Date of Completion

Spring 5-27-2026

Degree Type

Open Access Project

Degree Name

Doctor of Nursing Practice (DNP)

Faculty Advisor

Kellie Olsen, DNP, NP-C, AOCNP, OCN, CBCN

Practice Site Mentor

Craig Drew, RN, DNP, APRN

Committee Mentor

Eileen Stuart-Shor, Ph.D., APRN

Abstract

BACKGROUND: Community-dwelling adults are at risk for adverse drug events such as falls, hospitalizations, cognitive decline, drug-to-drug interactions, and mortality related to high-risk medication use and polypharmacy, often defined as concurrent use of five or more different medications. Lack of provider knowledge of polypharmacy and high-risk medication use as well as suboptimal communication with primary care providers can lead to gaps in medication management in this vulnerable population.

LOCAL PROBLEM: Patients seen by the Comprehensive Annual Health Assessment Program advanced practice clinicians (APCs) at the project Medicare Advantage insurer organization often experience polypharmacy. Given the lack of provider knowledge of polypharmacy and high-risk medication use, as well as inadequate communication with patient primary care providers (PCPs), these patients are at risk for adverse drug events which increases the likelihood of poor outcomes.

METHODS: A systematic review of the literature was conducted to identify strategies to address polypharmacy and high-risk medication use in community-dwelling adults. Six themes emerged from the literature and improving provider knowledge was chosen to address the lack of information on the topic of polypharmacy. The purpose of the project was to improve provider knowledge on high-risk medication use and improve communication with patients and PCPs. The overall aim of the project was to co-design, implement, and evaluate a provider-focused asynchronous multimodal educational initiative to address polypharmacy and high-risk medication use and improve communication with patients and PCPs.

INTERVENTION: The initiative, aligned to the Chronic Care Model, was designed to improve healthcare quality and safety, and involved the creation of a co-designed asynchronous multimodal educational presentation for APCs on the topic of polypharmacy. The initiative incorporated the updated 2023 American Geriatric Society (AGS) Beers Criteria, all components of the local problem, and post-visit patient education.

RESULTS: This was a rolling pre-test post-test design quality improvement study conducted from October 2025-December 2025. Four of the six specific project aims were met. This project demonstrated that a multimodal educational initiative improved advanced practice provider knowledge, confidence, behavior and attitudes towards polypharmacy and high-risk medication use and improved communication with patients and PCPs.

CONCLUSIONS: Through adapted training and local leadership support, 100% of APCs who participated in the quality improvement project reported improvement in in-home assessment practices and enhanced patient care for older adults with high-risk medication use. Findings from this quality improvement project suggest the need for more educational initiatives such as this to impact provider knowledge and confidence around the AGS Beers Criteria, improve provider communication, and reduce risks of polypharmacy and high-risk medication use in older adults.

Comments

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