Engelsk titel: Pharmacotherapy in nursing homes - how appropriate is the quality?
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Författare:
Ruths, Sabine
Email: sabine.ruths@isf.uib.no
Språk: Nor
Antal referenser: 17
Dokumenttyp:
Översikt
UI-nummer: 11067570
Sammanfattning
Aim: To summarize actual knowledge on general drug therapy and prescribing quality in nursing homes in Scandinavia.
Material and methods: Search in Pubmed and Embase (1990-2010) for nursing homes and drug therapy identified 13 Norwegian, 3 Danish and 15 Swedish studies. Studies on general drug and prescribing quality were selected while studies on specific drug groups were excluded. Seven articles from Norway and 4 from Sweden were included, none from Denmark.
Results: Mean numbers of regular drugs per patient vary from 4.6 to 9.6. Overall drug use appears to be lower in Norwegian than in Swedish nursing homes. All studies show that laxatives are used by a majority of patients. More mentally intact patients than those with dementia use drugs for somatic conditions, while relatively more patients with than without dementia use psychotropics.
Drug-related problems are common. Following factors may be associated with poor prescribing quality: mentally healthy, age <80 years, various prescribers, limited physician time. Unnecessary drugs and lack of monitorering are the most common problems. Psychotropics are frequently involved in the problems. Severe drug-drug interactions are scarce.
Conclusion: Studies indicate large potentials for improving prescribing quality in nursing homes. Systems and routines should be implemented for regular medication reviews in order to provide safe drug therapy to this particularly vulnerable population.