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Decreasing medication use in a nursing-home patient-care unit.
1Bay Pines Veterans Affairs Medical Center, St. Petersburg, FL.
American Journal of Hospital Pharmacy
|January 1, 1992
Summary
A pharmacist implemented a computerized drug review and standing-order policy in a nursing home, significantly reducing patient medication use and saving costs. This initiative lowered average medications per patient and decreased routine drug administration.
Area of Science:
- Gerontology
- Pharmacology
- Health Services Research
Background:
- Nursing home residents often have complex medication regimens.
- Polypharmacy in older adults increases the risk of adverse drug events and healthcare costs.
Purpose of the Study:
- To evaluate the impact of a computerized drug regimen review and expanded clinical pharmacy services on medication use in a nursing home.
- To assess the effectiveness of a pharmacist-led intervention in reducing the number of medications per patient.
Main Methods:
- A full-time pharmacist was assigned to a 120-bed nursing home care unit.
- Implemented a monthly, computer-generated drug regimen review report to track and recommend medication reductions.
- Initiated a standing-order policy to streamline medication use and reduce as-needed (p.r.n.) orders.
Main Results:
- Average medications per patient decreased from 7.20 to 5.34 within one year.
- Routinely scheduled medication use was reduced by approximately 30%.
- Calculated cost savings of approximately $27,400 based on medication costs.
Conclusions:
- A pharmacist can effectively reduce medication use in nursing home settings through systematic review and policy implementation.
- Computerized drug regimen review and standing orders are valuable tools for optimizing pharmacotherapy in long-term care.
- Interventions targeting polypharmacy in nursing homes can lead to significant cost savings and potentially improved patient outcomes.