Prescribing practices in an Irish Long Term Care Setting

The elderly constitute 11.4% of the Irish Population and are prescribed 47% GMS prescription medications. Polypharmacy is well described in studies as being the norm and not the exception in the elderly. A long term care setting represents a particular group of these patients having medical problems that are both complex in nature and copious in number. Prescribing practices have not been well documented in the Irish Long Term Care setting. We therefore determined a need to describe prescribing patterns in the Irish Long Term Care Setting. Seventy-six patients were identified in two Long Term Care units. Data collected per patient included type of diagnosis, age, and medication prescribed. Paired data was available on 52 patients at baseline and again at six months. The impact of regular consultant review on prescribing was assessed during this period. We found that the average age of the residents was 80.9 years. Female residents accounted for 75% of the patients and males 25%. There was an average of 8.8 diagnoses per patient. At baseline there was an average of 9.2 medications prescribed per patient. The vast majority of prescriptions were for CNS preparations (42%), followed by Cardiovascular (16%) Gastrointestinal (16%) and Respiratory (6%). Medication prescribed changed in nature but numerically was not reduced by regular consultant review. The number of scheduled medications did not change over six months of review, at 5.5 per patient. However there was an increase in the number of PRN prescriptions from 3.7 to 4.25 per patient. We concluded that there is a higher than expected number of medications prescribed to patients in Long Term Care. On the basis of this descriptive study we recommend that standards be set for Prescribing in Long Term Care.