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Quality of prescribing in Belgian nursing homes: an electronic assessment of the medication chart.
- Source :
-
International Journal for Quality in Health Care . Feb2014, Vol. 26 Issue 1, p93-99. 7p. 3 Charts, 2 Graphs. - Publication Year :
- 2014
-
Abstract
- Objectives To develop a computerized assessment tool for monitoring the quality of prescribing in Belgian nursing homes. Design In a observational cross-sectional study of the medication charts of nursing home residents, potentially inappropriate medication (PIM) was investigated using three scoring systems for the elderly (Beers, ACOVE, BEDNURS) complemented with a list of drug–drug interactions. Setting A representative stratified sample of Belgian nursing homes (n = 76). Participants A random sample of nursing home residents with a complete data set (n = 1730) excluding palliative care patients. Main Outcome Measure A combination of PIM scores to assess inappropriate, under- and overprescribing. Results Included residents had a mean age of 85, 78% were female. They used a mean of 7.1 chronic medications. Most PIMs were detected by the application of the ACOVE criteria for underprescribing with 58% of patients having at least one PIM. Using the BEDNURS and the Beers criteria, at least one PIM was noticed in 56 and 27% of patients, respectively. Patients' characteristics showing a positive relationship with the PIM score were age, female gender, amount of clinical and nursing care problems, number of prescriptions and the use of psychotropic drugs (multiple regression analysis R2 = 0.332). Conclusions In Belgian nursing homes, the observed high level of drug utilization was associated with potentially inappropriate prescribing. The development of a combined assessment tool and the implementation of a computerized monitoring system of PIMs is highly recommended to improve the quality of prescribing. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 13534505
- Volume :
- 26
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- International Journal for Quality in Health Care
- Publication Type :
- Academic Journal
- Accession number :
- 94394687
- Full Text :
- https://doi.org/10.1093/intqhc/mzt089