title: [Medication safety in nursing home residents with renal insufficiency - Results of a qualitative study].
abstract: BACKGROUND
  Nursing home residents often suffer from multimorbidity and polypharmacy. Impaired renal function and the lack of dose adjustments further increase the risk of adverse drug reactions (ADR). The aims of this qualitative study were to analyze the reasons for inadequate drug treatment and to identify possible intervention options to improve safety of drug treatment in nursing home residents with renal insufficiency.
  
  
  METHODS
  Using a mixed-method approach a cross-sectional study and focus group discussions were performed in the project. Focus groups with general practitioners, nursing staff, nephrologists and pharmacists were held. Audiotapes were transcribed verbatim, qualitative content analysis of the transcripts according to Mayring was conducted using MAXQDA.
  
  
  CONCLUSIONS
  Focus groups discussed different aspects and possible interventions related to inadequate drug treatment in nursing home residents with renal insufficiency. The main topics identified were "health service situation", "reasons for ADR" and "interventions". Regarding the current health service situation "infrastructure", "role of polypharmacy", "assessment of renal function" and the "different role models" were identified as relevant aspects for improving the safety of drug treatment in nursing homes. According to the participants, there is a lack of evidence-based standards regarding laboratory monitoring and estimation of kidney function.
authors.affiliation: Abteilung Versorgungsforschung, Institut für Public Health und Pflegeforschung (IPP), Universität Bremen, Bremen, Deutschland; Health Sciences Bremen, Universität Bremen, Deutschland. Electronic address: schmiema@uni-bremen.de.
authors.forename: Guido
authors.initials: G
authors.lastname: Schmiemann
authors.affiliation: Abteilung Versorgungsforschung, Institut für Public Health und Pflegeforschung (IPP), Universität Bremen, Bremen, Deutschland; Health Sciences Bremen, Universität Bremen, Deutschland.
authors.forename: Anne
authors.initials: A
authors.lastname: Dehlfing
authors.affiliation: Abteilung Versorgungsforschung, Institut für Public Health und Pflegeforschung (IPP), Universität Bremen, Bremen, Deutschland; Health Sciences Bremen, Universität Bremen, Deutschland.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Pulst
authors.affiliation: Department für Versorgungsforschung, Fakultät für Medizin und Gesundheitswissenschaft, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland.
authors.forename: Falk
authors.initials: F
authors.lastname: Hoffmann
mesh_terms: D015897:Comorbidity; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005858:Germany; D006707:Homes for the Aged; D006801:Humans; D009735:Nursing Homes; D019338:Polypharmacy; D051437:Renal Insufficiency / Q000188:drug therapy / Q000378:metabolism*
keywords: Medikamentensicherheit; Niereninsuffizienz; Pflegeheim; Polypharmazie; medication safety; nursing home; polypharmacy; renal insufficiency