Effect of systematic review of medication by general practitioner on drug consumption among nursing-home residents.
BACKGROUND
nursing-home patients usually have many medical problems and often take many drugs. They are therefore at risk from drug side effects and interactions.


OBJECTIVE
to evaluate the impact of a visit by a general practitioner and a comprehensive repeat prescribing review on the consumption of inappropriate drugs in nursing homes.


METHODS
two general practitioners made one comprehensive visit to four randomly selected nursing homes. In each home we discussed all patients in detail with a senior member of staff. We reviewed the prescribing record of each patient and stopped items if we considered them inappropriately prescribed or unnecessary.


RESULTS
repeat prescriptions were altered in 65% of patients: 51% had an item stopped and 26% had an item changed to a cheaper alternative or the dose reduced. There was a reduction in the mean number of repeat prescriptions prescribed.


CONCLUSIONS
a single visit by a general practitioner to a nursing home and a comprehensive repeat prescribing review can lead to a reduction in the number of items prescribed and to substantial savings for the health service. Further rigorous, cost-effectiveness studies are needed.
Khunti
K
K
Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, UK. kk22@le.ac.uk
Kinsella
B
B
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000367:Age Factors; D016527:Drug Costs; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D017723:Drug Utilization Review / Q000592:standards; D004739:England; D005194:Family Practice / Q000592:standards; D008485:Medical Audit; D009735:Nursing Homes; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D015397:Program Evaluation