Medication use in rest and nursing homes in Belgium. - KCE

18 Medication use in Nursing Homes KCE reports 47
An older study by Vander Stichele et al. 14 investigated the medication use and
knowledge of medication among residents of a sample of nursing homes in Flanders dd . In
addition, the medication distribution and information activities inside the homes were
described. The selection of nursing homes was based on the selection of
23 experienced nurses working in different nursing homes but meeting regularly for
postgraduate training. In each of the nursing homes a random sample of ten residents
was taken.
The 23 nurses interviewed the nurse responsible for the selected resident and the
resident, if possible. Eventually 198 residents (20 institutions) were included in the
study, 128 of them could be interviewed directly. Although the average number of
residents in the 20 institutions was somewhat larger than the Flemish average, the
selected institutions were representative for Flanders. The residents had a mean of
4.5 different medicines (range 0-12) on their medication chart. 4% did not take any
medication, half of them because of therapeutic abstinence in terminal care. 47% had at
least 5 medicines. The number of medicines increased with age (3.7 to 4.8 medicines
between the age of 60 and 79), but stabilized from the age of 80 onwards
(4.3 medicines). On average 19 different GPs attended residents.
In Pitruzzella et al. 15 the medication use in rest and nursing homes in the Walloon
Region was analyzed for the year 2003 and compared with the results of a survey
carried out in 1993. For a representative sample of elderly residents (2,343 elderly
residing in 37 different institutions) the medication chart on a specific day
(November 15, 2003) was analyzed. On that day a total of 16,808 medications or 7.19
drugs per resident were registered with large differences between the institutions
(range of 5.9-8.7). In 1993 this was only 5.04. Almost 19% of the residents received
more than 10 drugs on one day, 19.4% received less than 5 drugs. Drugs related to the
nervous system (n=5,410), the cardiovascular system (n=4,133), the gastrointestinal
system (n=3,713) and blood and blood forming organs (n=1,257) represented the
largest groups. Age, gender and the presence of dementia were found to be explaining
factors.
dd As in chapters 2 and 3 we use the term nursing home for an institution with exclusively nursing
beds or with rest and nursing beds.