Sir, – Carl O'Brien's recent article confirms that polypharmacy (the use of multiple and sometimes inappropriate medications) is a significant problem in Irish nursing homes ("Overmedicated: the drug problem in our nursing homes", June 1st; "Chemical restraint of intellectually disabled common in residential centres, study finds", June 2nd).
We would like to highlight that simple and cost-effective measures are available to improve this situation.
Last year, geriatricians from St Vincent’s University Hospital (SVUH) piloted a scheme in which we held monthly meetings in nursing homes in our catchment area. Along with nurses, GPs and pharmacists we scrutinised each resident’s individual medication list. On average we were able to recommend to residents and their families that at least two potentially unnecessary medications could be stopped. Their response to these recommendations was universally positive.
As an aside we analysed medication cost, and found that by removing only two medications per patient, we saved the health service €518.19 per resident per year. This would amount to more than €1.5 million in annual savings to the HSE for nursing homes in the catchment area of SVUH alone.
Many hospitals in the country are running similar projects with the aim of improving the quality of life of nursing home residents. But the problem – as always – is that resources are scarce. A relatively small investment by the HSE in appointing more specialists in geriatric medicine would not only pay for itself 10 times over per year, but potentially have a hugely positive impact on the lives of scores of thousands of elderly nursing home residents. – Yours, etc,
Dr JAMES MAHON,
Specialist Registrar in
General and Geriatric
Medicine;
Dr GRAHAM HUGHES,
Consultant Geriatrician
and General Physician,
St Vincent’s University
Hospital,
Dublin 4.