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Medication prescriptions of residential home patients compared to nursing home patients

Versteeg, M. (2013) Medication prescriptions of residential home patients compared to nursing home patients.

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Abstract:Background: Polypharmacy, the prescription of multiple medications and the prescription of potential inappropriate medications (PIMs) seem to be highly prevalent in elderly patients and are often associated with adverse drug events. Polypharmacy and PIMs seem to occur more often in elderly with medications prescribed by general practitioners, compared to elderly with medication prescribed by nursing home physicians. In this study possible differences in the medications prescribed to residential home and nursing home patients were studied and factors influencing medication prescriptions to elderly were investigated. Methods: A descriptive comparative study was conducted to explore possible differences in the medications prescribed to residential home patients and nursing home patients. The medication prescriptions were examined for the presence of polypharmacy, the number of medications prescribed and the number of PIMs prescribed. Factors influencing medication prescriptions of nursing home physicians and general practitioners to elderly patients were investigated by a questionnaire filled out by the concerned physicians. Results: The medication prescriptions of 21 nursing home patients and 37 residential home patients were analyzed. In complex patient groups, patients with intensity of care package (ZZP) ≥ 3 and the number of co morbidities ≥ 3, and patients with ZZP ≥ 4 and the number of co morbidities ≥ 3, the mean number of medications prescribed per patient was significantly higher within the residential home patients, compared to the nursing home patients (p = respectively .012 and .009). In the complex patient groups, significantly more residential home patients had polypharmacy compared to the nursing home patients. No significant differences were found in the prescription of PIMs between the nursing home patients and the residential home patients. The number of PIMs prescribed was significantly related to the number of medications prescribed. Almost half of the physicians seemed to have reasons to be more likely to prescribe medications when it concerned an elderly patient, and when a patient wanted to get medications prescribed. None of the physicians intensively used the STOPP criteria. Conclusions: Medication prescribed to residential home patients at certain points significantly differ from medication prescribed to nursing home patients. Because of the small sample, but significant relevant differences found in this study, it would be interesting to conduct a similar but larger study in The Netherlands investigating differences in medications prescribed to residential and nursing home patients. In this study, no final answers could be given about factors causing the differences found in the prescribed medications. It is not known whether geriatric training, experience and/or criteria/guidelines reduce the prescription of multiple medications, PIMs and polypharmacy to elderly patients, therefore more research should be conducted to study these factors in Dutch nursing homes and residential homes.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/63850
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