Evaluation of the quality of drug therapy among elderly patients in nursing homes

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Abstract
Objective. To evaluate drug therapy quality among elderly nursing home residents. Secondary aims were to compare quality in young and old elderly and to determine whether number of prescribers affected quality of drug therapy. Design. A cross-sectional population-based register study. Setting. Nursing home residents in the Gothenburg area using the multi-dose system (e.g. patients who get their drugs machine dispensed into one unit for each dose occasion, a service offered by the National Corporation of Pharmacies). Subjects. All nursing home residents aged 65 years and older. Main outcome measures. The quality of drug therapy assessed using five quality indicators for the elderly recently introduced by the Swedish National Board of Health and Welfare; number of prescribed drugs per resident. Results. Over 70% of residents had one or more potentially inappropriate prescription. Younger nursing home residents (65–79 years) had significantly (p < 0.001) lower quality of drug therapy than older residents (80 + ). The average number of prescribing physicians per resident was high at almost four per resident. An increasing number of prescribers per resident was associated with a higher number of drugs prescribed and a lower quality of drug therapy. Conclusion. Computerized quality assurance systems can provide support for healthcare providers. Quality indicators should be modified to give maximum support for users.

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