Impact of medication reviews on drug-related problems (DRPs) in older patients living in nursing homes in West Occitania.

ABSTRACT

Despite several guidelines for preventing potentially inappropriate medication (PIM) use in older, their prescription rates remain high (25%). The aim of this study was to determine the impact of medication reviews (MRs) on the drug-related problems (DRPs) in older patients in Elderly Residential Care Homes (nursing homes [NHs]). DRP was defined as an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes. We conducted a retrospective study on 2819 residents of the 46 NHs between 1 January 2017 and 31 December 2018. Drug prescription was analysed according to European EU(7)-PIM list and START/STOPP list. We then linked each PIM to an appropriate type of DRP. Three months later, we requested the 'updated' drug prescriptions to assess whether the recommendations had been followed. A total of 17 850 prescription lines were registered. A DRP was identified for 25% of them. Following the second request, 13 NHs (28%) responded. About 26% (n = 1188) of the overall prescriptions lines identified as a DRP involved these 13 NHs, which resulted in a recommendation being made during the first MR. Data from the second MR suggested that 53.9% (n = 640) of recommendations were followed with the requested change 32.0% involved drug withdrawal (n = 381), 9.7% concerned dose adjustment (n = 115) and 6.5% required drug changes (n = 77). Our results show the benefit impact of MR on the quality of drug prescription in older NH residents. MRs should be one of the tools used to improve drug prescriptions in the elderly.