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Drug use in the nursing home
1Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Annals of Internal Medicine
|August 1, 1995
Summary
Nursing homes require careful medication management for frail patients, balancing effective drug use against risks like polypharmacy. Geriatric pharmacology principles can reduce morbidity, but more research is needed on drug benefits and risks in this population.
Area of Science:
- Geriatric Pharmacology
- Health Services Research
- Clinical Pharmacy
Background:
- Nursing homes care for complex, vulnerable patients requiring intensive pharmacotherapy.
- The nursing home setting presents both opportunities for effective drug use and risks such as polypharmacy and adverse events.
- Interdisciplinary collaboration among healthcare professionals is crucial for drug decision-making in frail, comorbid nursing home residents.
Purpose of the Study:
- To highlight the importance of comprehensive drug regimen review in nursing homes.
- To identify potentially underused beneficial drug therapies for nursing home residents.
- To underscore the need for more research into geriatric pharmacotherapy in this setting.
Main Methods:
- Review of current practices and federal regulations regarding drug use in nursing homes.
- Identification of drug classes requiring careful review (psychoactive medications, analgesics, laxatives).
- Assessment of potential underuse of beneficial therapies (antidepressants, antihypertensives, antithrombotics, calcium, vaccines).
Main Results:
- Nursing homes offer an ideal setting for drug regimen review, often neglected.
- There is a need to quantify and address the underuse of beneficial medications.
- Significant gaps exist in the knowledge base for geriatric pharmacology in nursing homes.
Conclusions:
- Applying established geriatric pharmacology principles can reduce morbidity and functional incapacity in nursing homes.
- More clinical and epidemiologic research is essential to guide pharmacotherapeutic choices.
- Data on efficacy, toxicity, and cost-effectiveness of drugs in nursing home patients are limited and require further investigation.
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