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Are Nursing Home Pharmacists Putting Patients at Risk?

Pharmacists in California nursing homes are putting patient lives at risk by committing serious medication errors, according to a recent report by the Bay Citizen. The report cites several recent state investigations that found nursing home pharmacists routinely allowed unnecessary prescriptions of antipsychotic medications, and failed to correct other potentially dangerous medication errors.

As detailed by The Bay Citizen, the California Department of Public Health found that in 18 of the 32 investigations conducted in California nursing homes between May 2010 and June 2011, pharmacists failed to red-flag cases in which residents were inappropriately prescribed powerful antipsychotic medications like Seroquel, a drug used to treat schizophrenia.

Pharmacists also failed to detect or approved cases in which medications were prescribed at questionable levels or in dangerous combinations that could put patients at risk of seizures, accidents or even death, according to the public health department.

“The consultant pharmacists’ review, which is intended to identify unnecessary or potentially inappropriate drugs among nursing home residents, is defective in the state of California,” said Dr. Jonathan Evans, a geriatrician and the vice president of the American Medical Directors Association. He also characterized the problem “widespread.”

By California state law, consulting pharmacists who work for nursing homes are required to conduct a monthly review of patients’ charts, and recommend to prescribing doctors that medications be stopped, reduced or modified if they pose safety risks or are causing harmful side effects. However, the state health department investigation revealed that pharmacists failed to identify the misuse of antipsychotic medications in 90 percent of cases.

Unfortunately, these findings reflect a national problem. Nursing home patients are increasingly being overprescribed anti-psychotic drugs. To address the problem, elder abuse and patient safety advocates are calling for stronger penalties for inappropriate prescribing, and a renewed focus on trying non-pharmacological solutions to a problem first.