Identifying and addressing drug-related problems in nursing homes: An unmet need in Malaysia?

To the Editor

Nursing homes are required to provide personal care to a broad range of residential patients. While medications are an integral part of this care, medication risks may not recognised, particularly in vulnerable elderly patients. Pharmacist-led medication reconciliation has been shown to reduce the number of medications in nursing homes, and is part of USA health care 1-3. In Malaysia, few studies have examined this issue. We conducted a prospective exploratory study which involved medication review of 20 residents of a nursing home in a semi-urban setting, from 1 November 2013 to 31 January 2014. Medication review was undertaken by a year 4 pharmacy student with input from a clinical pharmacist, who together took a medical history, recorded details of all medication, and current medical problems. Medication-related problems were identified from this data. Potentially inappropriate medications with clear causal correlations or contribution to the principal reason were documented. Another clinical pharmacist independently classified each medication-related problem. Disagreement was resolved through discussion to arrive at a consensus classification. The Monash University Human Research Ethics Committee approved this study (CF13/2911-2013001564).