Monitoring drug therapy in skilled nursing facility patients.

A discussion of one system designed for monitoring drug therapy in skilled nursing facility (SNF) patients is presented. This system will enable the pharmacist to fulfill the federal requirement for monitoring drug therapy and will provide the opportunity for gathering and analyzing drug usage data in fulfillment of the facility's utilization review requirement. The system described was developed and tested at five SNF's. Follow-up studies at each of the five facilities were then performed for comparison purposes. The data presented describe and analyze the results from both studies for two of the ten drugs studied: digoxin and hydrochlorothiazide. The high rates of nonconformance to the established criteria are discussed and specific insights as to why drug therapy in these patients often seems inappropriate are provided.