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Use of potentially inappropriate drugs in nursing homes
Jyotsna Dhall1, E Paul Larrat, Kate L Lapane
1Department of Applied Pharmaceutical Sciences, University of Rhode Island, Kingston, USA.
Study Objectives:
To examine patterns and determine predictors of inappropriate drug use in nursing homes.
Design:
Retrospective study.
Setting:
One thousand four hundred ninety-two nursing homes in five states.
Patients:
A total of 44,562 residents admitted to nursing homes over 1 year.
Methods:
Frequency of discontinuation and initiation of potentially inappropriate drugs over the first 90 days after admission to a nursing home was calculated. Data were collected using the minimum data set.
Results:
On admission, 33% of residents were receiving at least one potentially inappropriate drug. After 90 days, the drug was discontinued in 16% of these residents. Of those not receiving a potentially inappropriate drug on admission, one was begun in 18%. Demographic factors and number of drugs taken by patients were associated with the use of potentially inappropriate drugs. CONCLUSIONS; Use of potentially inappropriate drugs was prevalent on admission and at 90 days after admission. Discontinuation was highest among patients with conditions for which potentially safer therapeutic alternatives existed.