| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 1998 Oxford University Press
research-article |
Medication prescribing and administration in nursing homes
Department of Medicine, University of Queensland, Princess Alexandra Hospital Woolloongabba, Queensland, Australia 4102
1Department of Social and Preventive Medicine, University of Queensland Herston, Queensland, Australia
2Welsh School of Pharmacy Cardiff, UK
Address correspondence to: M. S. Roberts. Fax: (+61) 7 3240 5806. E-mail: M.Roberts{at}mailbox.uq.edu.au
OBJECTIVE:: to examine the key determinants of pharmaco-epidemiology in Australian nursing homes.
DESIGN:: a cross-sectional survey of medication use in 998 residents in 15 nursing homes in Southern Queensland and Northern New South Wales.
RESULTS:: the total, laxative, digoxin/diuretic, benzodiazepine and psycholeptic medication prescribed and administered to residents of nursing homes was affected to differing extents by age and gender, the nursing home, resident functional disability and medical practitioner. Resident Classification Instrument (RCI) category and nursing home were the dominant determinants for prescribing and administration of the total drugs, laxative, benzodiazepine and psycholeptic medications. In contrast, the resident use of digoxin and/or diuretics was dependent on the resident age and on the functional disability (RCI category) of the resident but not medical practitioner or nursing home. Approximately 30% of medications were prescribed on a pro re nata (p.r.n.) basis and administered at the discretion of registered nurses.
CONCLUSION:: nursing home culture is a major determinant of the variability in medication use between residents, particularly for those medications often prescribed for p.m. use. The nursing home does not account for variation in the use of digoxin and/or diuretics which are prescribed on a non-discretionary basis.
Keywords: cross-sectional studies, decision making, drug prescriptions, drug utilization, frail elderly people, pharmaco-epidemiology, physician's practice patterns, nurses, nursing homes
Received February 26, 1997;
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. Isralowitz, A. Reznik, and S. Borkin Late-life benzodiazepine use among Russian-speaking immigrants in Israel. Gerontologist, October 1, 2006; 46(5): 677 - 679. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Snowdon, S. Day, and W. Baker Audits of medication use in Sydney nursing homes. Age Ageing, July 1, 2006; 35(4): 403 - 408. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Ruths, J Straand, and H A Nygaard Multidisciplinary medication review in nursing home residents: what are the most significant drug-related problems? The Bergen District Nursing Home (BEDNURS) study Qual. Saf. Health Care, June 1, 2003; 12(3): 176 - 180. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Cheek and T. Gibson Issues impacting on registered nurses providing care to older people in an acute care setting Journal of Research in Nursing, March 1, 2003; 8(2): 134 - 149. [Abstract] [PDF]
|
|