A pharmaceutical advisory service in a private nursing home: provision and outcome

A survey of pharmaceutical care in two private nursing homes in Norfolk identified concerns relating to the extent and nature of patient therapy as well as its administration and documentation (see p83). With the support of medical and nursing staff, relevant policy documents were reviewed by the investigating pharmacist and then implemented. A laxative policy was also introduced. During the next five months, monthly medication reviews were made for the 60 patients (eight male, 52 female; mean age 84 [±9] years) who remained from the original survey. Recommendations concerning individual drug therapy were subsequently evaluated. Of the 44 recommendations for changes in prescribing and administration of drugs that were accepted by the medical/nursing staff, 37 produced positive outcomes for the patient. Compared with the baseline data, there were significant increases in the number of patients who were free of possible drug induced problems (P<0.05) or no longer constipated (P<0.005) and a significant increase in the proportion of medicines administered in accordance with the prescriber's wishes (P<0.05). The accuracy and completeness of drug administration records had improved and guidelines for nurse prescribing had been rationalised. The mean daily number of items taken by patients had fallen by 1.5. Based on these data, provision of pharmaceutical care to private nursing homes should produce significant cost savings and improve patient care.