Polypharmacy Among Older Adults in Long Term Care Facilities

Abstract

Polypharmacy among older adults in long-term care facilities is a relevant issue, which leads to an increase in health care costs and adverse drug reactions. The implementation of comprehension medication reviews or medication reconciliation identifies and helps reduce polypharmacy. Evidence shows that nurses help to alleviate polypharmacy through comprehensive medication reviews. The purpose of this DNP project was to reduce polypharmacy among adults 65 years and older through the implementation of the Screening Tool to Older Person’s Prescriptions (STOPP) and Screening Tool to Alert Doctors to the Right Treatment (START) while conducting medication reconciliation. This quality improvement project occurred at two sites of a long-term care facility in eastern North Carolina for developmentally disabled adults. The licensed practical nurse (LPN) and registered nurse (RN) team leader were educated on medication reconciliation and trained to use the STOPP/START tool. The results revealed that 100% of older adults (N = 11) pre-implementation and post-implementation had polypharmacy. There was one patient by the end of the project that had a reduction in medication orders and potentially inappropriate medications. Future projects should focus on implementing medication reconciliation with every medication change and transitions of care, including provider education and participation, to have an increasing impact on the reduction of polypharmacy.