A multidisciplinary approach to improve drug therapy in nursing homes

Figures & data

Table 1 Number (and %) of DRPs discussed in the multidisciplinary team, changes made, changes maintained after 3 months, and drugs most frequently associated with DRPs in 93 nursing home patients

Type of DRP discussed	N (%)	Management outcome			Drugs most frequently involved (number of times with DRPs)
		Changes not made, N (%)	Changes made, N (%)	Changes maintained after 3 months (% of the changes made), N (%)
Treatment without clear indication	87 (37)	34 (39)	53 (61)	43 (81)	Acetylsalicylic acid (7), citalopram (7), furosemide (8), haloperidol (4)
Inappropriate drug choice	46 (20)	22 (48)	24 (52)	20 (83)	Hydroxyzine (7), zopiclone (3), senna glycosides (3), alimemazine (3)
Drug–drug interaction	26 (11)	16 (62)	10 (38)	8 (80)	Paracetamol/codeine combination (9), metoprolol (5), oxazepam (6), escitalopram (4)
Too high dose	24 (10)	4 (17)	20 (83)	20 (100)	Furosemide (4), memantine (2), sodium picosulfate (2)
Too low dose	22 (9)	6 (27)	16 (73)	15 (94)	Paracetamol (6), calcium/vitamin D combination (2)
Lack of monitoring	18 (8)	0	18 (100)	–	Levothyroxine sodium (4), enalapril (4)
Suboptimal dosing time or formulation	6 (3)	0	6 (100)	5 (83)	–
Need for additional drug	5 (2)	1 (20)	4 (80)	4 (100)	–
Adverse drug reactions	0	0	–	–	–
Total	234 (100)	83 (35)	151 (65)	133 (88)	–

Table 2 Type of changes made according to DRP category

Type of change	DRP category
	No clear indication for drug use	Inappropriate drug choice	Drug–drug interaction	Too high dose	Too low dose	Lack of monitoring	Suboptimal dosing time or formulation	Need for additional drug	Total
Drug discontinuation	40	15	1	1	–	–	1	–	58
Dose adjustment	2	2	4	18	15	–	1	–	42
Monitoring	–	–	3	1	–	18	–	–	22
Drug switch/change of administration	1	3	–	–	–	–	3	1	8
Addition of a new drug	–	–	–	–	–	–	–	3	3
Total	43	20	8	20	15	18	5	4	133

Notes: Data collected 3 months after intervention.