A 2014 U.S. medical study revealed an alarming pattern in adverse reactions to medication among nursing home residents. The results of that study pointed to the transition of elderly care as a leading cause of inappropriate medication distribution, particularly antibiotics.
Three years later, a study conducted at the University of Groningen in the Netherlands by Hans Wouters, PhD, has resulted in successfully ceasing inappropriate medication in nursing homes using the Multidisciplinary Multistep Medication Review tool (3MR).
Sarah Scarpato, MD, from the internal medicine department at Hospital of the University of Pennsylvania, addressed the 2014 study in which patients were prescribed “an antimicrobial at discharge from an academic quaternary care hospital from January 1, 2014, through December 31, 2014.”
Antibiotic prescription accounted for 76% of inappropriate prescriptions due to clinicians’ unfamiliarity with patients’ courses of medication due to handoffs. “They wrote the prescription with a given duration expecting discharge on a different day or they may just not have been familiar with the recommended durations,” Dr. Scarpato said.
Holly M. Holmes, MD, MS, from the University of Texas Health Science Center McGovern Medical School, Houston co-authored the study, explaining 3MR “consisted of an evaluation of the patient’s perspective, medical history and use of medications; a meeting between the physician and pharmacist; and the execution of medication changes.”
Greg A. Sachs, MD, from the Indiana University School of Medicine and Regenstrief Institute, Indianapolis, also worked with Drs. Wouters and Holmes on the study, observing that “improvements in medication use can be facilitated by working closely with the multidisciplinary team, particularly the consultant pharmacist.”
Following Dr. Scarpato’s observation that “Nearly one-quarter of patients suffer an adverse event from an error in transition of care during hospital discharge,” Wouter’s and Holmes’ 3MR result should be seriously considered by the nursing home community and put into future practice.
Nursing home negligence occurs regularly, and overprescription is far too common. Continued research will help to shed light on the needs for improvement in the sphere of elder residential care.