Effect of clinical pharmacy input on physician prescribing habits in the nursing home care unit

The goal of this study was to evaluate any changes in medication use in our 60-bed nursing home care unit as a result of eliminating clinical pharmacy services during a 2-week period. Information was obtained on patient medications and number of doses dispensed. All patients were found to have a 6% increase in average number of scheduled medications, a 3% increase in average total medications, and an increase in scheduled doses dispensed by 10% during the absence of clinical pharmacy services. These numbers declined by 16, 18, and 9%, respectively, 2 weeks after the return of clinical pharmacy services. When evaluating only those 37 patients present the entire 4 week period, average scheduled medications rose 5% and total medications rose 4% during the absence of clinical pharmacy services and declined 13 and 17%, respectively, upon return of services. Eleven patients showed an increase in total number of medications during the absence of clinical pharmacy services whereas 21 patients showed a decline in medications after the return of clinical pharmacy services (P less than 0.001). The authors conclude that clinical pharmacy services must be provided on a continuous basis to maintain good physician prescribing habits in the nursing home care unit.