Institutional Prescribing for the Elderly: Patterns of Prescribing in a Municipal Hospital and a Municipal Nursing Home

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Abstract
The drugs prescribed for long-term use by 56 elderly patients while they were under domiciliary care in a municipal hospital were compared with the drugs prescribed for the same patients 6 mo. after they had moved to a city nursing home. All patients were at least 65 yr old, and were in the hospital for at least 6 mo. Mean numbers of prescriptions per patient were 4.1 in the hospital and 3.7 in the nursing home. Diuretics and potassium chloride were prescribed less often in the nursing home, but the number of patients taking digitalis glycosides increased. Use of tranquilizers and of sedatives and hypnotics was less in the nursing home, whereas a larger proportion of patients were given antidepressant drugs. In the hospital, tranquilizers and nonsteroidal antiinflammatory drugs were usually ordered to be administered routinely, while in the nursing home these drugs were ordered mostly for use as needed. Explanation of the differences between the 2 institutions in prescribing for the same patients is hindered by the frequent lack of recorded diagnoses accounting for the drugs prescribed in the hospital. The lesser use of tranquilizers in the nursing home may be a result of the difference between the environments there and at the hospital. In comparison with previous reports of institutional prescribing for the elderly, far fewer patients in both the institutions studied were receiving tranquilizers, sedatives, and hypnotics.