Nursing-home residents and their drug use: a comparison between mentally intact and mentally impaired residents

The authors present a case study to illustrate how a mentally impaired but socially intact nursing home resident, who had no one to act as an advocate for her, was denied appropriate treatment for an acute illness which ultimately resulted in her death. The case raises important questions about advocacy for the mentally-impaired, acutely-ill institutionalized patient. This Article explores the role of the advocate, how advocates are selected, what qualities and talents they should possess, and what responsibilities should be assigned to them. The authors suggest that nursing home residents should be encouraged to engage in self-advocacy to the greatest extent possible. The competent elderly should be urged to name their preferred advocates. Individuals who serve in advocacy roles should be advised to seek information regarding the patient's wishes from those who know the patient well. Furthermore, there is a need for quality education and training of those who serve in advocacy roles on behalf of nursing home residents, and state laws need to specify the responsibilities of persons who serve as advocates.

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Use of medication among nursing home residents: a Danish drug utilisation study

Age and Ageing ◽

10.1093/ageing/afaa029 ◽

2020 ◽

Vol 49 (5) ◽

pp. 814-820 ◽

Cited By ~ 5

Author(s):

Carina Lundby ◽

John Jensen ◽

Søren Post Larsen ◽

Helene Hoffmann ◽

Anton Pottegård ◽

...

Keyword(s):

Nursing Home ◽

Drug Use ◽

Drug Utilisation ◽

Census Data ◽

Nursing Home Residents ◽

Nursing Home Admission ◽

Drug Classes ◽

Prescription Drug Use ◽

Antidementia Drugs ◽

New Treatments

Abstract Background Data on drug utilisation patterns in nursing home populations is scarce. We aimed to describe drug use patterns in Danish nursing home residents. Methods We established a cohort of 5,179 individuals (63% women; median age of 84 years) admitted into 94 nursing homes across Denmark during 2015–2017. Data on prescription drug use and other census data were obtained from the nationwide Danish health registries. Results The total number of drug classes filled increased from a median of 6 drugs (interquartile range [IQR] 3–9) at 18–24 months before nursing home admission to a median of 8 drugs (IQR 6–11) just after admission, with the most common drug classes comprising paracetamol (61%), platelet inhibitors (41%), proton pump inhibitors (34%), statins (33%) and potassium supplements (31%). The incidence rate of new drug treatments increased from 21 new treatments/100 residents/month at 12–24 months before admission to a peak of 71 new treatments/100 residents/month in the month prior to admission, while it levelled off to about 34 new treatments/100 residents/month after 6–9 months. The drug classes primarily responsible for this peak were laxatives, antibiotics and analgesics. The largest absolute increases were seen for laxatives (53%), paracetamol (43%) and antidepressants (36%), all showing a marked increase up to and following admission. A high proportion of residents remained on therapy in the 3-year period following admission, with users of antidepressants and antidementia drugs being most persistent. Conclusion Nursing home admission is associated with an increase in use of both predominantly preventive and non-preventive drug classes.

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