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Call for monthly care home prescribing reviews

By Lilian Anekwe

Researchers have called for monthly medication reviews for patients in care homes to prevent inappropriate prescribing.

A systematic review of interventions to optimise prescribing in care homes found there is no one intervention that has proven universally effective for reducing the risk of inappropriate prescribing – but that monthly reviews, which are already mandatory in the US, could improve care.

Last October, a Pulse investigation into funding for care homes revealed GPs face a funding lottery, and a third of primary care organisations said they made no provision for prescribing support by community pharmacists in reviewing patient medication.

GP academics at Imperial College London and the School of Pharmacy reviewed 16 studies of four interventions – staff education, multi-disciplinary team meetings, pharmacist medication reviews and computerised clinical decision support systems.

Six studies showed staff education resulted in statistically significant improvements in prescribing quality, two studies of multidisciplinary team meetings showed statistically significant findings, and three studies demonstrated a significant effect of pharmacists' interventions on prescribing – including monthly reviews.

Dr Mathumalar Loganathan, a doctoral researcher in primary care and public health at Imperial College, concluded: ‘MDT meetings as well as staff education involving pharmacists proved successful, despite insufficient evidence for pharmacist-led reviews alone.'

‘Monthly pharmacists medication review is mandatory in the USA to improve prescribing in care homes - this has also been proposed for the UK.

‘We propose that UK policy be directed to improve the quality of prescribing in care homes based on results of controlled trials. Standardised measurements for measuring inappropriate prescribing are also needed to enable effective benchmarking. Finally, we recommend that a combination of two or more interventional strategies is explored to improve prescribing in this population.'

The study was published online in the journal Age and Ageing on 24 January.

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