Medication monitoring for people with dementia in care homes: the feasibility and clinical impact of nurse-led monitoring.
OBJECTIVE
People with dementia are susceptible to adverse effects of medicines. However, they are not always closely monitored. We explored (1) feasibility and (2) clinical impact of nurse-led medication monitoring.


METHODS
Feasibility "before-and-after" intervention study.


METHODS
Three care homes in Wales.


METHODS
Eleven service users diagnosed with dementia, taking at least one antipsychotic, antidepressant, or antiepileptic medicine.


METHODS
West Wales Adverse Drug Reaction (ADR) Profile for Mental Health Medicines.


METHODS
(1) Feasibility: recruitment, retention, and implementation. (2) Clinical impact: previously undocumented problems identified and ameliorated, as recorded in participants' records before and after introduction of the profile, and one month later.


RESULTS
Nurses recruited and retained 11 of 29 eligible service users. The profile took 20-25 minutes to implement, caused no harm, and supplemented usual care. Initially, the profile identified previously undocumented problems for all participants (mean 12.7 (SD 4.7)). One month later, some problems had been ameliorated (mean 4.9 (3.6)). Clinical gains included new prescriptions to manage pain (2 participants), psoriasis (1), Parkinsonian symptoms (1), rash (1), dose reduction of benzodiazepines (1), new care plans for oral hygiene, skin problems, and constipation.


CONCLUSIONS
Participants benefited from structured nurse-led medication monitoring. Clinical trials of our ADR Profile are feasible and necessary.
Department of Nursing, The College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales SA2 8PP, UK.
Sue
S
Jordan
Department of Nursing, The College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales SA2 8PP, UK.
Marie
M
Gabe
Department of Nursing, The College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales SA2 8PP, UK.
Louise
L
Newson
Department of Nursing, The College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales SA2 8PP, UK.
Sherrill
S
Snelgrove
Department of Nursing, The College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales SA2 8PP, UK.
Gerwyn
G
Panes
Fieldbay Ltd., Chestnut House, Tawe Business Village, Swansea Enterprise Park, Swansea SA7 9LA, UK.
Aldo
A
Picek
The College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
Ian T
IT
Russell
The College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
Michael
M
Dennis
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy / Q000453:epidemiology*; D016903:Drug Monitoring; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses; D009735:Nursing Homes; D011446:Prospective Studies
D014150:Antipsychotic Agents