No abstract

There is excessive prescription of psychotropic drugs in Swedish nursing homes. Improved teamwork among caregivers can improve prescribing as defined by clinical guidelines.

No abstract

Regular intervention conducted by a multidisciplinary team incorporating a pharmacist can effectively improve prescribing practices, increase staff knowledge about appropriate drug therapy in the elderly, and result in improved quality of care for nursing home residents.

being in an institution had a stronger association with the use of certain drugs (e.g. psychotropics) than did dementia status. Demented people, especially those in institutions, used a large number of antipsychotics and opioids, but fewer laxatives and minor analgesics. Prescribers and institutional staff should be aware of these factors so they can optimize patient treatment.

No abstract

Prescription errors identified and dealt with by personnel at 36 Swedish community and hospital pharmacies during March, 1992, were analysed. During the study period, the participating pharmacies handled 76,956 prescriptions for 41,908 patients. All prescription errors, even minor ones, were registered. In total 32,132 errors were detected and reported, corresponding to an overall rate of 42 per cent. The most common error was omission of the purpose of the therapy. This type of error was found in 20,517 prescriptions (64 per cent of all noted errors). Most detected errors did not require any special intervention by the dispensing pharmacist. Errors of commission, which are potentially harmful to the patient, totalled 338 or 1 per cent of the errors. The most common of these was that the dosage form stated was incorrect. The pharmacists were able to resolve almost three‐quarters of the errors that required intervention and dispense the elucidated or amended prescription.

Extensive and somewhat inappropriate drug use in Swedish nursing homes is a significant and serious problem. Careful monitoring is necessary to ensure well tolerated drug therapy in this frail population. Neither written information from the Medical Products Agency, nor the campaign in the pharmacies alone had an impact on drug use in Swedish nursing homes. Multidisciplinary team discussions contributed to improved drug use, but more research is needed to understand the mechanisms behind this finding.