Inappropriate medication prescribing in skilled-nursing facilities.

Area of Science:

• Gerontology
• Pharmacology
• Healthcare Management

Background:

• Medication management in nursing homes is complex, with potential for inappropriate prescribing.
• Assessing medication appropriateness is crucial for patient safety and quality of care in long-term facilities.

Purpose of the Study:

• To determine the prevalence and identify risk factors for inappropriate medication prescriptions among nursing home residents.

Main Methods:

• A prospective cohort study involving 1106 residents across 12 nursing homes in Los Angeles.
• Medication appropriateness was assessed using explicit consensus-based criteria developed by expert panels.
• Criteria identified drugs to avoid and maximum recommended doses, frequencies, or durations of use.

Main Results:

• 40% of residents received at least one inappropriate medication order; 7% of all prescriptions were deemed inappropriate.
• Female residents and residents of larger nursing homes were more likely to receive inappropriate prescriptions.
• No association found between inappropriate prescribing and the proportion of Medicaid residents or physician numbers.

Conclusions:

• Inappropriate medication prescribing is a significant issue in nursing home settings.
• Identifying high-risk patient groups (females, residents of large facilities) can guide targeted interventions.
• Further research and interventions are needed to reduce medication errors and improve resident safety.