Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care
Objective: Traditionally, nursing homes have been associated with suboptimal drug therapy and drug-related problems (DRPs). In contrast, less is known about drug safety in homecare. The aim of this study was to describe and compare DRPs in older persons across two care settings: nursing homes and ho...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2018-07-01
|
| Series: | Scandinavian Journal of Primary Health Care |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/02813432.2018.1499581 |
| _version_ | 1828472544066273280 |
|---|---|
| author | Siri A. Devik Rose Mari Olsen Inger Lise Fiskvik Terje Halbostad Tone Lassen Natalia Kuzina Ingela Enmarker |
| author_facet | Siri A. Devik Rose Mari Olsen Inger Lise Fiskvik Terje Halbostad Tone Lassen Natalia Kuzina Ingela Enmarker |
| author_sort | Siri A. Devik |
| collection | DOAJ |
| description | Objective: Traditionally, nursing homes have been associated with suboptimal drug therapy and drug-related problems (DRPs). In contrast, less is known about drug safety in homecare. The aim of this study was to describe and compare DRPs in older persons across two care settings: nursing homes and home nursing care. Design: Cross-sectional study using descriptive and inferential statistics. Setting: Nursing homes (n = 5) and home nursing care units (n = 8) across nine municipalities in the middle of Norway. Participants: Multidisciplinary medication reviews for 61 nursing home residents and 93 patients receiving home nursing care performed over the 2013–2014 period, were mapped and examined (N = 154). Main outcome measures: DRPs classified by a Norwegian Classification Tool. Results: In all, 740 DRPs were detected in the total sample, 227 in nursing homes and 513 in home nursing care. DRPs were significantly higher among patients receiving home-based care (Mean =5.5) compared to patients in nursing homes (Mean =3.7, p = 0.002). Among the problem categories, the need for additional drug was most frequent in nursing homes (p = 0.001), while documentation discrepancies reached the highest numbers in patients receiving home nursing care (p = 0.000). Additionally, patients in home nursing care had more problems concerning adverse reactions (p = 0.060); however, this was not statistically significant. Differences in DRP categories leading to changes in the patients’ medication lists were also discovered. Conclusions: The frequency of unclear documentation and adverse reactions found in the homecare setting is alarming. This is an important issue given the trend in aged care towards caring people in their own homes. Further research is warranted to explore how different care settings may influence the safety of pharmacotherapy for older persons.Key Points Drug related problems are a significant cause of concern among patients receiving home nursing care as well as for patients living in nursing homes. The findings of this study showed that: •Significantly more DRPs were detected among patients receiving home nursing care than patients living in nursing homes. •While patients living in nursing homes were often undermedicated, documentation discrepancies were more frequent in home nursing care. •DRP categories leading to changes on the medication lists differed between the settings. |
| first_indexed | 2024-12-11T05:31:28Z |
| format | Article |
| id | doaj.art-98d4382bcc7f45cab917f9749081e5e1 |
| institution | Directory Open Access Journal |
| issn | 0281-3432 1502-7724 |
| language | English |
| last_indexed | 2024-12-11T05:31:28Z |
| publishDate | 2018-07-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Scandinavian Journal of Primary Health Care |
| spelling | doaj.art-98d4382bcc7f45cab917f9749081e5e12022-12-22T01:19:24ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242018-07-0136329129910.1080/02813432.2018.14995811499581Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing careSiri A. Devik0Rose Mari Olsen1Inger Lise Fiskvik2Terje Halbostad3Tone Lassen4Natalia Kuzina5Ingela Enmarker6Centre of Care Research Mid-NorwayNord UniversityCentre for Development of Institutional and Home care Services in Nord- TrøndelagHospital PharmacyApotek 1Norwegian University of Science and TechnologyCentre of Care Research Mid-NorwayObjective: Traditionally, nursing homes have been associated with suboptimal drug therapy and drug-related problems (DRPs). In contrast, less is known about drug safety in homecare. The aim of this study was to describe and compare DRPs in older persons across two care settings: nursing homes and home nursing care. Design: Cross-sectional study using descriptive and inferential statistics. Setting: Nursing homes (n = 5) and home nursing care units (n = 8) across nine municipalities in the middle of Norway. Participants: Multidisciplinary medication reviews for 61 nursing home residents and 93 patients receiving home nursing care performed over the 2013–2014 period, were mapped and examined (N = 154). Main outcome measures: DRPs classified by a Norwegian Classification Tool. Results: In all, 740 DRPs were detected in the total sample, 227 in nursing homes and 513 in home nursing care. DRPs were significantly higher among patients receiving home-based care (Mean =5.5) compared to patients in nursing homes (Mean =3.7, p = 0.002). Among the problem categories, the need for additional drug was most frequent in nursing homes (p = 0.001), while documentation discrepancies reached the highest numbers in patients receiving home nursing care (p = 0.000). Additionally, patients in home nursing care had more problems concerning adverse reactions (p = 0.060); however, this was not statistically significant. Differences in DRP categories leading to changes in the patients’ medication lists were also discovered. Conclusions: The frequency of unclear documentation and adverse reactions found in the homecare setting is alarming. This is an important issue given the trend in aged care towards caring people in their own homes. Further research is warranted to explore how different care settings may influence the safety of pharmacotherapy for older persons.Key Points Drug related problems are a significant cause of concern among patients receiving home nursing care as well as for patients living in nursing homes. The findings of this study showed that: •Significantly more DRPs were detected among patients receiving home nursing care than patients living in nursing homes. •While patients living in nursing homes were often undermedicated, documentation discrepancies were more frequent in home nursing care. •DRP categories leading to changes on the medication lists differed between the settings.http://dx.doi.org/10.1080/02813432.2018.1499581Drug safetyolder patientsprimary healthcaremedication reviewNorwegian Classification Tool for DRPscross-sectional study |
| spellingShingle | Siri A. Devik Rose Mari Olsen Inger Lise Fiskvik Terje Halbostad Tone Lassen Natalia Kuzina Ingela Enmarker Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care Scandinavian Journal of Primary Health Care Drug safety older patients primary healthcare medication review Norwegian Classification Tool for DRPs cross-sectional study |
| title | Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care |
| title_full | Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care |
| title_fullStr | Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care |
| title_full_unstemmed | Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care |
| title_short | Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care |
| title_sort | variations in drug related problems detected by multidisciplinary teams in norwegian nursing homes and home nursing care |
| topic | Drug safety older patients primary healthcare medication review Norwegian Classification Tool for DRPs cross-sectional study |
| url | http://dx.doi.org/10.1080/02813432.2018.1499581 |
| work_keys_str_mv | AT siriadevik variationsindrugrelatedproblemsdetectedbymultidisciplinaryteamsinnorwegiannursinghomesandhomenursingcare AT rosemariolsen variationsindrugrelatedproblemsdetectedbymultidisciplinaryteamsinnorwegiannursinghomesandhomenursingcare AT ingerlisefiskvik variationsindrugrelatedproblemsdetectedbymultidisciplinaryteamsinnorwegiannursinghomesandhomenursingcare AT terjehalbostad variationsindrugrelatedproblemsdetectedbymultidisciplinaryteamsinnorwegiannursinghomesandhomenursingcare AT tonelassen variationsindrugrelatedproblemsdetectedbymultidisciplinaryteamsinnorwegiannursinghomesandhomenursingcare AT nataliakuzina variationsindrugrelatedproblemsdetectedbymultidisciplinaryteamsinnorwegiannursinghomesandhomenursingcare AT ingelaenmarker variationsindrugrelatedproblemsdetectedbymultidisciplinaryteamsinnorwegiannursinghomesandhomenursingcare |