A nurse practitioner led protocol to address polypharmacy in long-term care

Area of Science:

• Gerontology
• Pharmacology
• Nursing Practice

Background:

• Polypharmacy is prevalent in long-term care facilities, often linked to adverse patient outcomes.
• Managing multiple medications in this setting presents significant challenges for residents and healthcare providers.

Purpose of the Study:

• To evaluate the impact of a nurse practitioner (NP)-led medication management protocol on polypharmacy and administration times in long-term care residents.
• To assess if regular, interval-based medication reviews by NPs can reduce medication burden.

Main Methods:

• A medication management protocol was implemented by NPs for long-term care residents at admission and every four months, or with acute condition changes.
• Data was collected from 2442 residents participating in a Centers for Medicare and Medicaid Services (CMS) grant initiative.
• The study analyzed changes in the number of scheduled medications and administration times.

Main Results:

• The protocol did not lead to a significant reduction in the total number of regularly scheduled medications.
• A statistically significant decrease was observed in the number of scheduled medication administration times per resident.
• NP assessments and recommendations, while valuable, were insufficient to decrease the overall medication burden.

Conclusions:

• While the NP-led protocol did not reduce the overall medication count, it effectively streamlined medication administration schedules.
• Further strategies are needed to address and reduce the medication burden in long-term care settings.
• The findings underscore the importance of NP involvement in medication management, particularly in optimizing administration frequency.