Use of potentially inappropriate drugs in nursing homes

Study Objectives. To examine patterns and determine predictors of inappropriate drug use in nursing homes. Design. Retrospective study. Setting. One thousand four hundred ninety-two nursing homes in five states. Patients. A total of 44,562 residents admitted to nursing homes over I year. Methods. Frequency of discontinuation and initiation of potentially inappropriate drugs over the first 90 days after admission to a nursing home was calculated. Data were collected using the minimum data set. Results. On admission, 33% of residents were receiving at least one potentially inappropriate drug. After 90 days, the drug was discontinued in 16% of these residents. Of those not receiving a potentially inappropriate drug on admission, one was begun in 18%. Demographic factors and number of drugs taken by patients were associated with the use of potentially inappropriate drugs. Conclusions. Use of potentially inappropriate drugs was prevalent on admission and at 90 days after admission. Discontinuation was highest among patients with conditions for which potentially safer therapeutic alternatives existed.