Interventions to optimize medication use in nursing homes: a narrative review

Area of Science:

• Gerontology
• Pharmacology
• Health Services Research

Background:

• Polypharmacy, medication errors, and adverse drug events are prevalent in nursing home residents.
• Medication use errors can occur throughout the entire medication management process.

Purpose of the Study:

• To review interventions aimed at optimizing medication use in nursing homes.
• To identify effective strategies, barriers, and enablers for improving medication management in this population.

Main Methods:

• A narrative review of quantitative and qualitative studies, including observational and experimental designs.
• Prioritization of recent studies relevant to the European context.

Main Results:

• Numerous interventions demonstrated improvements in medication use, though outcome heterogeneity complicated comparisons.
• Medication review, multidisciplinary collaboration, and patient-centered care were key micro-level interventions.
• Guidelines, legislation, and technology utilization were significant macro-level and administration-focused strategies.
• Barriers and enablers were identified at individual, organizational, and system levels.

Conclusions:

• Current interventions are effective for optimizing medication use in nursing homes.
• Further large-scale European evaluations are needed for health information technology, patient-centered approaches, specific drug classes, and non-prescribing interventions.
• Development of core outcome sets and qualitative research on implementation barriers are crucial for future intervention design.