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Nurse-led monitoring tool could curb overprescribing in care homes

A checklist used by nurses could help overuse of medicines for mental health issues in care homes, researchers have found
Picture shows a nurse doing a medicines review with an older man. A nurse-led monitoring tool that checks for adverse drug reactions could help curb overuse of mental health medicines in care homes, researchers say.

A checklist used by nurses could help avoid overuse of medicines for mental health issues in care homes, researchers at Swansea University have found

A nurse-led monitoring tool that checks for adverse drug reactions could help curb overuse of mental health medicines in care homes, researchers say.

The tool, a checklist called the adverse drug reaction profile (ADR), helped identify problems more quickly and improved care and medication reviews for residents taking medication for mental health issues, the study by researchers at Swansea University found.

Overuse of mental health medicines in care homes has long been a cause for concern, the authors say, and insufficient monitoring of patients has been seen

A checklist used by nurses could help avoid overuse of medicines for mental health issues in care homes, researchers at Swansea University have found

Picture shows a nurse doing a medicines review with an older man. A nurse-led monitoring tool that checks for adverse drug reactions could help curb overuse of mental health medicines in care homes, researchers say.
Picture: iStock

A nurse-led monitoring tool that checks for adverse drug reactions could help curb overuse of mental health medicines in care homes, researchers say.

The tool, a checklist called the adverse drug reaction profile (ADR), helped identify problems more quickly and improved care and medication reviews for residents taking medication for mental health issues, the study by researchers at Swansea University found.

Overuse of mental health medicines in care homes has long been a cause for concern, the authors say, and insufficient monitoring of patients has been seen as an important cause of medicines-related harms.

Profile system records vital signs, helps recognise adverse reactions

The ADR profile system is completed by a nurse and resident. It records vital signs and helps staff to recognise and act on signs of adverse drug reactions such as pain or aggression.

Nurses can share the completed form with multidisciplinary team members such as a GP or pharmacist to discuss prescriptions and doses.

The study looked at the use of the nurse-led checklist for 30 older residents in ten care homes across Wales.

It found that nurses using the tool picked up issues that led to nursing care being changed for 27 of 30 residents, with medication for 17 patients being reviewed.

Other findings included:

  • Use of antipsychotic medicines was reduced.
  • Eight out of 30 residents were identified as being in pain and ADR helped to resolve this, such as by recommending a review of painkillers.
  • Care plans were changed for five of nine residents who had had falls.
  • Residents were less agitated or less aggressive when care plans were changed to reduce antipsychotic medicines.

Nurse academic Sue Jordan, who led the research, said the positive impact should persuade healthcare leaders to adopt the monitoring tool.

‘It shows how nurses can play a full part in the multidisciplinary team’

Professor Jordan said: ‘This research is important in that it shows how nurses can engage with and apply knowledge, as well as play a full part in the multidisciplinary team.

‘When ADR is used patients get a chance to raise their problems. When these are addressed patients are less distressed and calmer.

‘The homes we worked with retained their staff because they did everything they could to make residents as comfortable as possible, and this made for contented residents.’


Find out more

Swansea University – ADRE – The Adverse Drug Reaction Profile


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