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Patients at care homes get pills they don’t need

By Claire Harrison

Over half of nursing home patients in Northern Ireland are prescribed inappropriate drugs for sedation when there is no medical need, research claimed today.

The study launched at the British Pharmaceutical Conference (BPC) in Manchester, found some 51% of nursing home patients are taking inappropriate psychoactive drugs.

The BPC said psychotropic medications have historically been used in nursing homes to sedate residents with no clinical need, including night-time sedation.

A psychoactive drug, or psychotropic substance, acts mainly on the central nervous system where it alters brain function, resulting in temporary changes in perception, mood, consciousness and behaviour.

Two pharmacy studies in Northern Ireland have focused on these drugs after the implementation of an adapted US model of pharmaceutical care, called The Fleetwood Northern Ireland Model. It takes a wider look at care in a nursing home setting and the impact of direct intervention from pharmacists.

Their aim was to evaluate the effect of its introduction on the number of residents who were receiving inappropriate psychoactive medication.

The researchers found while the model led to a significant decrease in the number of residents who received inappropriate psychoactive medication, levels were still high.

Lead Fleetwood NI Model researcher Susan Patterson said: “In nursing homes, our study indicated there is a 51% prevalence of inappropriate prescribing. This is a known risk factor for adverse drug events for elderly residents. These results support previous work carried out in Canada showing a prevalence of 55%.

“Pharmacists are the experts and they have a significant role to play in terms of finding and championing innovations that reduce risks for patients.

“The Fleetwood NI project has demonstrated that pharmacist intervention can reduce medication risks for nursing home residents and improve the quality of prescribing.”

In a separate study at BPC, it emerged inappropriate prescribing of psychoactive drugs may be influenced by organisational and/or treatment culture.

Staff from two nursing homes were interviewed about prescribing and how it might be influenced by organisational culture. Researchers found psychoactive drugs might be prescribed during times of staff shortages, and could be a way of keeping the residents calm and “make life easier” in some homes.

Today’s conference also heard about the results of Queen’s University Belfast research which showed that a new coating for urinary catheters could reduce the risk of infection.

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