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A multidisciplinary approach to improve drug therapy in nursing homes

Management of drug therapy in nursing home patients is challenging due to complex health problems, use of multiple medications, and age-related changes in pharmacokinetics and pharmacodynamics. The objective of this study was, first, to examine the effect of systematic medication reviews conducted b...

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Autores principales: Davidsson, Malin, Vibe, Olaug Elisabeth, Ruths, Sabine, Blix, Hege Salvesen
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065561/
https://www.ncbi.nlm.nih.gov/pubmed/21468243
http://dx.doi.org/10.2147/JMDH.S15773
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author Davidsson, Malin
Vibe, Olaug Elisabeth
Ruths, Sabine
Blix, Hege Salvesen
author_facet Davidsson, Malin
Vibe, Olaug Elisabeth
Ruths, Sabine
Blix, Hege Salvesen
author_sort Davidsson, Malin
collection PubMed
description Management of drug therapy in nursing home patients is challenging due to complex health problems, use of multiple medications, and age-related changes in pharmacokinetics and pharmacodynamics. The objective of this study was, first, to examine the effect of systematic medication reviews conducted by multidisciplinary nursing home teams on prescribing quality and, second, to evaluate if drug therapy changes were maintained over time. Patients in a large nursing home in Oslo, Norway, were prospectively followed during a 1.5-year period. Systematic comprehensive medication reviews were carried out and the identified drug-related problems (DRPs) were discussed at multidisciplinary team meetings. After 3 months, the patients’ drug regimens were reviewed again to evaluate if drug therapy changes were maintained. Altogether, 93 patients were included (89% women, mean age 87 years). In total, 234 DRPs were identified in 82 patients, and 151 drug therapy changes were performed in 73 patients. The most common DRPs were ‘drug treatment without a clear indication’ (37% of all DRPs) and ‘treatment with an inappropriate drug’ (20%). After 3 months, 85 patients (91%) were available for follow-up. In these patients, 133 (88%) of the drug therapy changes were maintained, and the mean number of DRPs had decreased from 2.6 to 1.0 per patient (P < 0.01). We were able to demonstrate that medication reviews conducted by multidisciplinary teams were effective to improve the quality of drug treatment in nursing home patients by significantly reducing both number of drugs and number of DRPs. The large majority of drug therapy changes were maintained after 3 months.
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spelling pubmed-30655612011-04-05 A multidisciplinary approach to improve drug therapy in nursing homes Davidsson, Malin Vibe, Olaug Elisabeth Ruths, Sabine Blix, Hege Salvesen J Multidiscip Healthc Original Research Management of drug therapy in nursing home patients is challenging due to complex health problems, use of multiple medications, and age-related changes in pharmacokinetics and pharmacodynamics. The objective of this study was, first, to examine the effect of systematic medication reviews conducted by multidisciplinary nursing home teams on prescribing quality and, second, to evaluate if drug therapy changes were maintained over time. Patients in a large nursing home in Oslo, Norway, were prospectively followed during a 1.5-year period. Systematic comprehensive medication reviews were carried out and the identified drug-related problems (DRPs) were discussed at multidisciplinary team meetings. After 3 months, the patients’ drug regimens were reviewed again to evaluate if drug therapy changes were maintained. Altogether, 93 patients were included (89% women, mean age 87 years). In total, 234 DRPs were identified in 82 patients, and 151 drug therapy changes were performed in 73 patients. The most common DRPs were ‘drug treatment without a clear indication’ (37% of all DRPs) and ‘treatment with an inappropriate drug’ (20%). After 3 months, 85 patients (91%) were available for follow-up. In these patients, 133 (88%) of the drug therapy changes were maintained, and the mean number of DRPs had decreased from 2.6 to 1.0 per patient (P < 0.01). We were able to demonstrate that medication reviews conducted by multidisciplinary teams were effective to improve the quality of drug treatment in nursing home patients by significantly reducing both number of drugs and number of DRPs. The large majority of drug therapy changes were maintained after 3 months. Dove Medical Press 2011-01-11 /pmc/articles/PMC3065561/ /pubmed/21468243 http://dx.doi.org/10.2147/JMDH.S15773 Text en © 2011 Davidsson et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Original Research
Davidsson, Malin
Vibe, Olaug Elisabeth
Ruths, Sabine
Blix, Hege Salvesen
A multidisciplinary approach to improve drug therapy in nursing homes
title A multidisciplinary approach to improve drug therapy in nursing homes
title_full A multidisciplinary approach to improve drug therapy in nursing homes
title_fullStr A multidisciplinary approach to improve drug therapy in nursing homes
title_full_unstemmed A multidisciplinary approach to improve drug therapy in nursing homes
title_short A multidisciplinary approach to improve drug therapy in nursing homes
title_sort multidisciplinary approach to improve drug therapy in nursing homes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065561/
https://www.ncbi.nlm.nih.gov/pubmed/21468243
http://dx.doi.org/10.2147/JMDH.S15773
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