Audits of medication use in Sydney nursing homes.

BACKGROUND most nursing home residents take several different medications. Reports have shown considerable variation in the frequency and types of prescriptions between nursing homes and between countries. OBJECTIVE to record the current pattern of medication use in Sydney nursing homes to allow comparison with patterns observed 5 and 10 years previously, and in other countries. METHODS data were recorded from the medication cards and clinical files of all 3,054 residents in 50 nursing homes in the Central Sydney Health Area and were compared with data recorded in 1993 and 1998. RESULTS the mean number of medications prescribed per resident in 2003 was 6.84, while the mean number consumed regularly (rather than 'as necessary') was 5.42. These numbers were higher than 5 and 10 years previously, though there had been reductions in use of diuretics, anticonvulsants, hypnotics and anxiolytics. There had been increased prescription of antidepressants, anti-diabetes drugs, calcium and (among women) thyroid hormones. Prescription rates for laxatives, cardiovascular medication and analgesics remained high. CONCLUSIONS the pattern of medication prescription has changed. This may be attributable to improved education of clinicians and nursing home staff, involvement of pharmacists and altered or increased prevalence of medical and mental disorders in nursing homes.