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Medications in long-term care: when less is more.
Thomas W Meeks1, John W Culberson, Monica S Horton
1Department of Psychiatry, Division of Geriatric Psychiatry, University of California, La Jolla, San Diego, CA 92093, USA. tmeeks@ucsd.edu
Clinics in Geriatric Medicine
|June 7, 2011
Summary
Potentially inappropriate medications, especially those affecting the central nervous system, pose risks in long-term care. This review highlights concerns and the need for critical medication review to improve patient safety.
Area of Science:
- Gerontology
- Pharmacology
- Clinical Pharmacy
Background:
- Long-term care facilities face challenges with medication safety.
- Certain medications, particularly those acting on the central nervous system, are frequently associated with adverse events in older adults.
- Lack of regular medication review contributes to prolonged use of potentially inappropriate drugs.
Purpose of the Study:
- To raise awareness of potentially inappropriate prescribing (PIP) in long-term care.
- To review the rationale behind classifying specific medications as inappropriate for this setting.
- To focus on central nervous system (CNS) acting agents commonly implicated in PIP.
Main Methods:
- Literature review of studies and guidelines on medication appropriateness in long-term care.
- Analysis of common drug classes associated with risks in the elderly population.
- Discussion of factors contributing to the continued use of inappropriate medications.
Main Results:
- A significant number of medications used in long-term care are deemed inappropriate.
- Central nervous system medications are a primary concern due to their potential for adverse effects.
- Prescribing often lacks clear indications and fails to consider deprescribing opportunities.
Conclusions:
- There is a growing recognition of the risks associated with potentially inappropriate medications in long-term care.
- Systematic medication reviews and deprescribing initiatives are crucial for enhancing patient safety.
- Focusing on CNS agents can mitigate significant risks in this vulnerable population.
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