K Khunti1, B Kinsella. 1. Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, UK. kk22@le.ac.uk
Abstract
BACKGROUND: nursing-home patients usually have many medical problems and often take many drugs. They are therefore at risk from drug side effects and interactions. AIMS: to evaluate the impact of a visit by a general practitioner and a comprehensive repeat prescribing review on the consumption of inappropriate drugs in nursing homes. METHOD: two general practitioners made one comprehensive visit to four randomly selected nursing homes. In each home we discussed all patients in detail with a senior member of staff. We reviewed the prescribing record of each patient and stopped items if we considered them inappropriately prescribed or unnecessary. RESULTS: repeat prescriptions were altered in 65% of patients: 51% had an item stopped and 26% had an item changed to a cheaper alternative or the dose reduced. There was a reduction in the mean number of repeat prescriptions prescribed. CONCLUSIONS: a single visit by a general practitioner to a nursing home and a comprehensive repeat prescribing review can lead to a reduction in the number of items prescribed and to substantial savings for the health service. Further rigorous, cost-effectiveness studies are needed.
BACKGROUND: nursing-home patients usually have many medical problems and often take many drugs. They are therefore at risk from drug side effects and interactions. AIMS: to evaluate the impact of a visit by a general practitioner and a comprehensive repeat prescribing review on the consumption of inappropriate drugs in nursing homes. METHOD: two general practitioners made one comprehensive visit to four randomly selected nursing homes. In each home we discussed all patients in detail with a senior member of staff. We reviewed the prescribing record of each patient and stopped items if we considered them inappropriately prescribed or unnecessary. RESULTS: repeat prescriptions were altered in 65% of patients: 51% had an item stopped and 26% had an item changed to a cheaper alternative or the dose reduced. There was a reduction in the mean number of repeat prescriptions prescribed. CONCLUSIONS: a single visit by a general practitioner to a nursing home and a comprehensive repeat prescribing review can lead to a reduction in the number of items prescribed and to substantial savings for the health service. Further rigorous, cost-effectiveness studies are needed.
Authors: Kjell Lindström; Anders Ekedahl; Anders Carlsten; Jan Mårtensson; Sigvard Mölstad Journal: Scand J Prim Health Care Date: 2007-03 Impact factor: 2.581