Nursing Homes

Question 1

Omnibus budgetary reconciliation act 1987 OBRA

Answer 1

Sought to improve the quality of care in US nursing homes through regulations and standards, detailed inspections, enforcement procedures

Under this law, consultant pharmacists are required to monitor the use of these drugs and challenge

Question 2

How difference did OBRA make

Answer 2

Reduction in pressure sores, dehydration, and use of physical restraints
Reduction in hospitalisations
Reduction in use of psychoactive drugs

Question 3

The minimum data set

Answer 3

Use to collect info on all nursing home residents
Section U = drugs residents were taking

Question 4

Fleetword NI project

Answer 4

Intervention - monthly visits by prescribing support pharmacists, algorithm to assess appropriateness lf prescriptions, liaison with GP, documentation on care plan

Impact - the odds ratio of a resident receiving an inappropriate psychoactive drug in an intervention home was 0.26

Question 5

CHIPPS study

Answer 5

The care homes independent prescribing pharmacist study
Pharmacist prescriber developed care plan, did med reviews/reconciliation, trained staff, deprescribed and prescribed

There was no difference in the rate of falls, qol, hospitalisations, or mortality
There was a change in the drug burden index with less anticholinergics/sedative medications