(PO-148) Interprofessional Care Rounds: Pharmacy and Dental Review of Medication Problems

Author: Kimberly A. Sanders – Assistant Professor, Clinical Pharmacist, University of North Carolina at Chapel Hill Adams School of Dentistry
Author: Lirong Yang, BS Clinical Pharmacy – University of North Carolina at Chapel Hill
Submitter: Kimberly A. Sanders – Assistant Professor, Clinical Pharmacist, University of North Carolina at Chapel Hill Adams School of Dentistry

ObjectiveThis retrospective study assessed the impact of the interprofessional clinical care discussion (IPCCD) rounds involving dental and pharmacy students by evaluating medication-related problems (MRPs) identified by pharmacy students and discussion topic types covered with dental students.

Method: Third-year dental students submitted medically complex patient cases active in their care for pharmacy consultation in a peer-to-peer format based on patients' medical and medication histories. Second-year pharmacy students with their pharmacy faculty preceptor reviewed the patient charts, identified MRPs, and documented their interactions with the dental students. Analysis of the 76 patient cases discussed are described.

Results: Submitted patient case demographics were mean age of 71 years (55.3% female). Average number of medical conditions per patient was six and average number of medications per patient was 11. The three most common medical conditions encountered were hypertension (87%), hyperlipidemia (64%), and diabetes (45%). Most common reasons for dental encounter were chronic periodontitis (28%) and caries management (29%). Based on the dental-adapted MRP framework, drug safety was the most common MRP type discussed (20%). Of the patient case topics, 66% included covering adverse drug effects (ADEs) and 36% covered potentially harmful drug-drug interactions (DDIs), such as medications associated with increased bleeding risk. Geriatric medication use concerns were also identified including increased risk of orthostatic hypotension and falls (17%), drug-induced hypoglycemia (11%), appropriateness of benzodiazepine use (9%). Most common medication-related oral health ADEs discussed were xerostomia (46%), gingival hyperplasia (12%), dysgeusia (7%), and oral thrush associated with inhaler use (4%).

Conclusion: The IPCCD rounds model involving dental and pharmacy students can help identify significant medication-related problems including risks of overall ADEs, harmful DDIs, and oral health ADEs, especially in high-risk older adult populations. It serves as an interprofessional education model that encourages peer-to-peer teaching and informs future implementation of dentistry-pharmacy collaborations.