Nursing Home Prescribing Remains A Cause For Concern

Main Category: Seniors / Aging
Also Included In: Pharmacy / Pharmacist;  Primary Care / General Practice
Article Date: 09 Sep 2008 - 2:00 PDT

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Research launched at the British Pharmaceutical Conference (BPC) in Manchester has shown that 51% of nursing home patients are taking inappropriate psychoactive drugs. A separate study at BPC describes how inappropriate prescribing of psychoactive drugs may be influenced by organisational and/or treatment culture.

Historically, psychotropic medications have been used in nursing homes to sedate the residents, when there is no clinical need. Two pharmacy studies in Northern Ireland have focused on these drugs.

Researchers investigated the effect of implementing an adapted US model of pharmaceutical care, "The Fleetwood Northern Ireland (NI) model", to evaluate its effect on the number of residents who received inappropriate psychoactive medication and the number who had a fall.

While application of the Fleetwood NI Model led to a 74% decrease in the number of residents who received inappropriate psychoactive medications in intervention homes, there was no effect on the number of residents who experienced a fall. This may be attributed to the fact that falls are influenced by multiple factors.

Lead Fleetwood NI Model researcher, Susan Patterson, said: "In nursing homes, our study indicated that there is a 51% prevalence of inappropriate prescribing. This is a known risk factor for adverse drug events for elderly residents. These results support previous work carried out in Canada showing a prevalence of 55%.

"Pharmacists are the experts in medicines and they have a significant role to play in terms of finding and championing innovations that reduce risks for patients. The Fleetwood NI project has demonstrated that pharmacist intervention can reduce medication risks for nursing home residents and improve the quality of prescribing."

In the second study, staff from two nursing homes were interviewed about prescribing and how it might be influenced by organisational culture. The latter has been defined by some experts as 'the way we do things around here'. They perceived that psychoactive drugs might be prescribed during times of staff shortages, and could be seen as a way of keeping the residents calm and "to make life easier" in some homes.

About the British Pharmaceutical Conference 2008 (BPC)

BPC 2008: Pharmacy in the 21st Century: Adding years to life and life to years. In 2008, as the NHS marks its 60th anniversary year, BPC will examine how pharmacy and the pharmaceutical services are helping to add years to life and life to the year of the UK population. The profession of pharmacy plays an important role in meeting the healthcare challenges associated with the UK's ageing population.

How can pharmacists contribute to caring for the population as well as ensuring quality of life? Increasingly, scientists and practitioners have to consider the cost implications of this conundrum, and the evidence base for all interventions is becoming of paramount importance: BPC 2008 will debate these issues and open up discussion on them.

http://www.bpc2008.org

The main sponsors of BPC 2008 are: Boots The Chemists (Lead Sponsor), AstraZeneca (Associate Sponsor and BPC-PJ Careers Forum Platinum Sponsor), Pharmacists' Defence Association (PDA) (Associate Sponsor) and GSK (BPC- PJ Careers Forum Platinum Sponsor).

Research released at BPC is published in the International Journal of Pharmacy Practice (IJPP).

British Pharmaceutical Conference