The recording of drug sensitivities for older people living in care homes

• Published in: British journal of clinical pharmacology 2010-05, Vol.69 (5), p.553-557
• Main Authors: Alldred, David P., Standage, Claire, Zermansky, Arnold G., Barber, Nicholas D., Raynor, D. K., Petty, Duncan R.
• Format: Article
• Language: English
• Subjects: adverse drug reaction; Adverse Drug Reaction Reporting Systems - standards; Adverse Drug Reaction Reporting Systems - trends; Aged; allergy; care homes; Drug Hypersensitivity - etiology; Homes for the Aged; Humans; Medical Records - standards; Nursing Homes; Pharmacies - standards; Prescription Drugs - therapeutic use; Short Report
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1111/j.1365-2125.2010.03631.x

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Care home residents are a frail and vulnerable population who are at a high risk of adverse drug reactions. • The recording of drug sensitivities is important to avoid the inadvertent prescribing, dispensing and administration of an offending drug to a sensitive resident. • There have been no studies investigating the recording of drug sensitivities for care home residents. WHAT THIS STUDY ADDS • The recording of drug sensitivities for care home residents is suboptimal and there are large discrepancies between records. • It is concerning that over 90% of sensitivities are not recorded on the care home medicines administration record. • Systems improvements are required, including the sharing of drug sensitivity status with community pharmacists; this could be achieved by printing sensitivities on prescriptions. AIMS The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes. METHODS A random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities. RESULTS The records of 121 residents in 31 care homes were studied. Thirty‐one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records. CONCLUSIONS It was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivi