PHYSICIAN AND STAFF ASSESSMENTS OF DRUG INTERVENTIONS AND OUTCOMES INSWEDISH NURSING-HOMES

OBJECTIVE: TO describe the type and frequency of drug-related problems discussed in regular team meetings conducted in 15 Swedish nursing ho mes and report physician and staff assessments of these interventions and residents' outcomes.DATA SOURCES AND METHODS: The data were collec ted within the context of a controlled trial with the primary aim of e xploring the effects of regular team interventions on drug prescribing practices in Swedish nursing homes. In 15 experimental nursing homes, the residents' drug therapy was discussed regularly by a team consist ing of a pharmacist, a physician, nurses, undernurses (similar to Lice nsed practical nurses), and nurse's aides. The pharmacist documented p roblems, made changes, and observed outcomes. Following the interventi on period, a questionnaire was sent to the medical staff that containe d items regarding perceived outcomes, the intervention's impact on kno wledge of drug therapy in the elderly, and attitudes toward the pharma cist's role. RESULTS: Unclear indication and problematic choice of dru gs were the most common drug-related problems discussed. In 19% of the situations, therapy changes were reported to have had a beneficial ef fect on the residents' clinical status; in 47% of the situations, staf f reported no observable outcome from changes, suggesting that the cha nges had been appropriate, Finally, medical staff claimed in the follo w-up survey that their knowledge about drug therapy had increased; the y expressed an overall positive attitude toward this interactive colla boration. CONCLUSIONS: Regular interventions conducted by a multidisci plinary team incorporating a pharmacist can effectively improve prescr ibing practices, increase staff knowledge about appropriate drug thera py in the elderly, and result in improved quality of care for nursing home residents.