ABSTRACT
BACKGROUND: Improving medication appropriateness is a priority of French national campaigns in nursing homes. A pilot study was conducted to evaluate the impact of a medication review in a French nursing home with a 3-month follow up. METHOD: A medication review was conducted in 2015 using version 2 STOPP and START criteria. The number and type of drugs meeting a STOPP that were reintroduced and the number and type of drug meeting a START that were stopped during follow up were measured. An expert committee adjudicated whether 3-month hospitalizations and deaths were related to medication review. The impact of medication review on the cost related to drug consumption was calculated for 3 months. RESULTS: The 52 residents (age 84 ± 9 years, 83% female) fulfilled, on average, 2 ± 1.4 of the STOPP criteria and 0.7 ± 0.6 of the START criteria. A total of 101 drugs were stopped and 34 drugs were started. Five deaths occurred during follow up and were judged as not related to medication review. Five drugs stopped were reintroduced in five residents for a rebound effect or a symptom occurrence and one resident had stopped a START medication (aspirin) for a minor adverse drug reaction. At 3 months, a gain of 20.21 ± 31.34 euros per resident was observed. CONCLUSION: The medication review using version 2 STOPP and START criteria and involving the physician in charge seems useful for detecting and correcting inappropriate prescribing in a nursing home.
ABSTRACT
An initiative to assess and improve practices in terms of fall prevention was instigated in 2008 within the follow-up and rehabilitation care department of the Les Ormes medium and long-term care facility in Montfermeil (Seine-Saint-Denis). This initiative has been continued in order to be able to identify patients and situations at risk and then implement targeted and coordinated actions to reduce this risk. Ultimately, the aim was to reduce the annual prevalence of the number of falls within the establishment.
