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Bradley R. Williams PHARM. D., John F. Thompson PHARM.D. & Kenneth V. Brummel-Smith M.D.

In: Improving Care in the Nursing Home: Comprehensive Reviews of Clinical Research

Chapter 2: Improving Medication Use in the Nursing Home

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Improving Medication Use in the Nursing Home
Improving medication use in the nursing home
BradleyR.WilliamsPHARM. D.
JohnF.ThompsonPHARM.D.
KennethV.Brummel-SmithM.D.
Introduction

The risk to elderly persons posed by medications is well documented. The population age 65 and older consumes more medication than any other segment of the population (51), and nursing home (NH) residents are among the most heavily medicated of this population (61). In addition to the risks presented by the use of multiple medications, the danger is compounded by age-related changes in pharmacokinetic and pharmacodynamic variables (58,49) and poor prescribing habits (63). Indicators of the problem include polypharmacy (37), overuse of PRN drug orders (6,32), and high cost of medications (7). Clinical results of the problem include a high prevalence of adverse drug reactions (9), particularly falls and mental confusion ...

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