gms | German Medical Science

Introduction: The KomPP (Kompetenznetzwerk Pflege und Pharmakotherapie) project aims to improve the management of drug regimes in long time care institutions for the elderly.

Though prescription and reassessment of drugs are main areas of medical responsibility, the project focuses on the contribution of nursing staff to the medication process in ambulatory care settings as well as in institutions. The objective is to explore the perceptions of nurses on current problems within the medication process and to support nursing staff in developing strategies to overcome them.

Methods: The project work is still in progress. To date semi-structured interviews and five focus groups with staff of 12 long term care agencies have been conducted. To get an idea about probable “pharmacological events” of main concern in the participating institutions we collected data on drug prescribing and drug administration in six of the twelve partner institutions (292 clients, 2,162 drugs).

Results: Most frequently prescribed drugs are plain sulfonamides, osmotically acting laxatives, platelet aggregation inhibitors, proton pump inhibitors, plain ACE-inhibitors and selective beta-blocking agents. Main problems reported by the carers include a lack of knowledge about side effects and drug interactions, a lack of access to relevant data due to data privacy (medical records about diagnostic and therapeutic procedures, laboratory findings), a lack in subject-matter jurisdiction due to current legal frameworks and separated health care sectors, and unsatisfactory communication between the professions, particularly concerning the medical doctors.

Discussion and conclusion: Acting within the given structures, the KomPP-network partners currently tackle problems that could be overcome on the local level (knowledge, improvement of collaboration, data access through individual agreements). Nevertheless, legal and structural conditions that hamper a substantial contribution of nurses to the reduction of adverse drug reactions may need a more advanced approach including political initiatives on different levels.