Drug therapy review in nursing homes: proposed standards and guidelines

In 1974, the Department of Health, Education, and Welfare mandated monthly drug regimen reviews by pharmacists for all Medicaid-financed residents in skilled nursing facilities. In 1980, proposed federal regulations were developed to extend the benefit of that type of review to residents of intermediate care facilities. The Government Accounting Office, in the meantime, found that a definition of the scope of medication review is still lacking, as is a single source of information on drug monitoring. As the proposed regulations and the corresponding guidelines appear to have severe shortcomings, the authors developed new standards and guidelines for the Baltimore City PSRO. Foremost in these is the statement that drug regimen review is not complete until the physician has responded in writing in the patient's chart to any recommendation the pharmacist-consultant has made.