Comparison of Medication Prescribing Before and After the COVID-19 Pandemic Among Nursing Home Residents in Ontario, Canada

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Abstract
The COVID-19 pandemic has had a devastating effect on the quality of care and lives of at-risk older adults.1,2 Persons of advanced age with complex chronic conditions, many of whom reside in nursing homes, have high rates of infection3,4 and adverse health-related outcomes with COVID-19.5,6 In economically advantaged countries, 50% to 80% of COVID-19–related early deaths occurred among older adults in congregate care settings such as nursing homes.7 There was widespread transmission of SARS-CoV-2 in these settings, partially owing to structural and operating factors.8-12 Resulting workforce shortages and visitor restrictions led to both inadequate staffing13,14 and the barring of essential support by family and friends from these homes.15 The decline in available clinicians and other health care professionals, along with resident isolation and disruptions in communication, activities, and services during the pandemic, may have resulted in less timely and/or less appropriate clinical care and oversight, including in the management of medications.16

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