Pharmacist Involvement in Optimizing Medication Use in Nursing Homes

Abstract

Nursing home residents have many comorbidities, for which medication therapy is the treatment modality most utilized. The extensive use of medications among these residents is beneficial, but puts these individuals at high risk of experiencing adverse drug events. To optimize medication use in nursing home residents, we have witnessed an increased pharmacist involvement. This review presents how pharmacists can be involved in optimizing medication use among Norwegian nursing home residents. The review is based on a literature search (PubMed), knowledge of Norwegian nursing home studies involving pharmacists, and fifteen years of work experience. A conceptual framework guided the knowledge synthesis regarding the different work tasks identified at the individual, healthcare, and system level. Pharmacists contribute on different levels to ensure high-quality medication use in nursing homes, which means involvement in multidisciplinary teams to identify and solve medication-related problems. Collaboration with other healthcare professionals and teaching them about medication management are examples on the healthcare level. Involvement on the system level includes developing medication management procedures, providing medication statistics, investigating costs, and facilitating tender rounds. Studies investigating hard endpoints in nursing home residents were not identified. Although pharmacists as healthcare providers seem to be expanding their role, municipalities and the healthcare system seem to lack a strategy about how and where this resource can be used most effectively. Developing job descriptions for pharmacists, and preparing the healthcare setting and nursing homes for future challenges, should be prioritized.