like medication reviews and reconciliation for reducing errors in elderly care. Randomized trials measure impacts on adherence and event rates.
Why It Matters
Adverse drug reactions contribute significantly to hospital admissions, as Pirmohamed et al. (2004) found in a prospective analysis of 18,820 patients where ADRs caused 6.5% of admissions in two Merseyside hospitals. The American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults by the 2019 AGS Beers Criteria® Update Expert Panel (2019) provides explicit recommendations to identify and avoid high-risk medications in older adults, widely used by clinicians and regulators. Lazarou et al. (1998) reported that serious and fatal ADRs occurred in 6.7% of hospitalized US patients, underscoring ADRs as a major clinical issue. Recent preprints highlight pharmacist integration in general practice to reduce polypharmacy burdens and structured medication reviews in primary care for patients on potentially addictive medications, while PCORI funding supports patient-centered studies on medication safety.
Reading Guide
Where to Start
"American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults" by the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel (2019), as it provides a practical, widely used list of high-risk medications in older adults with clear clinical recommendations.
Key Papers Explained
"Prediction of Creatinine Clearance from Serum Creatinine" by Cockcroft and Gault (1976) enables dosing adjustments foundational for geriatric practice; "A method for estimating the probability of adverse drug reactions" by Naranjo et al. (1981) builds causality assessment tools; "Incidence of Adverse Drug Reactions in Hospitalized Patients" by Lazarou et al. (1998) quantifies ADR prevalence; "Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients" by Pirmohamed et al. (2004) extends this to admission risks; and "American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults" by the 2019 AGS Panel (2019) synthesizes prevention strategies.
Paper Timeline
Most-cited paper highlighted in red. Papers ordered chronologically.
Advanced Directions
Recent preprints emphasize pharmacist integration effectiveness and costs, structured medication review outcomes, and hospital pharmacy trends; PCORI funding advances patient-centered CER studies on medication management; FHIR tools like cqframework/opioid-cds and HL7/ebm support evidence-based guidelines for real-time interventions.
Papers at a Glance
| # | Paper | Year | Venue | Citations | Open Access |
|---|---|---|---|---|---|
| 1 | Prediction of Creatinine Clearance from Serum Creatinine | 1976 | Nephron | 15.3K | ✕ |
| 2 | A method for estimating the probability of adverse drug reactions | 1981 | Clinical Pharmacology ... | 11.3K | ✕ |
| 3 | ECDEU Assessment Manual for Psychopharmacology | 1976 | Internet Archive (Inte... | 8.8K | ✕ |
| 4 | Adherence to Medication | 2005 | New England Journal of... | 7.8K | ✕ |
| 5 | Incidence of Adverse Drug Reactions in Hospitalized Patients | 1998 | JAMA | 4.8K | ✕ |
| 6 | SF-36 Health Survey Update | 2000 | Spine | 4.4K | ✕ |
| 7 | SOME QUANTITATIVE USES OF DRUG ANTAGONISTS | 1959 | British Journal of Pha... | 4.0K | ✓ |
| 8 | A RATING SCALE FOR EXTRAPYRAMIDAL SIDE EFFECTS | 1970 | Acta Psychiatrica Scan... | 3.2K | ✕ |
| 9 | Adverse drug reactions as cause of admission to hospital: pros... | 2004 | BMJ | 3.2K | ✓ |
| 10 | American Geriatrics Society 2019 Updated AGS Beers Criteria® f... | 2019 | Journal of the America... | 3.1K | ✕ |
In the News
PCORI awards funding for new patient-centered healthcare ...
**Funding highlights** * Eleven new patient-centered CER studies addressing a range of pediatric and adult health challenges * Eight studies advancing CER methods, including strategies for meaningf...
Advancing Competency, Policy, and Patient Need in 2026
One development this year deserves particular attention. For the first time, the American Pharmacists Association and Accreditation Council for Pharmacy Education have been written into US legislat...
Dartmouth-led Research Team Receives $13 Million ...
a five-year, $13 million funding award from the Patient-Centered Outcomes Research Institute (PCORI). Their project will test the effectiveness of video as a communication tool during patient visit...
UNC Awarded Funding To Implement Useful Research ...
We are pleased to announce that the University of North Carolina at Chapel Hill has been approved for funding by the Patient-Centered Outcomes Research Institute (PCORI) to implement research findi...
Future of Pharma: Breakthroughs at Scale
**By 2035, the pharmaceutical industry is poised to play a more expansive and transformative role in healthcare. Breakthroughs in science enable pharmaceutical companies to treat, and even cure, di...
Code & Tools
The Clinical Quality Framework is a joint effort by the Clinical Decision Support and Clinical Quality Information Work Groups to identify, develop...
This implementation guide describes an approach to using evidence-based medicine on FHIR (EBMonFHIR) in combination with FHIR Clinical Guidelines t...
# FHIR Specification This repository is used in the NHS Digital FHIR Medicines Implementation Guide NHSDigital IOPS Validation) ## About NHS D...
## Repository files navigation # Opioid Prescribing Support Implementation Guide (FHIR STU3 (3.0.1))
Implementation guidance for base usage of FHIR Resources (and base Profiles) for representation of scientific knowledge, including Citation, Eviden...
Recent Preprints
The effectiveness and cost of integrating pharmacists ...
Background Polypharmacy and associated potentially inappropriate prescribing (PIP) place a considerable burden on patients and represent a challenge for general practitioners (GPs). Integration of...
Implementation and impact analysis of a clinical pharmacy ambulatory: a two-year experience
Evidence from international literature consistently supports the role of CPSs in improving medication safety, optimizing pharmacotherapy, and enhancing patient outcomes, while also reducing healthc...
Outcomes of Structured Medication Reviews for Selected ...
Structured medication reviews are now a common part of primary care practice, but little information is available on the outcomes of these reviews. We incentivised practices to submit a report via ...
Evolving Trends in Hospital Pharmacy and Impact on ...
## **Conclusion**
Pharmacy Practice & Practice-Based Research
special populations, evaluation tools, inter-professional alliances, or technologies that support practice. This section also provides a venue for scholarship that involves practice-based clinicia...
Latest Developments
Recent developments in pharmaceutical practices and patient outcomes research in 2026 include a focus on advancing competency, policy, and patient needs through innovative pharmacy practices (Pharmacy Times). Additionally, there is a trend toward accelerated drug approval processes and new treatment pathways, particularly for rare diseases (Physicians Weekly). The industry is also emphasizing personalized engagement and digital strategies to improve outcomes (Outcomes). Furthermore, research on cardiovascular outcomes of GLP-1 receptor agonists like semaglutide indicates ongoing efforts to evaluate and improve treatment efficacy for high-risk diabetes patients (NEJM; Nature Medicine). Overall, the industry is increasingly integrating innovative clinical research, personalized care, and policy adaptation to enhance patient outcomes (ZS insights, McKinsey).
Sources
Frequently Asked Questions
What are the Beers Criteria?
The American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults lists medications and classes to avoid in older adults due to risks outweighing benefits. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel (2019), these criteria are used by clinicians, educators, researchers, and regulators. They have been updated since 2011 under AGS stewardship.
How common are adverse drug reactions in hospitals?
Lazarou et al. (1998) found serious and fatal ADRs in 6.7% of hospitalized US patients across 30 studies. Pirmohamed et al. (2004) reported ADRs caused 6.5% of admissions in 18,820 patients aged over 16 in two UK hospitals. These incidences highlight ADRs as a key patient safety concern.
What is the Naranjo algorithm?
The Naranjo algorithm estimates the probability of adverse drug reactions using a scoring system based on clinical judgment categories. Naranjo et al. (1981) developed it to reduce variability in causality assessments. It applies definitions for definite, probable, possible, or doubtful reactions.
Why is medication adherence important?
Osterberg and Blaschke (2005) state that full benefits of medications require patient adherence to regimens. Nonadherence terms like 'noncompliant' can stigmatize patients and affect future care. Adherence impacts outcomes in chronic disease management.
What role do pharmacists play in patient outcomes?
Recent preprints show pharmacist integration in general practice addresses polypharmacy and potentially inappropriate prescribing. 'Implementation and impact analysis of a clinical pharmacy ambulatory: a two-year experience' (2025) supports clinical pharmacy services in optimizing pharmacotherapy and reducing costs. These interventions prevent errors and hospitalizations.
How is creatinine clearance predicted in the elderly?
Cockcroft and Gault (1976) developed a formula to predict creatinine clearance from serum creatinine in adults, adjusted 15% lower for females. It incorporates age and body weight based on 249 patients aged 18-92. This aids dosing adjustments in older adults.
Open Research Questions
- ? How can pharmacist integration in primary care settings be scaled to reduce polypharmacy burdens across diverse elderly populations?
- ? What are the long-term outcomes of structured medication reviews for patients on potentially addictive medications?
- ? How do evolving hospital pharmacy trends impact adverse drug event rates in geriatric care?
- ? What metrics best evaluate the cost-effectiveness of deprescribing interventions in frail older adults?
- ? How can FHIR-based tools like opioid-cds and EBMonFHIR improve real-time detection of inappropriate prescribing?
Recent Trends
Preprints from the last six months highlight pharmacist integration in general practice to tackle polypharmacy, structured medication reviews for addictive drugs, and clinical pharmacy ambulatory impacts over two years.
PCORI awarded funding for eleven patient-centered CER studies and eight methods studies as of December 2025.
American Pharmacists Association gained legislative recognition in 2026 for drug provision competencies.
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