Reduction of irrational drug duplication in geriatric nursing homes

The reduction of irrational drug duplication by rigorous drug regimen review, in-service education, and physician acceptance of consultant pharmacist recommendations in a 72-bed geriatric long-term-care facility is described. In decreasing order of frequency of duplication, laxatives, analgesics, NSAIDs, diuretics, hypnotics, antipsychotics, KC1 supplements, hematinics/vitamins, antacids, and antinauseants and antidiarrheals were the drug classes most often duplicated. Apparent reasons for the duplications were confusion over the term "of choice," physician convenience, failure to review medication orders actively, and individual nurse preferences for different agents in each duplicated drug class.