Bakım evlerinde demans olan kişiler için ilaç izleme: hemşire liderliğindeki izlemenin fizibilite ve klinik etkisi.

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ObjectivesPeople with dementia are susceptible to adverse effects of medicines. However, they are not always closely monitored. We explored (1) feasibility and (2) clinical impact of nurse-led medication monitoring.DesignFeasibility "before-and-after" intervention study.SettingThree care homes in Wales.ParticipantsEleven service users diagnosed with dementia, taking at least one antipsychotic, antidepressant, or antiepileptic medicine.InterventionWest Wales Adverse Drug Reaction (ADR) Profile for Mental Health Medicines.Outcome measures(1) Feasibility: recruitment, retention, and implementation. (2) Clinical impact: previously undocumented problems identified and ameliorated, as recorded in participants' records before and after introduction of the profile, and one month later.ResultsNurses recruited and retained 11 of 29 eligible service users. The profile took 20-25 minutes to implement, caused no harm, and supplemented usual care. Initially, the profile identified previously undocumented problems for all participants (mean 12.7 (SD 4.7)). One month later, some problems had been ameliorated (mean 4.9 (3.6)). Clinical gains included new prescriptions to manage pain (2 participants), psoriasis (1), Parkinsonian symptoms (1), rash (1), dose reduction of benzodiazepines (1), new care plans for oral hygiene, skin problems, and constipation.ConclusionsParticipants benefited from structured nurse-led medication monitoring. Clinical trials of our ADR Profile are feasible and necessary.

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