Clinical budgeting and drug management on long-stay geriatric wards

Over-prescribing on long-stay wards for the elderly is a common problem. A scheme of senior doctor surveillance of prescribing on long-stay wards in a district general hospital is described, which involved stopping all drugs except those considered essential. A reduction of over 50% in the number of drugs taken per patient, and a saving of 34% in drug costs was achieved, without detriment to patients' well-being. Increased drug utilization on some wards is considered to occur because of the ward sister's demand for patients to be given drugs such as sedatives and tranquilizers. Regular re-education of nursing and junior medical staff to reduce over-prescribing is recommended.