Nursing and residential care for the elderly in Northern Ireland: the contribution of the pharmacist
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Aim of the study: To gain more detailed information on the current pharmaceutical service provision in nursing and residential homes in Northern Ireland and to assess the views of care staff on future pharmacy services.
Method: A structured questionnaire was developed and mailed to all nursing and residential homes (n=586) in Northern Ireland on two occasions.
Results: A response rate of 68% (n=396) was obtained. The most frequent services currently provided by community pharmacists were the supply of medication and the collection of unwanted, discontinued or out‐of‐date medicines. The majority of respondents also reported receiving advice on safe‐keeping, correct administration of medicines, advice on more appropriate formulations and advice on patient medication records from the community pharmacist. Over a third of all the respondents received advice on compliance devices. A similar proportion stated that their care staff were trained by the pharmacist on broad medication management issues.
Over 90% of all homes strongly supported staff training by pharmacists on the recognition of medication‐related problems as a future service. Over 70% of all respondents thought additional guidelines and advice for missed dosages and the use of home remedies would be beneficial. A review of patient medication records to assess drug‐drug interactions and possible adverse drug reactions by pharmacists was supported by over 65% of all respondents.
Conclusions: This work has demonstrated that those responsible for care in nursing and residential facilities strongly support further involvement by the pharmacist in these care facilities; pharmacy policy makers must ensure that such services are developed to meet the needs of these vulnerable elderly residents.
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- 1.Department of Health. The NHS Plan-The Government's response to the royal commission on long term care. 2000.Google Scholar
- 2.The Royal Commission on Long Term Care. With respect to old age. 1999.Google Scholar
- 3.Corbett J. Provision of prescribing advice for nursing and residential homes patients. Pharm J 1997;259:422-4.Google Scholar
- 4.Lunn J, Chan K, Donoghue J, Riley B, Walley T. A study of the appropriateness of prescribing in nursing homes. Int J Pharm Pract 1997;5:6-10.Google Scholar
- 5.Nolan L, O'Malley K. The need for a more rational approach to drug prescribing for elderly people in nursing homes. Age Ageing 1989;18(1):52-6.Google Scholar
- 6.Walker J, Wynne H. The frequency and severity of adverse drug reactions in elderly people. Age Ageing 1994; 23:255-259.Google Scholar
- 7.Seppala M, Sourander L. A practical guide to prescribing in nursing homes. Avoiding the pitfalls. Drugs Aging 1995; 6(6):426-35.Google Scholar
- 8.Nolan L, O'Malley K. Prescribing for the elderly. Part I: Sensitivity of the elderly to adverse drug reactions. J Am Geriatr Soc 1988;36(2):142-9.Google Scholar
- 9.Gurwitz JH, Field TS, Avorn J, McCormick D, Jain S, Eckler M, Benser M, Edmondson AC, Bates DW. Incidence and preventability of adverse drug events in nursing homes. Am J Med 2000,109:87-94.Google Scholar
- 10.Hughes CM, Lapane KL, Mor V. Impact of legislation on nursing home care in the United States: lessons for the United Kingdom. BMJ 1999;319:1060-2.Google Scholar
- 11.Spong L. Role of the pharmacist in nursing homes in northern Europe. Pharm J 1992;249:23-5.Google Scholar
- 12.Haines J, Bradley M. Pharmaceutical services to residential homes: present and future. Br J Pharm Pract 1990;12(Oct): 326-7 334.Google Scholar
- 13.Smith F. Survey research: (1) Design, samples and response. Int J Pharm Pract 1997;5:152-66.Google Scholar
- 14.Sprey L.S. Monitored dosage systems. Pharm J 1995;254: 767-70.Google Scholar
- 15.Deshmukh AA, Sommerville H. A pharmaceutical advisory service in a private nursing home: provision and outcome. Int J Pharm Pract 1996;4:88-93.Google Scholar
- 16.Reeve JF, Peterson GM, Rumble RH, Jaffrey R, Care CP. Programme to improve the use of drugs in older people and involve general practitioners in community education. J Clin Pharm Ther 1999;24:289-97.Google Scholar
- 17.Krass I, Smith C. Impact of medication regimen reviews performed by community pharmacists for ambulatory patients through liasion with general medical practitioners. Int J Pharm Pract 2000;8:111-20.Google Scholar
- 18.Schmidt IK, Claesson CB, Westerholm B, Nilsson LG. Physician and staff assessments of drug interventions and outcomes in Swedish nursing homes. Ann Pharmacother 1998;32:27-32.Google Scholar
- 19.Furniss L, Burns A, Craig SK, Scobie S, Cooke J, Faragher B. Effects of a pharmacist's medication review in nursing homes. Br J Psychiatry 2000;176:563-7.Google Scholar
- 20.Wright D, Purvis J, Aykroyd R, Chrystyn H. Clinical pharmacy services to residential and nursing homes: Potential benefits of medication review. Pharm J 1994;R 8.Google Scholar
- 21.Bootman JM, Harrison DL, Cox E. The health care cost of drug-related morbidity and mortality in nursing facilities. Arch Intern Med 1997;157:2089-96.Google Scholar