The development and test of an intervention to improve ADR screening in nursing homesThe development and test of an intervention to improve ADR screening in nursing homes
Stichele, Vander, Robert H.
Faculty of Medicine and Health Sciences
Centre for Research and Innovation in Care (CRIC)
Journal of the American Medical Directors Association. -
14(2013):5, p. 1-6
University of Antwerp
Objectives: The aim of this study was to develop and test the effect of an instrument, Pharmanurse, to facilitate nurse-driven adverse drug reaction (ADR) screening as an input for interdisciplinary medication review in nursing homes. Design: Intervention study with a pre-posttest design Participants: All residents of a convenience sample of 8 nursing homes of more than 80 beds were eligible if they resided at least 1 month in the nursing home and took 4 or more different medications. Residents receiving palliative care were excluded. Intervention: The intervention consisted of interdisciplinary medication review, prepared by nurse observations of potential ADRs using personalized screening lists generated by the Pharmanurse software. Pharmanurse is specifically adapted to use by nurses and to use in nursing homes. Measurements: Outcome parameters were the number of ADRs detected by nurses, ADRs confirmed by general practitioners, and medication changes. After the intervention, health care professionals involved completed a questionnaire to evaluate the value and the feasibility of the intervention. Results: Nurses observed 1527 potential ADRs in 81% of the 418 residents (mean per resident 3.7). Physicians confirmed 821 ADRs in 60% of the residents (mean per resident 2.0). As a result, 214 medication changes were planned in 21% of the residents (mean per resident 0.5) because of ADRs. Health care professionals gave the Pharmanurse intervention a score of 7 of 10 for the potential to improve pharmacotherapy and 83% of the physicians were satisfied about nurses' screening for ADRs. Conclusions: The Pharmanurse intervention supports nurses in ADR screening and may have the potential to improve pharmacotherapy. Copyright (C) 2013 - American Medical Directors Association, Inc.