title: District nurses' preventive home visits to 75-year-olds: an opportunity to identify factors related to unsafe medication management.
abstract: OBJECTIVE
  To investigate factors related to unsafe medication management among 75-year-olds during preventive home visits, and to describe the interventions district nurses used.
  
  
  METHODS
  An explorative study. During a 9- to 12-month period, 36 DNs used the Safe Medication Assessment (SMA) tool during preventive home visits to 75-year-olds who used at least one drug (n=113).
  
  
  RESULTS
  One or more factors related to unsafe medication management were identified in 84% of the 75-year-olds. More than 40% used five or more drugs, and 34.5% reported symptoms potentially indicative of adverse effects of their drugs. Nearly 30% had prescribers from more than two medical units, and 7.1% of the older persons were appraised as having reduced cognitive ability. DNs intervened in more than two-thirds of the cases and used a variety of nursing care interventions to improve the safety of medication management.
  
  
  CONCLUSIONS
  Preventive home visits seem to provide a unique opportunity to promote safe medication management. Several factors related to unsafe medication management were identified, and several different nursing care interventions were carried out to ensure safe medication management. Use of the SMA tool in preventive home visits seems to be advantageous in improving the safety of medication management among older persons.
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden annica.lagerin@sll.se.
authors.forename: Annica
authors.initials: A
authors.lastname: Lagerin
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden Department of Public Health and Caring Sciences/Section of Geriatrics, Uppsala University, Uppsala, Sweden.
authors.forename: Axel C
authors.initials: AC
authors.lastname: Carlsson
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Nilsson
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Westman
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Törnkvist
mesh_terms: D000368:Aged; D003071:Cognition; D003152:Community Health Nursing; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D005851:Geriatric Nursing; D006792:House Calls; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D059065:Medication Reconciliation; D054539:Medication Therapy Management; D015403:Nursing Evaluation Research; D019338:Polypharmacy; D011314:Preventive Health Services; D018570:Risk Assessment
keywords: Assessment; elderly; medication management; nursing care; preventive home visit; tool