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GERIATRICS

Quality of Medication Records and Use of Pharmacy Resources in Community Residential Care Facilities

Associate Professor and Director, Geriatric Pharmacy Program, School of Pharmacy, University of Washington, Seattle, WA

Peggy S Odegard, PharmD

Associate Professor and Director, Certificate Program in Geriatrics, School of Pharmacy, University of Washington

Anne EB Sales, MSN PhD

Research Scientist, Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle; Associate Professor, Department of Health Services, University of Washington

Heather M Young, PhD

Professor, School of Nursing, Oregon Health and Sciences University, Ashland, OR

Jean H Sullivan, BA

Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System

Susan C Hedrick, PhD

Research Career Scientist, Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System; Professor, Department of Health Services, University of Washington

Reprints: Dr. Gray, University of Washington, School of Pharmacy, Box 357630, Seattle, WA 98195-7630, fax 206/543-3835, slgray{at}u.washington.edu

BACKGROUND: In community residential care (CRC) facilities, medication administration is often performed by unlicensed personnel with minimal knowledge in medication use. Medication management is one of the top 3 quality-of-care issues facing these facilities.

OBJECTIVE: To examine the type of medication assistance residents received, determine the proportion of facilities that used pharmacy resources, and examine the quality of facility medication records in CRC facilities (eg, adult family homes, adult residential care, assisted living facilities).

METHODS: Baseline in-person interviews were conducted with 349 residents and 299 facility providers in the Puget Sound region of Washington. Information was also obtained from facility medication records at enrollment and state databases. A pharmacist determined quality of the records using a standardized form.

RESULTS: The average resident was a 78-year-old white female taking 7 drugs. Medication records that were computer generated were significantly less likely to have misspelled names of drugs and errors in or absence of dose, directions for use, and route of administration. Overall, 26.3% of facilities reported that a consultant pharmacist reviewed residents' medication lists, 52.0% reported the use of preprinted lists, and 75.6% received prepackaged medications from the pharmacy. Adult family homes, the smallest facility type, were the least likely to use pharmacy-related services.

CONCLUSIONS: The quality of handwritten medication records was a concern in CRC facilities. These facilities may benefit from services offered by pharmacies that may enhance medication management, many of which were underutilized.

Key Words: cohort study, community residential care, medication management.

Published Online, April 25, 2006. www.theannals.com, DOI 10.1345/aph.1G585

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