Effect of systematic review of medication by general practitioner on drug consumption among nursing-home residents

Background: nursing-home patients usually have many medical problems and of ten take many drugs. They are therefore at risk from drug side effects and interactions. Aims: to evaluate the impact of a visit by a general practitioner and a com prehensive repeat prescribing review on the consumption of inappropriate dr ugs in nursing homes. Method: two general practitioners made one comprehensive visit to four rand omly selected nursing homes. In each home we discussed all patients in deta il with a senior member of staff. We reviewed the prescribing record of eac h patient and stopped items if we considered them inappropriately prescribe d or unnecessary. Results: repeat prescriptions were altered in 65% of patients: 51% had an i tem stopped and 26% had an item changed to a cheaper alternative or the dos e reduced. There was a reduction in the mean number of repeat prescriptions prescribed. Conclusions: a single visit by a general practitioner to a nursing home and a comprehensive repeat prescribing review can lead to a reduction in the n umber of items prescribed and to substantial savings for the health service . Further rigorous, cost-effectiveness studies are needed.