Patient focused drug surveillance on elderly patients with chronic diseases in nursing homes
International Journal of Integrated Care, 4 June 2008 - ISSN 1568-4156
Conference abstract
Patient focused drug surveillance on elderly patients with chronic diseases in nursing homes
Inger Nordin Olsson, MD, PhD-student, Family Medicine Research Centre, School of Health and Medical Science, Örebro University, Örebro, Sweden
Peter Engfeldt, MD, PhD, Family Medicine Research Centre, School of Health and Medical Science, Örebro University, Örebro, Sweden
Correspondence to: Inger Nordin Olsson, Family Medicine Research Centre, School of Health and Medical Science, Örebro University, PO Box 1613, 701 16 Örebro, Sweden, E-mail: inger.nordin-olsson@orebroll.se
Abstract


Background: Modern drugs have made great contributions to better quality of life, less disabling symptoms, decreased demands of health care and a better prognosis. Despite this, one can nowadays notice an increasing proportion of negative side effects and adverse drug reactions due to extensive pharmacological treatment.


Study objectives: To examine if patient-focused drug surveillances were associated with a higher quality of drug treatment at nursing homes?


Methods: Physicians were told to systematically focus on the patient's basic health status as a fundamental starting point for further continuous medication, with the aim to obtain a rational drug usage.


Setting: An intervention study in nursing homes in Sweden.


Outcomes: Mortality, health care consumption and number of drugs. Health status and evaluation of drug therapy.


Results: No significant difference in mortality rate. Extensive health care consumption in both groups. Significant differences of examinations like weight, blood pressure and renal function. Monitoring and evaluation of medications showed significant differences favouring the intervention group. Due to existing polypharmacy there was a significant reduction of number of drugs in the intervention group vs. a significant increase in the control group.


Conclusions: The intervention seemed to have achieved significant positive results in ‘quality of drug treatment’, although it has shown immense lacks of monitoring the health status of frail elderly.

Keywords
care for the elderly; medication; safety; chronic diseases

Presentation slides available from: http://www.integratedcarenetwork.org/Sweden2008/slides/02-06-nordin-olsson.ppt