2026 Eastern States Conference

Title 
Assessing the acceptance of pharmacist recommendations and impact on polypharmacy management in ambulatory care 
 
Authors 
Primary Author: Peaches Brown, PharmD, Bayhealth Medical Center, Delaware 
Co-Author: Amanda Kobylinski, PharmD, BCGP 
 
Learning Objective 
At the conclusion of this activity, participants will be able to describe acceptance of pharmacist recommendations and their impact on polypharmacy management in ambulatory care. 
 
Self-Assessment Question 
What impact do pharmacist-led medication recommendations have on reducing polypharmacy in ambulatory care settings?  
 
Background 
Polypharmacy, defined as the use of five or more medications, increases the risk of drug-related problems and adverse outcomes, particularly in older adults. This study evaluated acceptance of pharmacist recommendations and their impact on polypharmacy management in ambulatory care. 
 
Methods 
This retrospective, multicenter chart review included adults at least 18 years of age who were prescribed at least 5 medications and were referred for pharmacist-led polypharmacy review from January 1, 2024, to June 30, 2025, within a community health system in Delaware. Data collected included demographics, the total number of medications, the number of recommendations provided by the clinical pharmacist, and the number of recommendations which were accepted by the consulting provider.  Secondary outcomes included number and type of potentially inappropriate medications based on Beers Criteria and clinical judgment. Descriptive statistics and Wilcoxon rank-sum testing were used. 
 
Results 
Patients with accepted pharmacist recommendations had substantially more deprescribed medications than patients whose recommendations were not accepted. This difference was statistically significant (Wilcoxon rank-sum p < 0.001) and represented the strongest observed association in the study. 
 
Conclusion 
The acceptance of pharmacist recommendations by clinicians was associated with meaningful reductions in polypharmacy in our patient population. These findings support the role of pharmacists in optimizing medication use and highlight opportunities to improve provider–pharmacist collaboration in ambulatory care.