[Medication safety for nursing home residents]

Abstract

Due to demographic change, the number of elderly patients in need of long-term care is continuously increasing. Residents in nursing homes often suffer from various chronic diseases leading to the prescription of a plethora of drugs and a high risk for adverse drug reactions (ADR). Particularly, CNS-active drugs are critical in this context. Moreover, the medication process in nursing homes is complex with numerous interfaces and error sources. Therefore, medication safety for long-term care residents is regarded as a multiprofessional challenge.In Germany, several model projects have been conducted and initiated that aim at enhancing medication safety in nursing homes. The AMTS-AMPEL project is the largest intervention study so far dealing with medication safety in German long-term care facilities. After implementation of a complex multiprofessional intervention consisting of educative and structural measures, prevalence and incidence of preventable ADR could be significantly reduced. This and other projects suggest that medication safety in long-term care residents can be improved by targeted multiprofessional interventions.Although there is already evidence that interventions enhancing medication safety can improve medication appropriateness and solve drug-related problems, they still lack evidence of affecting clinical endpoints like hospitalization rate and mortality. Nevertheless, the model projects already enhance patient safety by increasing the awareness for risks in the medication process in long-term care facilities.

Keywords: Adverse drug reactions; Elderly patients; Long-term care; Medication process; Polymedication.