Perspectives on Geriatrics by Pioneers in Aging: Reflections of a Clinical Pharmacist

Joseph T. Hanlon PharmD, MS, BCGP, AGSF

Disclosures

J Am Geriatr Soc. 2021;69(4):896-899. 

In This Article

Hopeful Future of Geriatric Pharmacy Practice and Research

So what does the future hold for Geriatric Pharmacy? There are numerable opportunities in professional organizations, and in the teaching, clinical and research arenas. The profession is supported by a major organization, ASCP and I and others have felt welcomed/valued by both the AGS and the Gerontological Society of America (GSA). Indeed, I served as the Chair of the Health Sciences Section in GSA and two PharmDs have served as president of AGS (Drs. Todd Semla and Sunny Linnebur). Teaching in Colleges/Schools of Pharmacies is supported by ASCP's "Geriatric Pharmacy Curriculum Guide" along with a second edition of a comprehensive textbook entitled "Fundamentals of Geriatric Pharmacotherapy: An Evidence-Based Approach." Regarding clinical practice, currently, there are over 4700 board certified geriatric pharmacists and the number of second year specialty geriatric pharmacy residencies has more than tripled in the past three decades (currently 25 accredited programs). They are supported by evidence from a recent meta-analysis that showed that pharmacist interventions reduce the risk of adverse drug reactions in older adults by 35%.[27] Geriatric pharmacy research however has lagged behind the advances in other areas. There are some hopeful trends that are worth mentioning. Shelly Gray, PharmD, MS heads up a research program at the University of Washington where one of their junior faculty members is the recipient of a Paul B. Beeson Emerging Leaders Career Development Award (K76AG059929; Zach Marcum, PharmD, PhD) and she is Co-PI of a CDC funded study (U01CE002967) entitled "Reducing CNS-Active Medications to Prevent Falls and Injuries in Older Adults." This program also has a research fellowship. The University of Maryland, Baltimore is the site for the Peter Lamy Center on Drug Therapy and Aging and is headed up by Nicole Brandt PharmD, MBA. They have a robust externally funded research program and also hosts a research fellowship. Both Drs. Gray and Brandt are actively involved in the NIA funded US Deprescribing Research Network (USDeN).

It is fitting to end with some definitive recommendations for future research, practice and policy. Regarding the latter, new policy is needed to allow geriatric clinical pharmacists to be paid for their cognitive services in the ambulatory care setting as they are in the nursing home setting. More studies of various interventions to improve inappropriate prescribing that focus on adverse drug events as the primary outcome are needed. In addition, more studies of the optimum strategies for deprescribing and avoiding adverse drug withdrawal events after deprescribing are needed. Finally, it is high time that the Food and Drug Administration be empowered to REQUIRE pharmaceutical companies to include older adults in pre- and post-marketing studies so we can better optimize geriatric pharmacotherapy.

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