Monitoring drug therapy in skilled nursing facility patients

Area of Science:

• Gerontology
• Pharmacology
• Health Services Research

Background:

• Skilled nursing facilities (SNFs) face federal requirements for drug therapy monitoring.
• Pharmacists play a crucial role in ensuring safe and effective medication use in elderly patients.
• Existing drug usage data analysis methods may not fully meet facility utilization review needs.

Purpose of the Study:

• To present a system for monitoring drug therapy in SNF patients.
• To enable pharmacists to meet federal drug therapy monitoring requirements.
• To facilitate the gathering and analysis of drug usage data for utilization review.

Main Methods:

• Development and testing of a drug therapy monitoring system in five SNFs.
• Conducting follow-up studies at the same facilities for comparative analysis.
• Analyzing drug usage data for specific medications, including digoxin and hydrochlorothiazide.

Main Results:

• The developed system was tested across multiple skilled nursing facilities.
• Data analysis focused on two key drugs: digoxin and hydrochlorothiazide.
• High rates of nonconformance to established drug therapy criteria were observed.

Conclusions:

• The system supports pharmacists in fulfilling federal drug therapy monitoring mandates.
• Significant instances of inappropriate drug therapy were identified in SNF patients.
• Further investigation is needed to understand and address the reasons for nonconformance.