Safe Medication Management in Nursing Homes

DOI: 10.3238/zfa.2019.0059-0065

german translation / full article

Tanja Schleef, Ulrike Junius-Walker, Olaf Krause

Keywords: family physician interprofessional collaboration medication review nursing home pharmacist

Background: Polypharmacy and the use of potentially inappropriate medications (PIM) adversely affect drug safety for nursing home residents (NHRs). Also, the lack of collaboration between professionals managing medications in nursing homes – family practitioners (FPs), nursing staff and pharmacists – can further contribute to this issue. We conducted a pilot study to test the implementation of a pharmacist-led medication review coupled with an interdisciplinary visit. The aims were to evaluate the collaboration of the professionals and the effects on the quality of NHRs‘ medication. Methods: An ATHINA-trained pharmacist (training programm for pharmacists to perform medication reviews) conducted medication reviews on the basis of the NHRs‘ medication charts and generated recommendations. The study protocol envisaged a subsequent meeting between the participating professionals. They decided how to implement the meeting. The analysis involved a pre-post comparison of NHRs-related medication data and interviews to learn about the professionals‘ views on their collaboration. Results: 12 NHRs,their responsible nursing supervisor, the supplying pharmacist, and their FPs (N = 3) participated. The pharmacist considered 152 medications in the reviews, and informed about interactions, PIM and double prescribing. As a consequence, medications were reduced from on average 13.6 to 11.8 per NHR. All participating professionals acknowledged the benefit of such an intervention but importance attribution differed between them. Conclusions: Involving pharmacists in the clinical medication management appears to improve drug safety and the awareness for it. Future studies should address clarifying roles, role expectations and co-operation between involved professionals.

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