The pilot project

The software supports physician, pharmacist or nurse in the preparation and execution of a medication consultation. It supports the decision-making process for an optimal rational medication policy in an individual resident through the recognition of potentially inappropriate medications and resident-specific focused nursing observations.

Older individuals in an assisted living facility are most vulnerable to medication consequences. Due to their high medication intake, there is a higher likelihood that they will experience bothersome symptoms such as; dry eyes, dry mouth, constipation, urinary retention, confusion, sedation, agitation, …. These symptoms can lead to a higher risk of falls and mortality. It is recommended by the government to conduct a regular medication review for each resident (a time when the medication is looked at and for each drug the benefit is weighed against the risks in order to obtain a rational medication prescription that is tailored to the resident’s needs). However, a medication review is challenging (due to a high workload, large time investment to collect the data, and the high degree of pharmacotherapeutic knowledge required to unravel a medication list); thus, there is a need for supporting resources. These resources should be practically deployed on a regular basis, and should require little work and time in terms of preparation.

The OptiMEDs intervention is the combination of (1) an electronic decision support tool based on the individual medication list with (2) resident-specific focused nursing observations.

1. From the resident’s medication list, there is an automated recognition of (a) potentially unsuitable medications known from validated international instruments, (b) anticholinergic medications, and (c) medications that can be tapered off in case of limited life expectancy.

2.Through the pharmanurse intervention, the nurse receives a list of possible drug-related adverse events based on an individual medication list from the residential care facility resident. This forms the basis for an observation assignment. 

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