Prescribing of Drugs in a Nursing Home

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Abstract
Drug utilization review (DUR) is rapidly becoming a major component of the quality assurance programs of institutions involved in health care. Other DUR investigations and systems have substantiated the need for further DUR studies. DUR in the nursing home has received only limited attention; therefore, a study was conducted to review the prescribing of drugs by 23 physicians who care for patients on a monthly basis in a 106-bed nursing home. The major objectives of the study were to review drugs prescribed by comparing their designated use with the FDA-approved use and with their efficacy and/or need in each case. Only 31 (4.1 percent) of the 759 drugs prescribed were not prescribed for their FDA-approved use. However, 171 (22.6 percent) of 758 drugs prescribed were considered not effective and/or not needed by criteria used in this study. The fact that the physician only reviews the patient's status monthly may motivate him to prescribe more drugs than needed in order to anticipate possible problems. This also requires the L.P.N. to make judgments concerning drug therapy that should be the role of other health professionals. The results of this study demonstrate the need for DUR in the nursing home and emphasize an important role for the pharmacist in this area.

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